老年维持性血液透析患者运动现状调查及障碍因素分析  

Status and obstacle factors of exercise in elderly maintenancehemodialysis patients

作　　者：梁臣 李爱仙[2] 裘艳雯 施锦凤 秦霞[2] Liang Chen;Li Aixian;Qiu Yanwen;Shi Jinfeng;Qin Xia(Medical College,Jiangsu University,Zhenjiang 212013,China;Nursing Department,Kunshan Hospital Affiliated to Jiangsu University,Suzhou 215300,China;Blood Purification Center,Kunshan Hospital Affiliated to Jiangsu University,Suzhou 215300,China;Blood Purification Center,the Third People's Hospital of Kunshan,Suzhou 215300,China)

机构地区：[1]江苏大学医学院,镇江212013 [2]江苏大学附属昆山医院护理部,苏州215300 [3]江苏大学附属昆山医院血液净化中心,苏州215300 [4]昆山市第三人民医院血液净化中心,苏州215300

出　　处：《中华现代护理杂志》2022年第35期4857-4862,共6页Chinese Journal of Modern Nursing

基　　金：昆山市社会发展科技专项(指令性)(KS1968)。

摘　　要：目的调查老年维持性血液透析(MHD)患者运动现状并分析其障碍因素,以期为老年血液透析患者的运动指导及后期针对性干预提供临床依据。方法采用一致性平行设计的混合方法研究,应用便利抽样法选取2021年12月昆山市2所三级医院180例老年MHD患者进行问卷调查,探究患者运动现状及运动自我效能;同时采用目的抽样法对17例老年MHD患者进行半结构式访谈,调查患者运动的障碍因素。结果量性研究回收有效问卷180份,闲暇时间体力活动代谢当量最高为1188 MET-min/周,最低为0 MET-min/周,中位数为396 MET-min/周,运动自我效能得分3.44(2.33,5.11)分。经Spearman相关分析得出老年MHD患者运动自我效能与体力活动呈正相关(r=0.783,P<0.05)。质性研究提炼出运动知识缺乏、自我效能感低下及家庭与社会环境资源限制3个主题及9个亚主题。结论老年MHD患者普遍缺乏理想运动状态,在临床实践中,医护人员应为其普及运动知识,提高患者运动自我效能,开展家庭支持教育,增加社会支持力度,同时根据患者的病情特点为其选取适合的运动方式并制定个体化运动方案,改善患者的运动现状。Objective To explore the status and obstacle factors of exercise in elderly maintenance hemodialysis(MHD)patients,so as to provide a clinical evidence for exercise guidance and targeted intervention in elderly maintenance hemodialysispatients.Methods A mixed method of consistent parallel design was adopted.A total of 180 elderly MHD patients in two Class II hospitals of Kunshan in December 2021 were enrolled using convenience sampling method and investigated by questionnaire.The statas of exercise and exercise self-efficacy were researched.Objective sampling method was used to interview 17 elderly MHD patients with semi-structured interviews.The obstacle factors of exercise were investigated.Results A total of 180 valid questionnaires were collected in the quantitative study.The highest metabolicequivalent of leisure time physical activity was 1188 MET-min/w,the lowest was 0 MET-min/w,and the median was 396 MET-min/w.Pearson correlation analysis showed that there was a positive correlation between exercise self-efficacy and physical activity in elderly MHD patients(P<0.05).Qualitative study extracted 3 themes and 9 subthemes,including lack of exercise knowledge,low self-efficacy,family and social environment resource limitation.Conclusions Elderly MHD patients lack ideal exercise state.In clinical practice,medical staff should popularize exercise knowledge,improve patients'exercise self-efficacy,carry out family support education,increase social support,and select suitable exercise methods and develop individualized exercise programs according to patients'disease characteristics,so as to improve their exercise status.

关 键 词：老年人 血液透析 运动 障碍因素 

分 类 号：R473.5[医药卫生—护理学]