老年慢性肾衰竭持续性血液透析患者自我感受负担与心理脆弱程度的关系  

Relationship between self-perceived burden and psychological vulnerability in elderly patients with chronic renal failure undergoing hemodialysis

作　　者：张亭亭 许贤荣 许静 马晴 叶雅君 曹世琦 陈吕静 左祥荣 ZHANG Tingting;XU Xianrong;XU Jing;MA Qing;YE Yajun;CAO Shiqi;CHEN Lvjing;ZUO Xiangrong(Renal Disease Intensive Ward,Jiangsu Provincial People’s Hospital(the First Affiliated Hospital of Nanjing Medical University),Jiangsu Province,Nanjing 210029,China;Department of Critical Care Medicine,Jiangsu Provincial People’s Hospital(the First Affiliated Hospital of Nanjing Medical University),Jiangsu Province,Nanjing 210029,China)

机构地区：[1]江苏省人民医院(南京医科大学第一附属医院)肾脏病重症病区,江苏南京210029 [2]江苏省人民医院(南京医科大学第一附属医院)重症医学科,江苏南京210029

出　　处：《中国医药导报》2023年第24期64-68,共5页China Medical Herald

基　　金：江苏省高层次卫生人才“六个一工程”拔尖人才科研项目和全省人事人才管理课题立项(LGY2019067)。

摘　　要：目的探讨老年慢性肾衰竭持续性血液透析患者自我感受负担与心理脆弱程度的关系。方法选取2019年9月至2022年5月于江苏省人民医院肾脏病重症病区进行维持性血液透析治疗的102例老年慢性肾衰竭患者为研究对象。收集患者一般资料、心理脆弱量表(MVQ)得分、Connor-Dacidson心理韧性量表(CD-RISC)得分、自我感受负担量表(SPBS)评分。分析患者SPBS评分与其MVQ得分和CD-RISC得分的关系。根据SPBS评分评价结果分为A组(SPBS评分<30分)和B组(SPBS评分≥30分),并分析患者自我感受负担的影响因素。结果102例老年慢性肾衰竭患者MVQ得分为(56.88±12.25)分,CD-RISC得分为(35.73±9.25)分,SPBS评分为(27.25±8.76)分,其中A组54例(52.94%),B组48例(47.06%)。Pearson相关分析结果显示,老年慢性肾衰竭维持性血液透析患者的SPBS评分与MVQ得分呈正相关(r>0,P<0.05),与CD-RISC得分呈负相关(r<0,P<0.05)。B组透析时间长于A组,年龄、医疗自费率、MVQ得分高于A组,CD-RISC得分低于A组,差异有统计学意义(P<0.05)。logistic回归分析结果显示,透析时间和MVQ得分为患者自我感受负担的危险因素(OR>1,P<0.05),CD-RISC得分为患者自我感受负担的保护因素(OR<1,P<0.05)。结论老年慢性肾衰竭持续性血液透析患者普遍存在不同程度的自我感受负担,其程度与透析时间和患者心理脆弱程度密切相关。Objective To explore the relationship between self-perceived burden and psychological vulnerability in elderly patients with chronic renal failure sustained hemodialysis.Methods A total of 102 elderly patients with chronic renal failure who underwent maintenance hemodialysis treatment in the Renal Disease Intensive Ward of Jiangsu People’s Hospital from September 2019 to May 2022 were selected as the study objects.General data,scores of mental vulnerability questionnaire(MVQ),Connor-Dacidson psychological resilience scale(CD-RISC),and self-perceived burden scale(SPBS)were collected.The correlation of SPBS score with MVQ score and CD-RISC score were analyzed.According to the scores of SPBS,patients were divided into group A(SPBS score<30 points)and group B(SPBS score≥30 points),and the influencing factors of patients’self-perceived burden were analyzed.Results Among 102 elderly patients with chronic renal failure,MVQ score was(56.88±12.25)points,CD-RISC score was(35.73±9.25)points,SPBS score was(27.25±8.76)points,of which 54 cases(52.94%)in group A and 48 cases(47.06%)in group B.Pearson correlation analysis showed that SPBS score of elderly patients with chronic renal failure maintenance hemodialysis was positively correlated with MVQ score(r>0,P<0.05),and negatively correlated with CD-RISC score(r<0,P<0.05).The dialysis time of group B was longer than that of group A,the score of age,medical expense and MVQ was higher than that of group A,and the score of CD-RISC was lower than that of group A,with statistical significances(P<0.05).Logistic regression analysis showed that dialysis time and MVQ score were risk factors for patients’self-perceived burden(OR>1,P<0.05),and CD-RISC score were protective factors for patients’self-perceived burden(OR<1,P<0.05).Conclusion Senile chronic renal failure patients with persistent hemodialysis generally have different degrees of self-perceived burden,and its degree is closely related to dialysis time and psychological vulnerability of patients.

关 键 词：老年 慢性肾衰竭 持续性血液透析 自我感受负担 心理脆弱程度 关系 

分 类 号：R692[医药卫生—泌尿科学]