维持性血液透析患者疾病接受度潜在类别与自我管理水平的关系  

Relationship between illness acceptance and self-management in Maintenance Hemodialysis patients:a latent profile analysis

作　　者：朱东阁 王菊子[1] 赵倩 何亚鹏 段凯星 张转转 ZHU Dongge;WANG Juzi;ZHAO Qian;HE Yapeng;DUAN Kaixing;ZHANG Zhuanzhuan(Nursing Department,Shanxi Provincial People's Hospital,Taiyuan,030012,China)

机构地区：[1]山西省人民医院护理部,太原市030012 [2]山西医科大学护理学院 [3]山西中医药大学护理学院

出　　处：《中国护理管理》2024年第8期1152-1157,共6页Chinese Nursing Management

基　　金：2022年山西省教育厅高等学校教学改革创新项目一般项目(J20220342)。

摘　　要：目的:探索维持性血液透析患者疾病接受度潜在类别,分析各类别与自我管理水平的关系,以期为患者提供更有效的个性化疾病管理和自我管理支持。方法:便利选取2023年4月至7月在山西省某三级甲等医院治疗的290例维持性血液透析患者作为研究对象。以疾病接受度量表8个条目作为外显指标进行潜在剖面分析,通过单因素分析、多元Logistic回归识别不同类别患者的影响因素,并采用回归混合模型探讨不同类别患者自我管理水平的差异。结果:维持性血液透析患者疾病接受度分为3个潜在类别,即“低接受-社交依赖组”(41.0%)、“中接受-自信缺失组”(26.6%)和“高接受-行动约束组”(32.4%)。家庭人均月收入、合并症数量和透析龄是不同类别维持性血液透析患者疾病接受度的影响因素(P<0.05)。“高接受-行动约束组”患者自我管理量表总分最高,“中接受-自信缺失组”患者在情绪处理维度上得分低于“低接受-社交依赖组”。结论:维持性血液透析患者的疾病接受度具有明显的异质性,不同类别患者自我管理水平存在差异。护理人员应根据患者疾病接受度的类别特征,提供个性化的干预措施,以提升其自我管理水平。Objective:To explore the latent categories of illness acceptance in Maintenance Hemodialysis patients,and to analyze the relationship between each category and the level of self-management,in order to provide patients with more effective personalized disease management and self-management support.Methods:A total of 290 patients undergoing maintenance hemodialysis who were treated in a tertiary grade A hospital in Shanxi Province from April to July 2023 were conveniently selected as the study subjects.Eight items of the Disease Acceptance Scale were used as explicit indicators for potential profile analysis,and the influencing factors of different categories of patients were identified by univariate analysis and multivariate logistic regression,and the regression mixed model was used to explore the differences in the selfmanagement level of different categories of patients.Results:The illness acceptance of Maintenance Hemodialysis patients was divided into three potential categories,namely"low acceptance-social dependence"(41.0%),"medium acceptancelack of self-confidence"(26.6%),and"high acceptance-action constraint"(32.4%).Per capita monthly household income,number of comorbidities and age on dialysis as factors influencing illness acceptance in different categories of maintenance hemodialysis patients(P<0.05).The total score of the patient self-management scale in the"high acceptance-action constraint group"was the highest.The scores of patients in the"medium acceptance-lack of self-confidence"group were lower than those in the"low acceptance-social dependence group"in the dimension of emotional processing.Conclusion:There is significant heterogeneity in illness acceptance among Maintenance Hemodialysis patients,and there are differences in the level of self-management among different types of patients.Caregivers should provide individualized interventions to improve self-management according to the category characteristics of patients'illness acceptance.

关 键 词：血液透析 疾病接受度 自我管理 潜在剖面分析 

分 类 号：R47[医药卫生—护理学] R197[医药卫生—临床医学]