维持性血液透析患者分层级管理对其主要照顾者的影响  

Eff ect of stratifi ed management of maintenance hemodialysis patients on their primary caregivers

作　　者：查飞 李文文 邓妍妍 王黎萍 毛娅妮 ZHA Fei;LI Wenwen;DENG Yanyan;WANG Liping;MAO Yani(Shiyan People's Hospital/Hubei Medical College Affi liated to People's Hospital,Shiyan 442000,China)

机构地区：[1]十堰市人民医院/湖北医药学院附属人民医院肾病内科(湖北省十堰市,442000)

出　　处：《护理实践与研究》2024年第9期1274-1281,共8页Nursing Practice and Research

基　　金：十堰市科学技术局科学技术研究与开发项目计划(编号:17R46)。

摘　　要：目的探讨分层级管理维持性血液透析(MHD)患者对其主要照顾者焦虑、抑郁状态及照顾负担和生活质量的影响。方法选择2023年1-6月十堰市人民医院门诊MHD患者的主要照顾者195名为研究对象,按照组间基线资料均衡可比的原则将其分为对照组97名和观察组98名。对照组的照顾对象行常规护理管理,观察组对照顾对象实施分层级护理管理。于干预前、后使用焦虑自评量表(Self-Rating Anxiety Scale,SAS)、抑郁自评量表(Self-Rating Depression Scale,SDS)、Zarit照顾者负担量表(Zarit Burden Interview,ZBI)和世界卫生组织生活质量评估简表(the World Health Organization’s Quality of Life Questionnaire-Brief Version,WHOQOL-BREF)对主要照顾者进行评估。结果干预前,两组照顾者的SAS评分、SDS评分、ZBI评分及WHOQOL-BREF量表中总体生存质量、一般健康、身体健康领域、心理领域、社会关系领域和环境领域评分比较差异均无统计学意义(P>0.05);干预后,观察组照顾者的SAS评分、SDS评分、ZBI评分均低于对照组,差异具有统计学意义(P<0.05);WHOQOL-BREF量表中总体生存质量、一般健康、身体健康领域、心理领域、社会关系领域和环境领域评分均高于对照组,差异均有统计学意义(P<0.05)。结论对MHD患者实行分层级管理,可以有效减少其主要照顾者的焦虑、抑郁状态和照顾负担,提高主要照顾者的生活质量。Objective To explore the impact of stratified management of maintenance hemodialysis(MHD)patients on their primary caregiver's anxiety,depressive state,care burden,and quality of life.Methods 195 primary caregivers of outpatients with MHD in Shiyan People's Hospital from January to June 2023 were selected as the study subjects,they were divided into a control group of 97 patients and an observation group of 98 patients according to the principle of balanced and comparable baseline data between groups.The subjects in the control group received routine nursing management,the observation group received stratified nursing management.Primary caregivers were assessed using the Self-rating Anxiety Scale(SAS),Self-rating Depression Scale(SDS),Zarit Burden Interview(ZBI),and the World Health Organization's Quality of Life Questionnaire-Brief Version(WHOQOL-BREF)before and after the intervention.Results Before the intervention,there was no statistically significant difference between the SAS score,SDS score,ZBI score,and the scores of overall quality of life,general health,physical healthfield,psychologicalfield,social relationshipfield,and environmentalfield in the WHOQOL-BREF scale of the two groups(P>0.05).After the intervention,the SAS score,SDS score,and ZBI score of the caregivers in the observation group were lower than those in the control group,the difference was statistically significant(P<0.05),the scores of overall quality of life,general health,physical healthfield,psychologicalfield,social relationshipfield,and environmentalfield in the WHOQOL-BREF scale were higher than those in the control group,the difference was statistically significant(P<0.05).Conclusion Stratified nursing management of MHD patients could effectively relief the anxiety,depression and care burden of their primary caregivers and improve the quality of life of their primary caregivers.

关 键 词：维持性血液透析 分层级管理 照顾者 焦虑 抑郁 照顾负担 生活质量 

分 类 号：R473.5[医药卫生—护理学]