老年慢性肾脏病患者心理痛苦在体力活动量与生活质量间的中介效应  

Mediating effect of psychological distress on relationship between physical activity and quality of life in elderly patients with chronic kidney disease

作　　者：彭红蕾 王恒[1] 翟朝阳 徐丹[1] Peng Honglei;Wang Heng;Zhai Chaoyang;Xu Dan(Department of Nephrology,Zhongnan Hospital of Wuhan University,Wuhan 430071,China)

机构地区：[1]武汉大学中南医院肾病内科,武汉430071

出　　处：《中华老年多器官疾病杂志》2024年第10期734-738,共5页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：国家自然科学基金(8207021862);湖北省自然科学基金创新群体项目(2021CFA051)。

摘　　要：目的调查老年慢性肾脏病(CKD)患者体力活动量,并分析心理痛苦在体力活动量与生活质量间的中介作用。方法选择2020年1月至2023年1月武汉大学中南医院收治的512例1~3期老年CKD患者为研究对象(CKD组),另收集同期入院体检的120例老年人作为对照组。使用国际体力活动量表短问卷中文版(IPAQ-S-C)调查两组人群的体力活动量,632份问卷中回收有效问卷598份(占94.62%),其中CKD组490份,对照组108份。采用SPSS 24.0统计软件进行数据分析。根据数据类型,分别采用t检验、χ^(2)检验或秩和检验进行组间比较。采用logistic回归分析老年CKD患者体力活动量低下的影响因素。使用Spearman秩相关分析评估老年CKD患者体力活动量与生活质量的相关性。采用三步骤中介效应检验方法评估心理痛苦在体力活动量与生活质量间的中介作用。结果CKD组患者体力活动量显著低于对照组,差异有统计学意义(P<0.05)。logistic回归分析显示,小学及以下受教育程度(OR=3.397,95%CI 2.016~5.726)、未婚/离异/丧偶(OR=2.442,95%CI 1.264~4.720)、重度疲乏(OR=2.038,95%CI 1.037~4.005)及心理痛苦显著(OR=8.265,95%CI 6.001~11.382)是老年CKD患者体力活动量低下的危险因素(P<0.05)。三步骤中介效应检验法显示心理痛苦在体力活动量对生活质量的影响中发挥中介作用,中介作用大小为0.09,中介效应占总效应的26.8%。结论老年CKD 1~3期患者体力活动量不足现象明显,活动量不足将影响其生活质量,且心理痛苦在其中发挥中介作用。Objective To investigate the physical activity in the elderly patients with chronic kidney disease(CKD)and to analyze the mediating effect of psychological distress on the relationship between physical activity and quality of life.Methods A total of 512 elderly patients with stage 1-3 CKD admitted to Zhongnan Hospital of Wuhan University from January 2020 to January 2023 were selected as the subjects(CKD group).In addition,120 elderly people who were admitted to the hospital for physical examination were collected as the control group.The international physical activity questionnaire short form Chinese version(IPAQ-S-C)was used to investigate the amount of physical activity in the two groups.Of 632 questionnaires distributed,598(94.62%)were recovered as valid,including 490 in the CKD group and 108 in the control group.SPSS 24.0 was used for data analysis.According to the data type,t test,Chi-square test or rank sum test was employed for between-group comparison.The influencing factors of low physical activity in the elderly CKD patients were analyzed by logistic regression analysis.Spearman rank correlation analysis was used to evaluate the correlation between physical activity and quality of life in the elderly CKD patients.Three-step mediating effect test was used to evaluate the mediating effect of psychological distress on the relationship between physical activity and quality of life.Results The physical activity in the CKD group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).Logistic regression analysis showed that primary school education or below(OR=3.397,95%CI 2.016-5.726),unmarried/divorced/widowed(OR=2.442,95%CI 1.264-4.720),severe fatigue(OR=2.038,95%CI 1.037-4.005)and significant psychological distress(OR=8.265,95%CI 6.001-11.382)were risk factors for low physical activity in the CKD elderly patients(P<0.05).Three-step mediating effect test showed that psychological distress played a mediating role in the effect of physical activity on

关 键 词：老年人 慢性肾脏病 体力活动 生活质量 心理痛苦 中介效应 

分 类 号：R592[医药卫生—老年医学] R692[医药卫生—内科学]