维持性血液透析病人症状潜在类别分析及其与生活质量的关系  

Latent class analysis of symptom characteristics in maintenance hemodialysis patients and their relationship with quality of life

作　　者：郑雨鹃 何璐晨 骆芬霞[1] 徐瑶 龙治巧 常立阳[1] ZHENG Yujuan;HE Luchen;LUO Fenxia;XU Yao;LONG Zhiqiao;CHANG Liyang(Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University,Zhejiang 310007 China)

机构地区：[1]浙江中医药大学附属杭州市中医院,浙江310007

出　　处：《护理研究》2024年第24期4325-4332,共8页Chinese Nursing Research

基　　金：浙江省中医药科技计划项目,编号:2024ZL672;浙江省医药卫生科技计划项目,编号:2023KY982。

摘　　要：目的:探索维持性血液透析病人症状类别,分析不同类别病人生活质量差异。方法:采用便利抽样法,选取2022年10月—2023年6月杭州市某三级甲等医院血液净化中心行维持性血液透析的病人341例。采用一般资料调查表、透析症状评估量表和肾脏疾病生活质量量表进行横断面调查,采用结构方程模型潜在类别分析维持性血液透析病人症状类别,采用单因素方差分析探索不同类别症状与病人生活质量的关系。结果:维持性血液透析病人症状按照其特征可分为4个潜在类别,分别为睡眠障碍症状组(55.4%)、症状低发组(23.5%)、尿毒症综合征症状组(10.6%)、皮肤问题症状组(10.6%)。4个症状类别人群的症状负担、肾脏疾病影响、肾脏疾病负担、身体成分、心理成分维度得分比较差异均有统计学意义(P<0.001)。不同类别病人年龄、从业情况、文化程度及婚姻状况方面比较差异均有统计学意义(P<0.05)。多元Logistic回归分析显示,文化程度和婚姻状况是维持性血液透析病人症状特征潜在类别分型的影响因素(P<0.05)。结论:维持性血液透析病人症状可以分为睡眠障碍症状组、症状低发组、尿毒症综合征症状组、皮肤问题症状组4个类别,尿毒症综合征症状组病人的生活质量最差,症状低发组病人生活质量最好,应重点关注文化程度较低且未婚/离异/丧偶的透析病人症状评估和管理。Objective:To explore the symptom characteristics of maintenance hemodialysis patients,and to analyze the differences in patients'quality of life in different categories.Methods:A total of 341 patients from the blood purification center of a tertiary grade A hospital in Hangzhou from October 2022 to June 2023 were selected by convenience sampling method.A cross⁃sectional survey was conducted using the general information questionnaire,Dialysis Symptom Index(DSI)and Kidney Disease Quality of Life⁃36(KDQOL⁃36TM).Latent class analysis of structural equation model was used to analyze the symptom categories of maintenance hemodialysis patients.One⁃way analysis of variance was used to explore the relationship between different types of symptoms and patients'quality of life.Results:The symptoms of maintenance hemodialysis patients could be divided into four latent class according to their characteristics:sleep disorder symptom group(55.4%),low symptom group(23.5%),uremic syndrome symptom group(10.6%)and skin problem symptom group(10.6%).There were statistically significant differences in the scores of symptom burden,kidney disease impact,kidney disease burden,body composition and psychological composition among the 4 symptom classes(P<0.001).There were significant differences in age,employment,education and marital status among different categories of patients(P<0.05).Further multiple Logistic regression analysis showed that education level and marital status were the influencing factors in the latent classes typing of symptom characteristics in maintenance hemodialysis patients(P<0.05).Conclusions:The symptoms of maintenance hemodialysis patients can be divided into four latent classes:sleep disorder symptom group,low symptom group,uremic syndrome symptom group and skin problem symptom group.The quality of life of patients with uremic syndrome symptom group is the worst,and the quality of life of patients with low symptom group is the best.Emphasis should be placed on symptom assessment and management of dialysi

关 键 词：维持性血液透析 潜在类别分析 生活质量 症状特征 

分 类 号：R473.5[医药卫生—护理学]