终末期肾脏疾病维持性血液透析患者营养素养变化轨迹的影响因素调查  

Investigation and analysis of influencing factors on the trajectory of nutritional literacy changes in patients with end-stage renal disease undergoing maintenance hemodialysis

作　　者：刘小娜 岳晓红[1] 王涛[1] 韩智 邹兰兰 陈静[1] 徐甜甜[1] LIU Xiao-na;YUE Xiao-hong;WANG Tao;HAN Zhi;ZOU Lan-lan;CHEN Jing;XU Tian-tian(Blood Purification Center,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan,CHINA)

机构地区：[1]郑州大学第一附属医院血液净化中心,河南郑州450000

出　　处：《海南医学》2025年第3期425-430,共6页Hainan Medical Journal

基　　金：郑州大学教学改革研究与实践项目(编号:2022ZZUJG287)。

摘　　要：目的调查分析终末期肾脏疾病(ESRD)维持性血液透析(MHD)患者营养素养变化轨迹的影响因素。方法选取2023年2月至2024年3月于郑州大学第一附属医院行MHD治疗的268例ESRD患者作为调查对象,采用终末期肾脏病透析患者营养素养评价量表分别于确诊(T0)、初次透析(T1)、透析1个月(T2)、透析3个月(T3)、透析6个月(T4)评估患者营养素养变化,并于T2时采用一般资料调查表、家庭关怀指数问卷(APGAR)、中文版慢性病赋权量表(LTCES)、多维度健康心理控制源量表C(MHLC-C)、移动健康信息搜索行为问卷收集患者的一般资料、家庭关怀度、赋权水平、心理控制源及健康信息搜索行为,利用潜变量增长模型(LCGM)识别营养素养变化轨迹类别,根据不同轨迹类别进行分组,采用单因素、多因素Logistic回归分析营养素养轨迹类别的影响因素。结果268例ESRD患者共收回有效问卷253份,最终纳入253例患者。行MHD治疗的ESRD患者经LCGM拟合共获取营养素养持续高水平、营养素养平稳、营养素养持续升高3条营养素养变化轨迹,分别占16.21%、29.64%、54.15%;三组患者的居住地、学历、糖尿病、年龄、家庭功能、健康赋权能力、健康内部控制、健康机遇控制、移动健康信息搜索行为比较差异均有统计学意义(P<0.05);Logistic回归分析结果显示,居住于城镇、学历、糖尿病、健康赋权能力、家庭功能、健康内部控制、移动健康信息搜索行为是行MHD治疗ESRD患者营养素养的保护因素(P<0.05),而年龄、健康机遇控制是其危险因素(P<0.05)。结论营养素养持续高水平、营养素养平稳、营养素养持续升高是行MHD治疗的ESRD患者营养素养的主要动态变化轨迹,居住于城镇、学历、糖尿病、健康赋权能力、家庭功能、健康内部控制、移动健康信息搜索行为、年龄、健康机遇控制是ESRD患者营养素养变化的影响因素。Objective To investigate the influencing factors of the trajectory of nutritional literacy changes in patients with end-stage renal disease(ESRD)undergoing maintenance hemodialysis(MHD).Methods A total of 268 ESRD patients who underwent MHD at the First Affiliated Hospital of Zhengzhou University from February 2023 to March 2024 were selected.The changes in nutritional literacy of these patients were assessed at diagnosis(T0),initial dialysis(T1),after 1 month of dialysis(T2),after 3 months of dialysis(T3),and after 6 months of dialysis(T4).At T2,general information questionnaire,Family APGAR Scale(Adaptability,Partnership,Growth,Affection,and Resolve,APGAR),Chinese version of Client Empowerment Scale(LTCES),Form C of Multidimensional Health Locus of Control Scale(MHLC-C),and mobile health information search behavior questionnaire were used to collect general information,family care level,empowerment level,psychological locus of control,and health information search behavior of patients.The Latent Class Growth Model(LCGM)was used to identify the trajectory categories of nutritional literacy changes.The patients were grouped based on different trajectory categories.The factors influencing the trajectory categories of nutritional literacy were analyzed using univariate and multivariate logistic regression analysis.Results A total of 253 valid questionnaires were collected from 268 patients with ESRD,and the final sample size included 253 patients.ESRD patients undergoing MHD treatment obtained three trajectories of nutritional literacy changes through LCGM fitting,including sustained high levels of nutritional literacy,stable nutritional literacy,and sustained increases in nutritional literacy,accounting for 16.21%,29.64%,and 54.15%,respectively.There were statistically significant differences in the residence,education,diabetes,age,family function,health empowerment ability,health internal control,health opportunity control,and mobile health information search behavior among the three groups of patients(P<0.05).Lo

关 键 词：血液透析 终末期肾脏疾病 营养素养 变化轨迹 影响因素 护理 启示 

分 类 号：R459.5[医药卫生—治疗学]