血液透析中心运动康复实施障碍的横断面调查  

Barriers to exercise rehabilitation in hemodialysis centers: a cross-sectional survey

作　　者：王欣欣[1] 吝泽华 王颖[2] 徐明成 康志敏 曾文[5] 马迎春[1] WANG Xin-xin;LIN Ze-hua;WANG Ying;XU Ming-cheng;KANG Zhi-min;ZENG Wen;MA Ying-chun(Department of Nephrology,Beijing Bo'ai Hospital of China Rehabilitation Research Center,Rehabilitation Medicine College of Capital Medical University,Beijing 100068,China;Department of Nephrology,Peking University People’s Hospital,Beijing 100044,China;Hemodialysis Center,Beijing Zhanlanlu Hospital,Beijing 100044,China;Hemodialysis Center,Beijing General Hospital of China Aviation,Beijing 100076,China;Hemodialysis Center,Chui Yang Liu Hospital,Beijing 100022,China)

机构地区：[1]首都医科大学康复医学院,中国康复研究中心北京博爱医院肾内科,北京100068 [2]北京大学人民医院肾内科,北京100044 [3]北京展览路医院血液透析室,北京100044 [4]北京航空总医院血液透析室,北京100076 [5]北京垂杨柳医院血液透析室,北京100022

出　　处：《中国血液净化》2019年第1期30-34,共5页Chinese Journal of Blood Purification

基　　金：首都卫生发展科研专项项目(首发2014-3-4142)

摘　　要：目的调查透析中心维持性血液透析(maintenance hemodialysis, MHD)患者实施康复治疗的主要动力和障碍。方法选择北京地区5家透析中心规律血液透析超过3个月的MHD患者,通过问卷的方式调查MHD患者运动康复实施的动力和障碍以及MHD工作人员实施运动康复的障碍。结果入组MHD患者共471例,包括男性277例(58.8%),女194例(41.2%),年龄(61.3±13.5)岁,63.3%的MHD患者愿意在接受血液透析治疗的同时进行康复治疗。MHD患者愿意进行康复治疗的动力:98.0%的患者希望提高自己的生活质量,98.0%希望身体更加健康;95.3%希望提高自己的躯体功能;MHD患者运动康复的主要障碍:身体不适(59.0%)、担心运动的安全性(36.7%)及没有兴趣运动(27.0%)。共有90名医护人员参与调查,MHD工作人员的障碍主要为缺乏康复治疗师进行专业的指导和专业建议(93.1%)、缺乏专业知识(86.2%)和缺乏专业设备(86.2%)。结论透析中心的MHD患者中实施康复存在多方面障碍,包括医护人员和患者多方面因素,影响MHD患者康复意愿的主要因素主要为身体不适、担心安全性和对运动的兴趣等,医护人员方面的主要因素为缺乏康复专业知识、缺乏康复治疗专业设备及缺乏康复治疗师进行专业的指导和建议等。因此,透析中心医护人员需要关注MHD患者功能障碍状况,积极鼓励患者参与肾脏康复,协助解决MHD患者康复实施面临的障碍,促进更多的MHD患者参与康复,提高MHD患者的生活质量。Objectives To explore the motivators and barriers to exercise rehabilitation in maintenance hemodialysis(MHD) patients. Methods We recruited patients treated with hemodialysis for more than 3months from 5 dialysis centers in Beijing, and explored the perceived motivators and barriers to exercise rehabilitation by questionnaire in these patients as well as in medical workers for MHD patients. Results A total of 471 MHD patients(277 males and 194 females, 61.3±13.5 years of age) were recruited, and 63.3% of the patients were willing to participate in exercise rehabilitation. The perceived motivators included to improve the quality of life(98.0%), to become healthier(98.0%), and to improve physical functions(95.3%). The perceived barriers included not feeling so well(59.0%), worrying about safety(36.7%), and no interest to join in(27.0%). Ninety medical workers participated in the survey, and the most common barriers were lack of rehabilitation therapists to provide professional guidance and advice(93.1%), insufficient knowledge about exercise rehabilitation(86.2%), and no suitable exercise equipments(P<0.01). Conclusion There were obstacles from patients and medical workers to implement exercise rehabilitation to help MHD patients in dialysis centers. Barriers from MHD patients mainly included not feeling well, safety consideration and lack of interest;barriers from staff included lack of knowledge about rehabilitation, rehabilitation equipment and professional guidance and advice from rehabilitation therapists. Therefore, staff in dialysis center should focus on the rehabilitation status of MHD patients, actively encourage MHD patients to participate in renal rehabilitation, and create a better environment to counter barriers, and promote more patients to participate in rehabilitation to improve the quality of life of MHD patients.

关 键 词：运动康复 维持性血液透析 动力 障碍 

分 类 号：R493[医药卫生—康复医学] R459.5[医药卫生—临床医学]