摘要
目的探讨影响维持性血液透析(MHD)患者依从性的相关因素及对策。方法回顾性分析90例MHD患者的临床资料,比较依从性好患者与依从性差患者下列因素:年龄、原发疾病构成、疾病并发症、性别、文化水平、婚姻状态、MHD时间、月收入、家庭支持、抑郁自评量表(SDS)评分、不良反应、相关知识掌握程度、医患关系、医疗费用来源。结果 90例患者中MHD依从性好患者50例(55.56%,50/90),依从性差40例(44.44%,40/90)。依从性好患者与依从性差患者的年龄、疾病并发症、性别情况、文化水平、婚姻状态、MHD时间、月收入、家庭支持、SDS评分、不良反应、相关知识掌握情况、医患关系、医疗费用来源等13项指标比较,差异均具有统计学意义(P<0.05)。Logistic回归分析显示,影响MHD依从性的独立危险因素包括:无家庭支持(OR=4.45)、医患关系一般(OR=3.90)、MHD相关知识缺少(OR=3.62)、SDS评分>50分(OR=2.70)。结论 MHD患者依从性较差,影响因素复杂,应采取针对性措施对患者进行护理干预,提供良好的家庭支持,为患者普及MHD的相关知识,以提高MHD患者的依从性。
Objective To investigate related influencing factors and measures for compliance of maintenance hemodialysis（MHD） patients. Methods Clinical data of 90 MHD patients were retrospectively analyzed. Comparison was made on age, primary disease composition, complications of disease, gender, educational level, marital status, MHD time, monthly income, family support, self-rating depression scale（SDS） score, adverse reactions, mastery degree of related knowledge, doctor-patient relationship and source of medical costs between patients with good and poor compliance. Results Among the 90 patients, there were 50 cases with good MHD compliance（55.56%, 50/90） and 40 cases with poor compliance（44.44%, 40/90）. The differences in 13 indexes of age, complications of disease, gender, educational level, marital status, MHD time, monthly income, family support, SDS score, adverse reactions, mastery degree of related knowledge, doctor-patient relationship and source of medical costs all had no statistical significance between patients with good and poor compliance. Logistic regression analysis showed independent risk influencing factors of MHD as non-family support（OR=4.45）, general doctor-patient relationship（OR=3.90）, lake of MHD related knowledge（OR=3.62）, and SDS score 〉50 points（OR=2.70）. Conclusion Due to poor compliance and complex influencing factors of MHD patients, implement of targeted measures is necessary for nursing intervention, in order to provide good family support, spread knowledge of MHD and enhance compliance in MHD patients.
出处
《中国实用医药》
2016年第34期171-173,共3页
China Practical Medicine
关键词
维持性血液透析
依从性
影响因素
干预措施
Maintenance hemodialysis
Compliance
Influencing factors
Intervention
