德阳地区维持性血液透析患者震后生存质量及其影响因素的多中心研究
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摘要
目的了解德阳地区维持性血液透析(MHD)患者地震后生存质量现状及其影响因素。方法选取德阳地区六家血液净化中心253名MHD患者作为调查对象,采用终末期肾脏疾病透析患者调查表(kidney disease quality of life short form,KDQOL-SFTM)对其进行生存质量问卷调查。结果①德阳地区MHD患者在部分领域得分低于北京郊区MHD患者,分别为认知功能50.56±16.90 vs66.24±23.30(P<0.001)、社交质量61.19±16.48 vs 67.32±16.5(P=0.011)、性功能14.17±23.45 vs 21.59±21.72(P=0.023)、工作状态9.90±20.02 vs 22.41±29.87(P=0.001)及患者满意度63.86±23.10 vs 76.34±19.22(P<0.001);②德阳地区MHD在部分领域得分低于广州地区MHD患者,分别为社会功能44.80±19.22 vs 52.6±21.5(P=0.001)、生理职能18.81±21.04 vs 27.9±35.9(P=0.01)、情感职能22.77±25.36 vs 37.3±41.4(P=0.001)、疼痛48.94±11.34 vs 65.1±26.2(P<0.001)、精力43.61±15.81 vs 50.1±20.1(P=0.003)、认知功能50.56±16.90 vs 66.9±15.6(P<0.001)、社交质量61.19±16.48 vs 65.6±16.6(P=0.017)及工作状态9.90±20.02 vs 18.3±27.0(P=0.003);③Stepwise多元逐步回归分析结果显示,需要家属陪护透析、经历5.12大地震与整体健康方面得分呈负相关,男性患者在整体健康方面得分高于女性患者。结论德阳地区MHD患者的生存质量总体水平低于广州地区,需要家属陪护透析、经历5.12大地震与整体健康方面得分呈负相关。
Purpose To study the survival quality and influencing factors of patients with maintenance hemodialysis disease(MHD) in Deyang region after 5.12 earthquake.Method 253 MHD patients in 6 blood purification centers of Deyang region were selected as the objects.The kidney disease survival quality short form(KDQOL-SFTM) was used for the questionnaire survey of the survival quality.Result: ① the scores of Cognitive function,Quality of social interaction,Sexual function,Working status and Patient satisfaction of MHD patients in Deyang region were lower than Beijing suburbs with statistical difference.② the scores of Social function,Role limitations-physical,Role limitations-emotional,Pain,Energy,Cognitive function,Quality of social interaction and Working status of the MHD patients in Deyang region were lower than Guangzhou region with statistical difference.③The result of Stepwise multivariate regression analysis showed that the need for family escort for dialysis and experiences of 5.12 earthquake were negatively correlated with the overall health score.Male patients scored higher than female patients in terms of overall health.Conclusion The overall level of survival quality of MHD patients in Deyang region is lower than Guangzhou region.the need for family escort for dialysis and experiences of 5.12 earthquake are negatively correlated with the Overall health,and male patients score higher than female patients in terms of overall health.
Purpose To study the survival quality and influencing factors of patients with maintenance hemodialysis disease(MHD) in Deyang region after 5.12 earthquake.Method 253 MHD patients in 6 blood purification centers of Deyang region were selected as the objects.The kidney disease survival quality short form(KDQOL-SFTM) was used for the questionnaire survey of the survival quality.Result: ① the scores of Cognitive function,Quality of social interaction,Sexual function,Working status and Patient satisfaction of MHD patients in Deyang region were lower than Beijing suburbs with statistical difference.② the scores of Social function,Role limitations-physical,Role limitations-emotional,Pain,Energy,Cognitive function,Quality of social interaction and Working status of the MHD patients in Deyang region were lower than Guangzhou region with statistical difference.③The result of Stepwise multivariate regression analysis showed that the need for family escort for dialysis and experiences of 5.12 earthquake were negatively correlated with the overall health score.Male patients scored higher than female patients in terms of overall health.Conclusion The overall level of survival quality of MHD patients in Deyang region is lower than Guangzhou region.the need for family escort for dialysis and experiences of 5.12 earthquake are negatively correlated with the Overall health,and male patients score higher than female patients in terms of overall health.
引文
[1]姜敏敏,李鲁,陈江华.血液透析患者的生活质量评价[J].中华肾脏病杂志,2003,19:397.
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[5]马祖,郑智华,张涤华等.血液透析患者生存质量的多中心研究[J].中国血液净化,2004,3:380-384.
[6]史浩,陈楠.慢性肾脏病患者心血管疾病的现状与思考[J].中华内科杂志,2012,51:499-501.
[7]Patrick D L,Morgan M,Charlton J R.Psychosocialsupport and change in the health status of physi-cally disabled people[J].Soc Sci Med,1986,22:1347-1354.
[8]Mittal S K,Ahern L,Flaster E,et al.Self-as-sessed quality of life in peritoneal dialysis pa-tients[J].Am J Nephrol,2001,21:215-220.
[9]李海燕,宋斌,李隽等.德阳地区灾后血液透析中心管理状况调查[J].临床肾脏病杂志,2013:13,79-80.
[10]王苏容与范亚平,生活质量评价在血液透析患者中的临床应用[J].中国血液净化,2007,6:320-323
[11]李隽,宋斌,李海燕.地震后德阳市血液透析患者的精神健康状况调查[J].贵阳中医学院学报.2013:34,93-94.
[12]Wu A W,Fink N E,Marsh-Manzi J V,et al.Changesin quality of life during hemodialysis and perito-neal dialysis treatment:generic and disease spe-cific measures[J].J Am Soc Nephrol,2004,15:743-753.
[13]Danquah F V,Wasserman J,Meininger J,et al.Qual-ity of life measures for patients on hemodialysis:a review of psychometric properties[J].NephrolNurs J,2010,37:255-269.
[14]Naik N,Hess R,Unruh M.Measurement of health-re-lated quality of life in the care of patients withESRD:isn't this the metric that matters?[J].Semin Dial,2012,25:439-444.
[2]洪涛,刘华锋.慢性肾衰竭患者的生存质量及其影响因素[J].国外医学(泌尿系统分册),2005,25:275-280.
[3]Hays R D.Kidney Disease Quality of Life Short Form(KDQOL-SF),Version 1.3:A Manual for Use andScoring[J].Santa Monica,CA:RAND,1997,P-7994.
[4]李向秋,邹海欧,董小革.北京市郊区维持性血液透析患者生活质量调查[J].中国血液净化,2006,5:720-723.
[5]马祖,郑智华,张涤华等.血液透析患者生存质量的多中心研究[J].中国血液净化,2004,3:380-384.
[6]史浩,陈楠.慢性肾脏病患者心血管疾病的现状与思考[J].中华内科杂志,2012,51:499-501.
[7]Patrick D L,Morgan M,Charlton J R.Psychosocialsupport and change in the health status of physi-cally disabled people[J].Soc Sci Med,1986,22:1347-1354.
[8]Mittal S K,Ahern L,Flaster E,et al.Self-as-sessed quality of life in peritoneal dialysis pa-tients[J].Am J Nephrol,2001,21:215-220.
[9]李海燕,宋斌,李隽等.德阳地区灾后血液透析中心管理状况调查[J].临床肾脏病杂志,2013:13,79-80.
[10]王苏容与范亚平,生活质量评价在血液透析患者中的临床应用[J].中国血液净化,2007,6:320-323
[11]李隽,宋斌,李海燕.地震后德阳市血液透析患者的精神健康状况调查[J].贵阳中医学院学报.2013:34,93-94.
[12]Wu A W,Fink N E,Marsh-Manzi J V,et al.Changesin quality of life during hemodialysis and perito-neal dialysis treatment:generic and disease spe-cific measures[J].J Am Soc Nephrol,2004,15:743-753.
[13]Danquah F V,Wasserman J,Meininger J,et al.Qual-ity of life measures for patients on hemodialysis:a review of psychometric properties[J].NephrolNurs J,2010,37:255-269.
[14]Naik N,Hess R,Unruh M.Measurement of health-re-lated quality of life in the care of patients withESRD:isn't this the metric that matters?[J].Semin Dial,2012,25:439-444.
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