老年血液透析患者自我感受负担与自护能力及其影响因素

Self-perceived burden and self-care ability in elderly hemodialysis patients and its influencing factors

【摘要】目的 分析老年血液透析患者自我感受负担与自护能力、生活质量的相关性。方法 收集2021年2月至2023年2月重庆医科大学附属大足医院收治的385例老年维持性血液透析(MHD)患者的临床资料。采用自我感受负担量表(SPBS)评估自我感受负担,自我护理能力测定量表(ESCA)评估自护能力,肾脏疾病生存质量专用量表(KDQOL-SFTM1.3)评估生活质量。根据SPBS得分将重度负担者纳入重度负担组,无明显负担、轻度负担及中度负担者纳入非重度负担组。采用SPSS 24.0软件进行数据分析。根据数据类型,组间比较分别采用t检验及χ²检验。使用logistic回归分析老年MHD患者重度自我感受负担的影响因素,采用Pearson相关系数分析老年MHD患者自我感受负担与自护能力、生活质量的相关性。结果 重度负担组纳入患者178例,非重度负担组纳入患者207例。两组患者社会经济地位、日常生活能力、并发症方面比较,差异均有统计学意义(P＜0.05)。logistic回归分析显示,社会经济地位低(OR=2.646,95%CI 1.485～4.716)、日常生活能力中度依赖(OR=3.408,95%CI 2.134～5.442)、并发症(OR=2.380,95%CI1.260～4.495)均为老年MHD患者重度自我感受负担的危险因素(P＜0.05)。Pearson相关系数分析显示,老年MHD患者SPBS评分与ESCA评分,肾脏相关和一般健康相关的KDQOL-SFTM1.3评分及KDQOL-SFTM1.3总分均呈显著负相关(r=-0.655、-0.836、-0.683、-0.734；P＜0.05)。结论 有并发症、日常生活能力差、社会经济地位低的老年MHD患者更易出现强烈自我感受负担,患者自我感受负担与自护能力、生活质量存在紧密联系。

基金项目:重庆市科技局科研基金(2022L027); 重庆市科技计划项目(DZKJ2021ACC1025)

【Abstract】Objective To analyze the correlation of self-perceived burden with self-care ability and quality of life in elderly patients undergoing hemodialysis. Methods Clinical data of 385 elderly patients undergoing maintenance hemodialysis (MHD) admitted in our hospital from February 2021 to February 2023 were collected. Self-perceived burden scale (SPBS), exercise of self-care agency scale (ESCA), and kidney disease quality of life short form version 1.3 (KDQOL-SFTM1.3) were used to evaluate the self-perceived burden, self-care ability and quality of life of the patients, respectively. According to SPBS score, they were divided into severe burden group and non-severe burden group (no obvious burden to moderate burden). SPSS statistics 24.0 was used for statistical analysis. Data comparison between two groups was performed using t test orχ² test depending on data type. Logistic regression analysis was employed to identify the influencing factors of severe self-perceived burden in elderly MHD patients, and Pearson correlation coefficient analysis was utilized to evaluate the correlation between self-perceived burden and self-care ability and quality of life in them. Results There were 178 patients assigned into severe burden group and 207 into non-severe burden group. Significant differences were observed between two groups in terms of socioeconomic status, daily living ability, and incidence of complications (P<0.05). Logistic regression analysis showed that low socioeconomic status (OR=2.646,95%CI 1.485-4.716), moderately dependent daily life ability (OR=3.408,95%CI 2.134-5.442) and complication (OR=2.380,95%CI 1.260-4.495) were risk factors of severe self-perceived burden in elderly MHD patients (P<0.05). Pearson correlation coefficient analysis revealed that in the elderly MHD patients, SPBS score was negatively correlated with ESCA score, and kidney-related score, general health-related score and total score of KDQOL-SFTM1.3 (r=-0.655, -0.836, -0.683, -0.734; P<0.05). Conclusion Elderly MHD patients with complications, poor daily life ability and low socioeconomic status are more likely to have strong self-perceived burden. Self-perceived burden of these patients is closely associated with their self-care ability and quality of life.

This work was supported by the Research Fund of Chongqing Science and Technology Bureau (2022L027) and the Project of Chongqing Science and Technology Plan (DZKJ2021ACC1025)