中国组织工程研究与临床康复2009，Vol.13Issue(44)：8721-8725,5.DOI:10.3969/j.issn.1673-8225.2009.44.027
肾移植前后实施维持性血液透析患者生活质量的评估及其影响因素
Evaluation on the quality of life in patients with maintained hemodialysis before and after kidney transplantation and the influencing factors
摘要
Abstract
BACKGROUND:Because of the peculiarity of disease and treatment,the maintenance hemodialysis(MHD)patients confront manifold stress related to treatment.Their physical function,mental health and social function were all serially impaired,resulting in the decrease in quality of life(QOL).OBJECTIVE:To measure and evaluate QOL in patients with MHD before and after kidney transplantation,and analyze the main related factors.DESIGN,TIME AND SETTING:Case-controlled study compared with health people was performed at Hemodialysis Center of the Affiliated Hospital of Guangdong Medical College from January 2008 to June 2008.PARTICIPANTS:120 patients with MHD were selected as patient group,and 120 healthy people without disease matched by age,gender,residence,marital status,educational background,family economic condition,were taken as control group.METHODS:The general information questionnaire was used to investigate individual age,gender,residence,educational background,profession,marital status,family economic condition,medical insurance modes.The general clinical information questionnaire was used to investigate the patients' primary diseases,complication,duration for accepting hemodialysis,serum creatinine(Scr),haemoglobin(Hb),serum calcium(Ca~(2+)),serum phosphorus(PO43~-),serum potassium(K~+),serum natrium(Na~+),and blood urea nitrogen(BUN)before hemodialysis,rate of the declining of urea nitrogen,as well as rate of interdialytic weight gain to dry weight(IWGR%).MAIN OUTCOME MEASURES:Their QOL were measured by using the Chinese version of Short Form-36(SF-36).Their depression,anxiety,family support and coping modes were measured by using the Chinese version of self-rating depression scale (SDS),self-rating anxiety scale(SAS),Perceivd Social Support from Family Scale and Medical Coping Modes Questionnaire (MCMQ).The scores of SF-36,SDS,SAS and Social Support from Family Scale of the MHD patients were compared with those of the normal controls.The scores of MCMQ of the MHD patients were compared with the norm.Univariate linear regression analysis and multiple linear regression analysis were applied to evaluate the related factors.RESULTS:120 questionnaires were put out to each group.112 qualified questionnaires in the patient group and 117 qualified questionnaires in the control group were retracted with the recovery rate of 93.3%and 95.7%,respectively.The mean scores of physical functioning,role-physical,bodily-pain,general health,vigor,social functioning,role-emotional and mental health were significantly lower in the patient group than those in the control group(P＜0.01).The mean scores of SAS,SDS were significantly higher in the MHD group than those in the control group(P＜0.01).The mean score of Perceivd Social Support from Family Scale was significantly lower in the patients group than that in the control group(P＜0.01).The mean score of confronce was significantly lower than the norm(P＜0.01).The mean scores of avoidance and resignation were significantly higher than the norm(P＜0.01).Univariate linear regression analysis showed that complication,age,haemoglobin(Hb),duration for accepting hemodialysis,family economic condition,depression,anxiety,family support,the factor of avoidance of medical coping modes and educational background had significant correlation with the total score of mental health(|r|=0.376-0.561,P＜0.05).Multiple linear regression analysis showed that the main factors that influenced the physical health of QOL in MHD patients were complication,depression,age,duration for accepting hemodialysis,perceivd social support from family and family economic condition,and the main factors that influenced the psychological health of QOL in MHD patients were depression,anxiety,complication,Perceivd social support from family and the factor of avoidance of MCMQ.CONCLUSION:The QOL of MHD patients are remarkably decreased,it is significantly related with their kidney function,complications and social-psychological factors.关键词
肾移植/维持性血液透析/生活质量/影响因素/多元线性回归分类
临床医学引用本文复制引用
侯永梅,胡佩诚,梁燕萍,莫湛宇..肾移植前后实施维持性血液透析患者生活质量的评估及其影响因素[J].中国组织工程研究与临床康复,2009,13(44):8721-8725,5.基金项目
2006年湛江市科技攻关项目 （）
