Correlation between the Psychological Status and Self-Management Ability of Patients on Continuous Ambulatory Peritoneal Dialysis
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摘要:
目的 腹膜透析患者的心理状态和自我管理技能研究，并研究影响它们的因素和相互联系。 方法 采用便利抽样方法，应用一般资料调查表、焦虑抑郁量表（HADS）、自尊量表和自我管理量表对158例腹膜透析患者进行问卷调查。 结果 腹膜透析患者的HADS得分为（7.46±4.14）分，高于常模；自尊水平得分为（26.40±5.17），低于常模（P < 0.05）；自我管理能力得分为（62.60±9.22）分，处于中等水平（P < 0.05）。文化程度、月平均收入、医保类型，患者的心理状态对腹膜透析患者自我管理能力有一定影响（P < 0.05）。 结论 腹膜透析患者的心理状态与自我管理技能之间存在相关性。为有针对性地降低患者的焦虑抑郁状态，增强患者的自尊和自我管理能力是临床护理干预的基础。 Abstract:Objective To study the psychological state and self-management skills of peritoneal dialysis patients and to examine the factors influencing them and their interrelationships. Methods A convenience sampling method was used, and general information surveys, the Hospital Anxiety and Depression Scale （HADS）, the Self-Esteem Scale, and the Self-Management Scale were employed to conduct a questionnaire survey of 158 patients undergoing peritoneal dialysis. Results The HADS score of peritoneal dialysis patients was （7.46±4.14）, which was higher than the norm; the self-esteem level score was （26.40±5.17）, which was lower than the norm （P < 0.05）; and the self-management ability score was （62.60±9.22）, which was at an average level （P < 0.05）. Factors such as education level, average monthly income, type of health insurance, and the psychological state of patients had a certain effect on the self-management ability of peritoneal dialysis patients （all P < 0.05）. Conclusion There is a correlation between the psychological state of peritoneal dialysis patients and their self-management skills. Targeted interventions to reduce anxiety and depression in patients, while enhancing their self-esteem and self-management abilities, are fundamental to clinical care. -
Key words:
- Peritoneal dialysis /
- Psychology /
- Anxiety /
- Depression /
- Self-esteem /
- Self-management ability
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表 1 不同特征腹膜透析患者自我管理能力得分的单因素分析（n = 153）
Table 1. Univariate analysis of self-management ability scores of peritoneal dialysis patients with different characteristics （n = 153）
项目 数值[n（%）] 自我管理能力得分（$\bar x \pm s $） t/F /χ2 P 性别 0.128 0.659 女 77（50.3） 62.27±8.90 男 76（49.7） 62.93±9.57 婚姻 0.307 0.906 已婚或同居 125 63.08±9.16 未婚及其他 13 62.78±8.20 文化程度 21.93 0.000* 初中及以下 118（94.1） 60.22±8.42 高中、大专 26（5.9） 70.69±7.17 本科及以上 9 70.44±7.17 透龄（月） 29.28 0.000* <10 116 59.87±8.07 ≥10～<20 15 69.40±6.35 ≥20 22 72.31±7.65 年龄（岁） 49.29 ±13.81 62.60±9.22 1.339 0.106 职业 1.776 0.173 企/事业单位行政机关 21 59.66±9.22 个体及自由职业者 43 61.88±9.04 务农及其他 89 63.64±9.22 月平均收入 10.526 0.000* 2000元及以下 121（79） 60.66±8.45 2000- 5999 元16（10.5） 64.08±8.32 6000 元以上16（10.5） 71.25±2.62 医保类型 未参加 4 57.75±11.95 4.513 0.001* 省级职工 9 71.00±12.7 市级职工 16 69.50±9.70 城镇居民 122 61.20±8.24 是否有定点医院 3.315 0.030* 否 70 61.37±10.37 是 83 63.63±8.04 *P < 0.05。 
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表 2 影响腹膜透析患者自我管理能力的多重线性回归分析
Table 2. Multiple Linear regression analysis on factors affecting self-management ability in peritoneal dialysis patients
变量 B 标准误 标准系数 t p 常数 50.954 2.784 18.303 0.000 文化程度 3.686 0.635 0.228 5.806 0.000 月平均收入 2.637 0.362 0.299 7.284 0.000 医疗保险类型 0.239 0.296 0.026 0.807 0.421 腹透时间（月） 0.025 0.013 0.064 1.974 0.050 选择定点医院 3.912 0.620 0.212 6.313 0.000 R2 = 0.856，调整R2 = 0.848，F = 107.110，P = 0.000。
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表 3 腹膜透析患者心理状态与自我管理能力相关性分析
Table 3. Correlation Analysis of psychological state and self-management ability in peritoneal dialysis patients
维度 腹透规范化
操作能力腹透效果评估和
监测能力药物管理
能力饮食管理
能力对腹透并发症和
腹透充分性评价的知晓度焦虑得分 0.055 −0.654* −0.759* −0.742* −0.727* 抑郁得分 −0.007 −0.667* −0.742* −0.722* −0.698* 自尊得分 0.022 0.572* 0.684* 0.659* 0.651* *P < 0.05。
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