中国血液净化

中国血液净化 ›› 2019, Vol. 18 ›› Issue (05): 349-351.doi: 10.3969/j.issn.1671-4091.2019.05.017

• 护理研究 • 上一篇    下一篇

维持性血液透析患者抑郁、睡眠质量与疲乏的相关性及中介效应分析

王亚楠1,马志芳2,向晶2,姜亚芳1   

  1. 1. 北京协和医学院护理学院
    2. 解放军总医院第一医学中心肾脏病科
  • 收稿日期:2019-02-22 修回日期:2019-03-11 出版日期:2019-05-12 发布日期:2019-05-15
  • 通讯作者: 姜亚芳 jiangyfpumc@126.com E-mail:jiangyfpumc@126.com
  • 基金资助:

    北京市保健科研课题京15-13号项目

Correlation and mediating effects of depression, sleep quality and fatigue in maintenance hemodialysis patients

  • Received:2019-02-22 Revised:2019-03-11 Online:2019-05-12 Published:2019-05-15

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摘要： 【摘要】目的了解维持性血液透析患者抑郁、睡眠质量与疲乏的现状及3 者之间的相关性及中介效应。方法采用一般资料调查表、抑郁自评量表、慢性病治疗功能评估-疲劳量表、阿森斯失眠量表对在北京3 家三级及三级以上医院血液净化中心进行维持性血液透析治疗的209 名患者进行调查。相关性分析采用Spearman 相关系数分析，中介效应采用线性回归分析。结果维持性血液透析患者抑郁发生率为40.2%，睡眠障碍发生率为77.5%，疲劳量表得分范围为8～52 分，中位数为38.00(32.00，44.00)。统计分析结果显示，抑郁评分与疲乏评分呈负相关(r=-0.590，P＜0.001)；睡眠质量评分与疲乏评分呈负相关(r=-0.404，P＜0.001)；睡眠质量评分与抑郁评分呈正相关(r=0.416，P＜0.001)。抑郁评分对疲乏评分有负向预测作用(β=-0.621，P＜0.001)，对睡眠质量评分有正向预测作用(β=0.214，P＜0.001)；加入睡眠质量评分后，抑郁评分对疲乏评分的效应减少，β值由-0.621 变为-0.552，提示睡眠质量在抑郁和疲乏的关系中起到部分中介效应。结论改善维持性血液透析患者的疲乏，不仅要关注其抑郁的发生，同时要关注其睡眠质量，改善抑郁和睡眠障碍是改善疲乏的重要措施。

关键词: 维持性血液透析患者, 抑郁, 睡眠质量, 疲乏

Abstract: 【Abstract】Objective To understand the status of depression, sleep quality and fatigue in maintenance hemodialysis (MHD) patients as well as the correlation and mediation effects between the three symptoms. Methods The general data questionnaire, Self-rating Depression Scale, Functional Assessment of Chronic Illness Therapy-Fatigue, and Athen’s Insomnia Scale were used to investigate 209 MHD patients in 3 top level hospitals. Correlation analysis was performed using Spearman correlation coefficient analysis, and mediating effect was analyzed by linear regression analysis. Results The incidence of depression and sleep disorder in the MHD patients were 40.2% and 77.5% respectively, and the score of fatigue scale was 8-52 points [median
38.00 (32.00, 44.00)]. Statistical analysis showed that depression score was negatively correlated with fatigue score (r=-0.590, P＜0.001), sleep quality score was negatively correlated with fatigue score (r=-0.404, P＜0.001), and sleep quality score was positively correlated with depression score (r=0.416, P＜0.001). The depression score had a negative predictive effect on fatigue score (β =-0.621, P＜0.001), and a positive predictive effect on sleep quality score (β=0.214, P＜0.001). After adding sleep quality score, the effect of depression scores on fatigue scores decreased and the beta value changed from - 0.621 to - 0.552, suggesting that sleep quality plays a partial mediating role in the relationship between depression and fatigue. Conclusions Improving fatigue in MHD patients should focus on the presence of depression as well as the quality of sleep. Improving depression and sleep disorders are the important measures to decrease fatigue.

Key words: maintenance hemodialysis patient, depression, sleep quality, fatigue