中国血液净化

中国血液净化 ›› 2019, Vol. 18 ›› Issue (05): 352-355.doi: 10.3969/j.issn.1671-4091.2019.05.018

• 护理研究 • 上一篇    下一篇

基于聚类分析的青年维持性血液透析患者亚群分类研究

黄莉娟1,2,3,段培蓓2,潘园3,金彩香3   

  1. 1南京中医药大学护理学院
    2南京中医药大学附属医院护理部
    3南京中医药大学附属南京市中西医结合医院肾内科
  • 收稿日期:2018-11-29 修回日期:2019-02-24 出版日期:2019-05-12 发布日期:2019-05-15
  • 通讯作者: 段培蓓 dpb_58@163.com E-mail:dpb_58@163.com

Subtyping of young hemodialysis patients based on cluster analyses

  • Received:2018-11-29 Revised:2019-02-24 Online:2019-05-12 Published:2019-05-15

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摘要： 【摘要】目的以影响青年维持性血液透析(maintenance hemodialysis，MHD)患者疾病管理行为的自我管理能力、自我效能和希望水平为基础，判断其分型，期望提出更有针对性的疾病管理策略。方法采用MHD 患者自我管理行为量表(self-management scale for hemodialysis，SMSH)、慢性病自我效能量表(self-efficacy scale for chronic，SESC)及Herth 希望量表(herth hope index，HHI)，对入选患者测评，通过SPSS 22.0 中的聚类分析方法分类，比较不同类型患者的一般特征。结果患者分4 类，Ⅰ类“乐观熟练型”(24.7%)，其自我管理能力、自我效能及希望水平得分均高于总体样本；Ⅱ类“盲目自信型”(16.7%)，其自我效能及希望水平高于总体水平，但自我管理能力较差；Ⅲ类“忧虑参与型”(41.4%)，其自我管理能力较好，但自我效能和希望水平略差；Ⅳ类“悲观无为型”(17.2%)，其自我管理能力、自我效能及希望水平均较低。4 类患者在文化程度(χ2=16.707,P=0.010)、工作状况(χ2=9.312,P=0.025)、主要照顾者类型(χ2= 57.570, P＜0.001)及透析年限(χ2=44.584, P＜0.001)方面的差异有统计学意义。结论将青年HD 患者分为4 种亚型，有助于医护人员制定更有针对性的干预措施，为实现疾病管理同类型标准化提供依据。

关键词: 青年, 维持性血液透析, 疾病管理, 聚类分析

Abstract: 【Abstract】Objective To explore the possible subtypes of young maintenance hemodialysis patients based on patients’self-management ability, self-efficacy and hope. Methods A total of 198 young maintenance hemodialysis patients were assessed by Self-management Scale for Hemodialysis (SMSH), Self-Efficacy Scale for Chronic (SESC) and Herth Hope Index (HHI). Cluster analysis was performed to categorize patients based on their scores using SPSS 22.0 software. Results Four different subtypes could be found in these patients. Type I patients (24.7% of the patients) showed very good self-management abilities, positively and optimistically. Type II patients (16.7% of the patients) showed blind permissive management and good self- efficacy and hope but with poor self-management ability. Type Ⅲ patients (41.4% of the patients) performed poorly in emotional accommodation but with good self-management ability. Type Ⅳ patients (17.2% of the patients) were pessimistic with poor self-management ability, self- efficacy and hope. Education level (χ2=16.707, P=0.010), job (χ2=9.312, P=0.025), primary caregivers (χ2=57.570, P＜0.001) and dialysis duration (χ2=44.584, P＜0.001) were significant different between the four subtypes of patients. Conclusion To divide young hemodialysis patients into four subtypes can help medical staff develop better targeted interventions and provide a basis for standardization of disease management.

Key words: young, maintenance hemodialysis, disease management, cluster analysis