中国血液净化

中国血液净化 ›› 2016, Vol. 15 ›› Issue (07): 372-376.doi: 10.3969/j.issn.1671-4091.2016.07.014

• 护理园地 • 上一篇    下一篇

影响维持性血液透析患者依从性相关因素的研究

陶珍晖1,陈育青1,曹立云1,左力2,檀敏2   

  1. 1. 北京大学第一医院肾内科
    2. 北京大学人民医院肾内科
  • 收稿日期:2015-12-04 修回日期:2016-04-12 出版日期:2016-07-12 发布日期:2016-07-12
  • 基金资助:

    北京大学第一医院科研基金资助课题

An investigation on the related factors for adherence behaviors in maintenance hemodialysis patients

  • Received:2015-12-04 Revised:2016-04-12 Online:2016-07-12 Published:2016-07-12

RichHTML

2

PDF

576

摘要： 目的了解维持性血液透析(maintenance hemodialysis，MHD)患者对治疗(包括透析、液体管理、药物及饮食等方面)的依从性、依从性的影响因素以及依从性与临床指标的关系。方法采用终末期肾脏病患者依从性问卷(end-stage renal disease-adherence questionnaire, ESRD-AQ)调查表，对北京市2 家三甲医院的MHD 患者进行问卷调查。用单因素方差分析患者依从性与临床指标的关系，用Logistic 回归模型分析不依从性的独立影响因素。结果共发放问卷189 份，收回186 份，收回率98.4%，其中有效问卷182 份。182 名患者中,男性87 人(47.8%)，平均年龄57.8±14.4 岁，51.1%的患者透析龄超过5 年。透析、药物、液体管理和饮食的依从性分别为70.9%、93.4%、79.1%和76.9%。性别(OR=2.298，95% CI 1.127～4.683，P=0.022)、经济条件(OR=2.539，95% CI 1.123～5.740，P=0.025)、教育水平(OR=3.453，95% CI 1.080～11.039，P=0.037)、工作状态(OR=3.286，95% CI 1.272～8.489，P=0.014)、民族(OR=7.611，95% CI 1.815～31.922，P=0.006)是依从性的独立影响因素。结论经济条件差、学历低、女性、上班者和少数民族的MHD患者对治疗依从性较差，需要加强宣教，以提高治疗和生活质量。

关键词: 维持性血液透析, 液体管理, 药物, 饮食, 依从性

Abstract: Objective To investigate the adherence to medical therapies, the related factors, and the relationship between the adherence and clinical outcomes in maintenance hemodialysis (MHD) patients. Methods We performed a survey to evaluate the adherence in MHD patients in two tertiary hospitals in Beijing using the end-stage renal disease-adherence questionnaire (ESRD-AQ). One-way ANOVA was used to analyze the relationship between adherence and clinical outcome. Logistic regression was used to analyze the related factors for non- adherence behaviors. Results A total of 189 patients participated in this survey and valid questionnaires were collected from 182 patients (males 87; average age 57.8+14.4 years; dialysis vintage >5 years in 51.1% patients). The adherence rates of treatment, medication, fluid and diet were 70.9%, 93.4%, 79.1% and 76.9% respectively. Gender (OR=2.298, 95% CI 1.127～4.683, P=0.022), income (OR=2.539, 95% CI 1.123～5.740, P=0.025), education level (OR=3.453, 95% CI 1.080～11.039, P=0.037), employment state (OR=3.286, 95% CI 1.272～8.489, P=0.014), and race (OR=7.611, 95% CI 1.815～31.922, P=0.006) were the positively related factors for adherence. Conclusion The adherence in MHD patients is insufficient, especially for men, working patients, minority patients, patients with lower education level and low economic level. This study suggests that health care workers should pay more efforts on health education to improve the clinical indicators of MHD patients, and thus to improve their quality of life and health condition.

Key words: maintenance hemodialysis, fluid intake, medication, dietary control, adherence