中国血液净化

中国血液净化 ›› 2026, Vol. 25 ›› Issue (04): 305-309.doi: 10.3969/j.issn.1671-4091.2026.04.007

• 临床研究 • 上一篇    下一篇

维持性血液透析患者服药依从性与社会支持的横断面调查

于海艳   王欣欣   陈 迪    周 冉    石 颖    程 军    马迎春   

  1. 100068 北京，首都医科大学康复医学院 中国康复研究中心北京博爱医院1肾内科 3计财处
    100068 北京，2中国康复科学所康复信息研究部
  • 收稿日期:2025-07-03 修回日期:2026-01-20 出版日期:2026-04-12 发布日期:2026-04-12
  • 通讯作者: 马迎春 E-mail:mych323@163.com
  • 基金资助:
    中国康复科学所中央级公益性科研院所基本科研业务费项目(CRSI2024CZ-2)

A cross-sectional survey on medication adherence and social support among maintenance hemodialysis patients

YU Hai-yan，WANG Xin-xin，CHEN Di，ZHOU Ran，SHI Ying， CHENG Jun，MA Ying-chun   

  1. Department of Nephrology，and 3Department of Finance , The School of Rehabilitation Medicine of Capital Medical University. China Rehabilitation Research Center/Beijing Boai Hospital，Beijing 100068，China; 2Rehabilitation Information Research Department，China Rehabilitation Science Institute, Beijing 100068, China
  • Received:2025-07-03 Revised:2026-01-20 Online:2026-04-12 Published:2026-04-12
  • Contact: 100068 北京，首都医科大学康复医学院 中国康复研究中心北京博爱医院1肾内科 E-mail:mych323@163.com

摘要： 目的 调查维持性血液透析(maintenance hemodialysis,MHD)患者服药依从性及社会支持状况。 方法 选取2025年1月1日—4月15日中国康复研究中心北京博爱医院MHD患者作为研究对象，通过肾脏康复电子信息管理平台，收集患者的人口统计学资料及医学资料，采用Morisky服药依从性量表和社会支持评定量表分别评估患者的服药依从性和社会支持情况，采用焦虑自评量表、抑郁自评量表评估患者焦虑抑郁状态。应用Logistic回归模型，分析患者服药依从性的影响因素。 结果 共纳入99例患者，其中服药依从性好组占45.45%(n=45)，依从性差组占54.55%(n=54)。服药依从性好组患者与服药依从性差组患者相比，血钾(t=2.015，P=0.047)、血磷(t=2.621,P=0.010)水平更低，尿素清除指数(t= 
-2.769,P=0.007)更高，焦虑评分更低(t=2.489,P=0.015)；2组患者的社会支持评分(t=1.160,P=0.249)、主观支持评分(t=0.687,P=0.494)、客观支持评分(t=1.450,P=0.151)、支持利用度(t=0.410,P=0.682)比较差异无统计学意义。患者服药依从性与社会支持评分无显著相关性(β=-0.139， P=0.169)；社会支持满意度高的患者服药依从性相对更差(χ2=5.727，P=0.014)。Logistic回归分析显示MHD患者焦虑水平越高(OR=0.933，95%CI：0.878～0.992，P=0.025)、尿素清除指数越低(OR=10.887， 95%CI：1.813～65.364，P=0.009)、社会支持越满意(OR=0.362，95%CI：0.138～0.951，P=0.039)，服药依从性越差。 结论  维持性血液透析患者服药依从性差的情况普遍存在，服药依从性与社会支持之间存在复杂的相互作用。护理人员应通过不同方式对患者进行健康教育，提高患者的社会支持度和服药依从性。

关键词: 药依从性, 社会支持, 维持性血液透析

Abstract: Objective  To investigate medication adherence and social support status among patients undergoing maintenance hemodialysis (MHD).  Methods  Patients receiving MHD at Beijing Boai Hospital of the China Rehabilitation Research Center from January 1 to April 15, 2025, were selected as study subjects. Demographic and medical data were collected via the Renal Rehabilitation Electronic Information Management Platform. Medication adherence was assessed using the Morisky Adherence Scale, while social support was evaluated using the Social Support Rating Scale. Anxiety and depression states were assessed with the Self-Rating Anxiety Scale and Self-Rating Depression Scale, respectively. A logistic regression model was applied to analyze factors influencing medication adherence.  Results  A total of 99 patients were included, with 45.45% in the good adherence group and 54.55% in the poor adherence group. Compared with the poor adherence group, patients in the good adherence group exhibited lower serum potassium (t=2.015, P=0.047) and phosphorus (t=2.621, P=0.010) levels, higher urea clearance index (t=-2.769, P=0.007), and reduced anxiety scores (t=2.489, P=0.015). No statistically significant differences were observed in social support scores (t=1.160, P=0.249), subjective support scores (t=0.687, P=0.494), objective support scores (t=1.450, P=0.151), or support utilization (t=0.410, P=0.682) between the two groups. No significant correlation was found between medication adherence and social support scores (β=-0.139, P=0.169). Patients with higher satisfaction with social support exhibited relatively poorer medication adherence (χ²=5.727, P=0.014). Logistic regression analysis revealed that higher anxiety levels (OR=0.933, 95% CI：0.878～0.992, P=0.025), lower urea clearance index (OR=10.887, 95% CI 1.813～65.364, P=0.009), and greater satisfaction with social support (OR=0.362, 95% CI：0.138～0.951, P=0.039) were associated with poorer medication adherence.  Conclusion  Poor medication adherence is prevalent among MHD patients, and there is a complex interplay between medication adherence and social support. Nursing staff should provide health education to patients through various methods to enhance their social support and medication adherence.

Key words: Medication adherence, Social support, Maintenance hemodialysis

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