维持性血液透析患者创伤后成长状况及影响因素研究

发布时间：2018-04-13 01:07

本文选题：维持性血液透析 + 创伤后成长　；参考：《青岛大学》2017年硕士论文

【摘要】：目的以维持性血液透析患者为研究对象,通过问卷调查和深入访谈来了解患者的创伤后成长体验的发生状况,并分析创伤后成长的影响因素,为护理人员的临床工作提供参考依据。方法1.量性研究:采用问卷调查的方法,以维持性血液透析患者的一般资料、修订后的创伤后成长量表、心理弹性量表、中文版事件相关反刍性沉思量表为测量工具,收集228例维持性血液透析患者的创伤后成长、心理弹性及反刍性沉思等资料。采用SPSS 17.0进行数据统计分析,应用相关分析探讨创伤后成长与心理弹性及反刍性沉思的关系,应用分层多元线性回归分析探讨各个变量对患者创伤后成长的影响作用。2.质性研究:采用诠释现象学分析法,对10位维持性血液透析患者进行深入访谈,探讨并分析其创伤后成长的发生历程及促进成长发生的因素。结果1.量性研究结果:(1)本次调查中维持性血液透析患者创伤后成长水平58.62±14.19。其中,患者在“与他人关系”维度上得分最低(8.49±2.90),“人生感悟”维度上得分最高(19.80±4.57)。(2)维持性血液透析患者的年龄、受教育程度、在职状态、家庭月收入和透析龄在创伤后成长有不同程度的统计学意义(P0.05),心理弹性以及目的性反刍性沉思与创伤后成长呈正相关(r=0.712,P0.01;r=0.506,P0.01),侵入性反刍性沉思与创伤后成长呈负相关关系(r=-0.276,P0.01)。(3)在分层回归分析中,进入模型的全部变量共解释创伤后成长总分66.8%的变异度(R2=0.668),其中维持性血液透析患者的年龄(b=-0.306,P0.001)、透析龄(b=0.136,P0.01)、坚韧性(b=0.181,P0.01)、力量(b=0.228,P0.001)、乐观(b=0.154,P0.01)以及目的性反刍性沉思变量(b=0.194,P0.001)对创伤后成长有影响作用。2.质性研究结果:(1)维持性血液透析患者的创伤后成长主要表现在三个主题上,分别是“存在意义的积极构建、自我力量的增强及人生感悟的加深”。(2)促进维持性血液透析患者创伤后成长的主要因素包括个人因素(即人格特征包括乐观开朗、坚韧性、希望和感恩)、对透析事件的认知加工(意义搜寻和意义构建)和环境因素(家庭环境和社会文化背景)。结论1.本研究维持性血液透析患者的创伤后成长水平稍低,患者的年龄、透析龄、心理弹性中的坚韧性、力量、乐观和目的性反刍性沉思对创伤后成长有影响作用。2.本研究维持性血液透析患者的创伤后成长主要表现在存在意义的积极构建、自我力量的增强及人生感悟的加深三方面,且个人因素、环境因素以及认知加工是促进成长的因素。
[Abstract]:Objective to investigate the occurrence of post-traumatic growth experience in maintenance hemodialysis patients by questionnaire survey and in-depth interviews, and to analyze the influencing factors of post-traumatic growth.To provide reference for the clinical work of nursing staff.Method 1.Quantitative study: the questionnaire was used to measure the general data of maintenance hemodialysis patients, the revised posttraumatic growth scale, the resilience scale, and the Chinese version of the ruminant ruminant scale.Data of post-traumatic growth, resilience and ruminant meditation in 228 patients with maintenance hemodialysis were collected.SPSS 17.0 was used to analyze the data, the correlation analysis was used to explore the relationship between posttraumatic growth, mental elasticity and ruminant meditation, and the effects of various variables on patients' post-traumatic growth were analyzed by multivariate linear regression analysis.Qualitative study: 10 patients with maintenance hemodialysis were interviewed by phenomenological interpretation, and the process of posttraumatic growth and the factors that promoted the growth were discussed and analyzed.Result 1.Quantitative study results: 1) the posttraumatic growth level of maintenance hemodialysis patients in this survey was 58.62 卤14.19.Among them, the lowest score was 8.49 卤2.90 in the "relationship with others" dimension, and the highest score in the "life perception" dimension was 19.80 卤4.57. 2) the age, education level and working status of the patients with maintenance hemodialysis.Family monthly income and dialysis age had different degree of statistical significance in post-traumatic growth (P 0.05). There was a positive correlation between psychological elasticity and purposeful ruminant meditation and post-traumatic growth. There was a positive correlation between P0.01 and P0.01. There was a negative correlation between invasive ruminant rumination and post-traumatic growth.In stratified regression analysis, the relationship between r-0.276 and P0.01 was analyzed.Post growth has an effect. 2.Qualitative study results: 1) Post-traumatic growth in maintainable hemodialysis patients is manifested in three main themes, namely, "positive construction of existential significance,"The main factors that promote posttraumatic growth in patients with maintenance hemodialysis include personal factors (i.e. personality traits include optimism, openness, tenacity, resilience, etc.)Hope and gratitude, cognitive processing of dialysis events (meaning search and meaning construction) and environmental factors (family environment and social and cultural background).Conclusion 1.The age, age, resilience, strength, optimism and purposive ruminant meditation of maintenance hemodialysis patients have an effect on posttraumatic growth.In this study, posttraumatic growth of maintenance hemodialysis patients was mainly manifested in the positive construction of existential significance, the enhancement of self-strength and the deepening of life perception, and personal factors, environmental factors and cognitive processing were the factors to promote growth.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.5

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