MHD患者反刍性沉思影响因素及与社会支持、应对相关性研究

发布时间：2018-06-30 17:27

本文选题：维持性血液透析 + 反刍性沉思　；参考：《吉林大学》2017年硕士论文

【摘要】：研究目的:了解维持性血液透析(Maintenance Hemodialysis,MHD)患者反刍性沉思水平及特征,探讨MHD患者反刍性沉思与社会支持、应对方式之间的相关性,分析MHD患者不同反刍性沉思的影响因素,为促进MHD患者身心健康提供新的思路和理论依据。研究方法:本研究应用随机抽样的方法选取2016年7月~2016年11月在长春市某三级甲等综合性医院血液净化中接受维持性血液透析治疗的患者220例进行问卷调查(有效回收的问卷210份,问卷的有效率为95.5%),研究工具包括一般资料调查表、简体中文版事件相关反刍性沉思问卷(C-ERRI)、领悟社会支持量表(PSSS)、医学应对方式量表(MCMQ)。应用Epidata3.1软件双人录入数据,应用SPSS20.0统计软件对数据进行统计学处理,统计学分析方法包括:描述性统计分析、t检验、单因素方差分析、Pearson相关分析、多元线性逐步回归分析等。研究结果:1.MHD患者反刍性沉思、社会支持及应对方式的特征在有效回收的210例问卷中,研究对象的反刍性沉思总分为30.66±7.17,目的性沉思维度得分17.07±5.47,侵入性沉思总分为13.62±3.95;领悟社会支持总分为62.33±7.42;面对得分20.18±3.73,回避得分17.68±3.79,屈服得分11.37±3.63,与常模相比,分值均高于常模,回避及屈服分值有意义(p0.05)。2.MHD患者反刍性沉思影响因素的单因素分析影响反刍性沉思的因素包括:性别(t=-3.959,p0.001)、文化程度(F=3.177,p=0.025)、疾病自觉知晓程度(F=6.863,p=0.001);影响目的性沉思的因素包括:文化程度(F=14.153,p0.001)、家庭人均月收入(F=7.974,p0.001)、透析龄(F=6.973,p0.001)、疾病自觉知晓程度(F=7.395,p=0.001)、疾病主观严重程度(F=3.066,p=0.049);影响侵入性沉思的因素包括性别(t=-5.062,p0.001)、文化程度(F=2.766,p=0.043)、家庭人均月收入(F=5.642,p=0.001)、透析龄(F=3.558,p=0.015)、疾病自觉知晓程度(F=4.227,p=0.016)、疾病主观严重程度(F=4.355,p=0.014)。3.MHD患者反刍性沉思、社会支持及应对方式三者间的相关性Pearson相关分析得出,目的性沉思与领悟社会支持相关系数为0.207(P0.01),与面对应对方式相关系数为0.170(P0.05),与回避应对方式相关系数为0.200(P0.01);侵入性沉思与屈服应对方式相关系数为0.287(P0.01);社会支持与面对应对方式、屈服应对方式的相关系数分别为0.221、-0.185(P0.01)。4.MHD患者反刍性沉思影响因素的多因素分析多元线性逐步回归分析的结果显示,文化程度、透析龄、疾病自觉知晓程度是影响MHD患者目的性沉思的重要因素,可以解释目的性沉思水平21.6%的变异量(R2=0.216);患者性别、家庭人均月收入是影响MHD患者侵入性沉思的重要因素,可以解释侵入性沉思水平21.1%的变异量(R2=0.211)。结论:1.MHD患者反刍性沉思水平处于中等水平,目的性沉思水平高于侵入性沉思水平;MHD患者领悟社会支持处于中等水平;倾向于采用回避、屈服应对等应对方式;2.一般资料中的性别、文化程度、疾病自觉知晓程度是MHD患者反刍性沉思的影响因素;文化程度、家庭人均月收入、透析龄、疾病自觉知晓程度、疾病主观严重程度是MHD患者目的性沉思的影响因素;性别、文化程度、家庭人均月收入、透析龄、疾病自觉知晓程度、疾病主观严重程度是MHD患者侵入性沉思的影响因素;3.MHD患者目的性沉思与领悟社会支持呈正相关、与积极应对方式呈正相关,MHD患者侵入性沉思与消极应对方式呈正相关;领悟社会支持与积极应对方式呈正相关,与消极应对方式呈负相关;4.透析龄、家庭人均月收入、疾病自觉知晓程度是影响MHD患者目的性沉思的主要因素;性别、家庭人均月收入是影响MHD患者侵入性沉思的主要因素。
[Abstract]:The purpose of this study is to understand the level and characteristics of ruminant meditation in patients with Maintenance Hemodialysis (MHD), to explore the correlation between ruminant meditation and social support and the coping style in MHD patients, and to analyze the factors influencing the different ruminant contemplation of MHD patients and to provide new ideas and theoretical basis for promoting the physical and mental health of MHD patients. Research methods: This study used random sampling methods to select 220 cases of patients receiving maintenance hemodialysis in a class three class a comprehensive hospital of Changchun in July 2016, July 2016 (210 questionnaires were effectively recovered, the effective rate of the questionnaire was 95.5%), and the research tools included the general data questionnaire. The simplified Chinese version of the event related ruminant questionnaire (C-ERRI), the understanding of the social support scale (PSSS), the medical coping style scale (MCMQ). The data were recorded by Epidata3.1 software and the SPSS20.0 statistical software was applied to the data processing. The statistical analysis methods included descriptive statistical analysis, t test, single factor ANOVA, P Earson correlation analysis, multivariate linear stepwise regression analysis, and so on. Research results: the characteristics of 1.MHD patients' ruminant meditation, social support and coping style were in 210 valid questionnaires. The total score of ruminant contemplation was 30.66 + 7.17, the score of objective meditation was 17.07 + 5.47, and the total score of invasive meditation was 13.62 + 3.95. The total score was 62.33 + 7.42, the score was 20.18 + 3.73, the score was 17.68 + 3.79, the yield score was 11.37 + 3.63, and the score was higher than the normal model. The single factor analysis of the influence factors of the ruminant reflection (P0.05).2.MHD patients was a single factor analysis of the factors of ruminant reflection: gender (t=-3.959, p0.001), The degree (F=3.177, p=0.025), the degree of awareness of the disease (F=6.863, p=0.001); the factors affecting the purpose of meditation include the F=14.153 (p0.001), the per capita monthly income of the family (F=7.974, p0.001), the age of dialysis (F=6.973, p0.001), the degree of awareness of the disease (F=7.395, p=0.001), the subjective severity of the disease, and the invasion of the disease. The factors of contemplation include t=-5.062 (p0.001), F=2.766 (p=0.043), family per capita monthly income (F=5.642, p=0.001), dialysis age (F=3.558, p=0.015), degree of awareness of disease (F=4.227, p=0.016), subjective severity of disease (F= 4.355, p=0.014), ruminant meditation, social support and coping styles among the three Pearson correlation analysis showed that the correlation coefficient of purposeful meditation and perceived social support was 0.207 (P0.01), the correlation coefficient of coping style was 0.170 (P0.05), and the correlation coefficient of avoidance coping style was 0.200 (P0.01); the correlation coefficient of invasive meditation and yield coping style was 0.287 (P0.01); social support and face coping style should be yielded. The correlation coefficient of the method is 0.221, -0.185 (P0.01).4.MHD patients' ruminant influence factors analysis multifactor analysis of multivariate linear stepwise regression analysis results show that the degree of cultural degree, dialysis age, the degree of awareness of disease consciousness is the important factor affecting the purpose of MHD patients' meditation, and can explain the variance of the level of 21.6% of the target meditation level. Volume (R2=0.216); patient sex, family per capita income is an important factor affecting invasive meditation in MHD patients. It can explain the variation in invasive meditation level 21.1% (R2=0.211). Conclusion: the level of ruminant meditation in 1.MHD patients is at the middle level, and the level of purposeful meditation is higher than that of invasive meditation; MHD patients understand social support. Middle level; inclined to adopt avoidance, yield response and other coping styles. 2. the gender, educational level, and awareness of disease consciousness in general data are the factors affecting the ruminant meditation of MHD patients; the degree of culture, the monthly income of the family, the age of dialysis, the degree of awareness of the disease, and the subjective severity of the disease are the shadow of the purpose of the MHD patients. Ringing factors, sex, education level, family per capita income, dialysis age, awareness of disease awareness, and subjective severity of disease are the factors affecting the invasive meditation of MHD patients; the purpose of 3.MHD patients' purposeful meditation is positively related to understanding social support, positive correlation with positive coping style, and MHD patients' invasive meditation and negative coping style are positive. There was a positive correlation between perceived social support and positive coping style, negative correlation with negative coping style; 4. dialysis age, family per capita income, and awareness of disease consciousness were the main factors affecting the target meditation of MHD patients; gender, and the monthly income of family per capita were the main factors affecting the invasive meditation of MHD patients.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.5

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