血透患者的心理社会因素与生活质量及认知功能的相关研究

发布时间：2018-07-21 11:36

【摘要】：目的:本研究主要探讨血透患者的心理社会因素、生活质量、认知功能以及可能相关的影响因素,为提高患者的心理健康水平,改善患者的生活质量和认知功能提供科学依据。方法:维持性血透患者61例,正常对照组60例。使用一般情况问卷、SCL-90、EPQ、SSRS、SF-36、MMSE、Olson婚姻质量问卷进行评定,并作血常规和生化常规检测。结果:(1)HD组SCL-90总分、总均分、躯体化、抑郁、焦虑、其它因子分高于正常人群;(2)HD组的神经质分有较正常人群高的趋势,且神经质分与SCL-90各因子分均呈正相关;(3)HD组对社会支持的利用度不如正常组,随透析年限的增加,获得社会支持的总分和主观支持分明显下降;(4)SCL-90总分与透析间期体重增加、合并症数、血钾呈正相关,与血红蛋白浓度、对社会支持的利用度呈负相关;(5)HD组的PF、RP、BP、GH、VT、SF、RE、MH显著低于正常人群,年龄、职业状况、婚姻状况、文化程度、营养不良及合并症对HD患者的生活质量有影响;(6)HD组的性生活满意度较低;(7)HD组的MMSE评分低于正常组,定向力、注意力和计算力、回忆力与正常组有显著差异;MMSE总分与血清白蛋白及血红蛋白浓度呈正相关,与患者年龄、透析间期体重增加、合并症数呈负相关。结论:合并症多、血钾高、EPQ-N分值高对HD患者心理状况影响较大,个性因素、社会支持也共同影响患者的心理健康水平。心理社会因素和透析治疗本身影响HD患者的生活质量。合并症多、血红蛋白含量下降及血清白蛋白降低与患者认知功能减退密切相关。
[Abstract]:Objective: to explore the psychological and social factors, quality of life, cognitive function and possible related factors in patients with hemodialysis, so as to provide scientific basis for improving the mental health of patients and improving the quality of life and cognitive function of patients. Methods: 61 patients with maintenance hemodialysis and 60 normal controls. The quality of marriage was assessed by SCL-90 EPQN SSRSX SF-36-MMSE Olson marriage quality questionnaire, and blood routine and biochemical routine tests were performed. Results: (1) the total score of SCL-90, total mean score, somatization, depression, anxiety and other factors in HD group were higher than those in normal group, (2) the neuroticism score in HD group was higher than that in normal group. (3) the utilization of social support in HD group was not as good as that in normal group, the total score and subjective support score of social support decreased with the increase of dialysis years, (4) the total score of SCL-90 and the weight of dialysis interval increased. The number of complications, serum potassium was positively correlated with hemoglobin concentration, and the utilization of social support was negatively correlated. (5) in HD group, it was significantly lower than that in normal population, age, occupational status, marital status, educational level. Malnutrition and complications had an effect on the quality of life of HD patients; (6) sexual satisfaction was lower in HD group; (7) MMSE score in HD group was lower than that in normal group, orientation, attention and calculation ability. The total score of MMSE was positively correlated with serum albumin and hemoglobin concentration, negatively correlated with age, weight gain during dialysis, and the number of complications. Conclusion: more complications and higher scores of EPQ-N have great influence on the psychological status of HD patients. Personality factors and social support also affect the mental health level of HD patients. Psychological and social factors and dialysis treatment itself affect the quality of life of HD patients. More complications, lower hemoglobin and lower serum albumin were closely related to patients' cognitive dysfunction.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2005
【分类号】：R395

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