维持性血液透析患者症状群调查研究

Symptom clusters among patients with maintenance hemodialysis

摘要:

目的：了解维持性血液透析（maintenance hemodialysis，MHD）患者症状发生率及严重程度，探讨症状群的分类构建。方法：采用自行设计的患者一般情况表、透析患者症状评估量表对重庆市4所三级甲等医院血液透析中心的280名MHD患者进行调查，获得资料采用描述性分析、相关分析及因子分析进行检验。结果：MHD患者发生率最高的5项症状依次为皮肤干燥（75.7%）、瘙痒（73.2%）、性欲减退（70.5%）、易惊醒（63.2%）、入睡困难（62.5%），而严重程度最明显的5项症状为瘙痒、皮肤干燥、口干、入睡困难、易惊醒。因子分析显示存在情感、疼痛疲乏、消化道、心肺系统、水电解质5个症状群，解释变异量的58.68%。结论：MHD患者经历多个症状群，医护人员应制定针对性护理措施，行有效的症状管理，提高患者生活质量。

Abstract:

Objective：To investigate the incidence and severity of symptoms of maintenance hemodialysis（MHD） and to discuss the classification and construction of symptom clusters. Methods：Totally 280 patients with MHD in hemodialysis center of 4 first-class hos－pitals in Chongqing were enrolled and investigated by completing dialysis symptom index and a self-designed general information questionnaire. Data were analyzed by descriptive statistics，correlation analysis and factor analysis. Results：Dry skin（75.7%），itching（73.2%），decreased interest in sex（70.5%），trouble staying sleep（63.2%），trouble falling sleep（62.5%） were the five most prevalent symptoms. The top five severe symptoms experienced by participants were itching，dry skin，dry mouth，trouble falling sleep，trouble staying sleep. Factors analysis indicated five symptom clusters，namely emotion，pain fatigue，digestive tract，cardiopulmonary system，water electrolyte，accounting for 58.68% of the total variance. Conclusions：Patients with MHD experienced several symptom clusters，medical staff should construct targeted nursing interventions to ensure the effective symptom management and improve patients’ life quality.