叙事护理对中青年维持性血液透析患者负性情绪及治疗依从性的影响
Journal: Basic Medical Theory Research DOI: 10.32629/bmtr.v8i3.20458
Abstract
目的：探讨叙事护理对中青年维持性血液透析（MHD）患者焦虑、抑郁情绪、疾病感知及治疗依从性的干预效果。方法：采用便利抽样法选取我院血液净化中心2025年1—6月42例中青年MHD患者，采用自身前后对照设计，所有患者接受常规护理联合12周（共6次）个性化叙事护理。评估干预前后实施效果。结果：干预后，患者HADS焦虑、抑郁评分，BIPQ总分均显著低于干预前，治疗依从性总分显著高于干预前（均P<0.01）。单因素及多元线性回归分析显示，文化程度、透析龄、婚姻状况影响患者相关指标，其中文化程度是焦虑、抑郁及治疗依从性的独立影响因素，透析龄是疾病感知的独立影响因素，已婚患者依从性更高。结论：叙事护理可有效缓解中青年MHD患者负性情绪，改善疾病感知，提升治疗依从性，值得临床推广。
Keywords
叙事护理；维持性血液透析；负性情绪；治疗依从性
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[3] 张莹,李亚洁,王彩云.中青年维持性血液透析患者重返工作准备度及影响因素研究[J].中华护理杂志,2022,57(15):1830-1836.
[4] Liu FX, Rutherford P, Smoyer-Tomic K. The prevalence of depression and the association between depression and kidney function in chronic kidney disease: a systematic review and meta-analysis.Int Urol Nephrol. 2023; 55(6): 1551-1562.
[5] 刘桂娟,王丽,孙慧.维持性血液透析患者焦虑抑郁现状及干预研究进展[J].中国血液净化,2021,20(5):345-348.
[6] Chan R, Dear BF, Titov N, et al. Examining the psychometric properties of the Brief Illness Perception Questionnaire in patients with end-stage kidney disease.J Psychosom Res. 2023; 164: 111081.
[7] 黄辉,刘义兰.叙事护理学[M].北京:人民卫生出版社,2021.
[8] Zigmond A S,Snaith R P. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983, 67(6): 361-370.
[9] Broadbent E, Petrie K J, Main J, et al. The Brief Illness Perception Questionnaire. J Psychosom Res. 2006, 60(6): 631-637.
[10] Kim Y,Evangelista L S.Relationship between illness perceptions, treatment adherence, and clinical outcomes in patients on maintenance hemodialysis: A prospective study.Nephrol Nurs J. 2023; 50(2): 139-148.
[11] 王静,李萍.叙事护理对中青年血液透析患者治疗依从性与希望水平的影响[J].中国实用护理杂志,2023,39(4):241-247.
[12] Charon R. The principles and practice of narrative medicine.Oxford University Press. 2021.
[13] Clark S,Farrington K,Chilcot J.The value of psychological skills support for haemodialysis staff and patients: A systematic review.J Renal Care. 2022; 48(2): 98-105.
[14] 陈丽,张悦,李艳.维持性血液透析患者治疗依从性影响因素及护理干预研究[J].中国血液净化,2022,21(3):256-258.
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