【摘要】目的了解成都市血液透析患者与家属对社区开展血液透析态度的差异性。方法选择成都市11 所医院的673 例血液透析患者和386 例家属作为研究对象。结果仅17.1%的患者和21.2%的家属曾听说过“社区血液透析”，两者间差异无统计学意义(c2=2.798，P=0.094)。患者自评的“建立社区血液透析中心必要性”、“社区血液透析中心治疗的接受度”2 个条目得分均低于家属[(2.14±1.11)比
(2.32±1.07)；(1.76±1.22)比(2.03±1.18)]，差异均有统计学意义(t=-2.577，P=0.010；t=-3.440，P=0.001)。就社区血液透析中心的类型而言，家属对公立医院和社区共同建立、社区卫生中心单独建立、公立医院和企业共同建立、企业出资单独建立的社区血液透析中心的接受度得分均高于患者[(2.08±1.18)比(2.39±1.12)；(1.77±1.09)比(2.17±1.11)；(1.85±1.10)比(2.16±1.11)；(1.68±1.08)比(1.99±1.13)]，差异均有统计学意义(t=-4.258，P＜0.001；t=-5.811，P＜0.001；t=-4.472，P＜0.001；t=-4.388，P＜0.001)。结论成都市血液透析患者和家属对社区血液透析的必要性和接受度处于较低水平。家属认为建立社区血液透析中心更有必要、对社区血液透析的接受度更高，且家属对不同类型的社区血液透析中心的接受程度高于患者。提示政府部门和公立医院机构应相互合作，制定有效措施，加强对社区透析的宣传，合理引导患者，提高患者与家属对社区透析的知晓和认识，减轻家属的照护负担。
【Abstract】Objective To understand the difference in the attitude of hemodialysis patients and their families towards hemodialysis in community in Chengdu. Methods A total of 673 hemodialysis patients and 386 family members from 11 hospitals in Chengdu were selected for the study. Results Only 17.1% of patients and 21.2% of family members had heard of "community hemodialysis", and there was no significant difference between patients and their family members (c2=2.798, P=0.094). The scores of self-assessed "necessities for establishing a community hemodialysis center" and "acceptance of treatment in a community hemodialysis center" were lower in patients than in their families (2.14±1.11 vs. 2.32±1.07; 1.76±1.22 vs. 2.03±
1.18), and the differences were statistically significant (t=-2.577, P=0.010; t=-3.440, P=0.001). In terms of the type of community hemodialysis centers, the acceptance scores of community hemodialysis centers jointly established by public hospitals and communities, community health centers alone, public hospitals and enterprises, and by enterprises alone were higher in family members than in patients (2.08±1.18 vs. 2.39±1.12; 1.77± 1.09 vs. 2.17±1.11; 1.85±1.10 vs. 2.16±1.11; 1.68±1.08 vs. 1.99±1.13). The differences were statistically significant (t=-4.258, P<0.001; t=-5.811, P<0.001; t=-4.472, P<0.001; t=-4.388, P<0.001). Conclusion The awareness and acceptance of community hemodialysis are low in patients and their families in Chengdu. Family members believe that it is necessary to establish a community hemodialysis center, with higher acceptance of community hemodialysis and different types of community hemodialysis centers than patients. The attitudes to community hemodialysis prompt government departments and public hospital institutions to cooperate with each other, design effective measures, strengthen the education and guidance of community dialysis, improve the awareness of patients and family members on community dialysis, and reduce the burden of medical care to family members.
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