【摘要】目的探讨接受维持性血液透析患者中灵性需求在社会支持与治疗依从性的中介效应,为提高患者生存质量提供参考。方法选取171 名维持性血液透析(maintenance hemodialysis,MHD)患者,采用治疗依从性量表、社会支持评定量表和中文版灵性需求量表进行问卷调查。结果MHD 患者治疗依从性、社会支持、灵性需求总分分别为(89.51±13.32)分、(38.36±8.00)分、(91.78±14.60)分;MHD患者治疗依从性与社会支持总分(r=0.204,P=0.005)、灵性需求总分(r=0.184,P=0.018)呈正相关,社会支持与灵性需求总分(r=0.207,P=0.008)呈正相关;灵性需求在治疗依从性与社会支持之间起部分中介效应,中介效应值为0.203。结论尽量满足MHD 患者的灵性需求,能够增强其社会支持,进而提高其治疗依从性。
【Abstract】Objective To explore the mediating effect of spiritual needs on social support and medical treatment adherence, and to provide references for improving quality of life in maintenance hemodialysis (MHD) patients. Method A total of 171 MHD patients were selected by convenience method. They were investigated using the Medical Treatment Adherence Scale, the Spiritual Needs Scale, and the Social Support Rating Scale. Result The total scores of medical treatment adherence, social support and spiritual needs were 89.51±13.32, 38.36±8.00 and 91.78±14.60 respectively in the MHD patients. The total score of medical treatment adherence was positively corelated with the total score of social support (r=0.204, P=0.005), and the total score of spiritual needs (r=0.184, P=0.018); the total score of social support was positively correlated with the total score of spiritual needs (r=0.207, P=0.008). Spiritual needs played a part of mediating effect between medical treatment adherence and social support, with the mediating effect of 0.203. Conclusion Sufficient spiritual needs carried to MHD patients will enhance their social support and improve their medical treatment adherence.
[1]Saran R, Robinson B, Abbott K C, et al.US Renal Data System 2017 Annual Data Report: Epidemiology of Kidney Disease in the United States[J].Am J Kidney Dis, 2018, 71(3):A7-A7
[2]Denhaerynck K, Manhaeve D, Dobbels F, et al.Prevalence and consequences of non-adherence to hemodialysis regimens[J].Am J Crit Care, 2007, 16(3):222-235
[3]冯苏琴,梅游英.维持性血液透析患者治疗依从性危险因素分析及护理对策[J].浙江医学教育, 2019, 18(5):35-37
[4]Bussing A,Pilchowska I,Surzykiewicz J.Spiritual Needs of Polish Patients with Chronic Diseases[J].J Relig Health, 2015, 54(5):1524-1542
[5] 孙盼盼.癌症患者灵性需求、疾病感知和社会支持的相关研究.[J].大连医科大学硕士学位论文, 2019, 1(1):28-30
[6] 张艳.终末期肾病维持性血液透析患者治疗依从性量表的编制 [D].长沙:中南大学, 2012:23 34.
[7]Yong J,Kim J,Han S,et a.Development and validation of a scale assessing spiritual needs for Korean patients with cancer[J].J Palliat Care, 2008, 24(4):240-246
[8]成琴琴,刘翔宇,谌永毅,等.中文版灵性需求量表的信效度研究[J].护理学杂志, 2018, 33(3):16-19
[9]肖水源.社会支持评定量表》的理论基础与研究应用[J].临床精神医学杂志, 1994, 4(2):98-100
[10]. 汪向东,王希林,马弘,等.心理卫生评定量表手册[M]. 北京:中国心理卫生杂志社,1999:112-115.
[11] 齐永扎.维持性血液透析患者疾病认知与治疗依从性关系的研究.[J].安徽医科大学硕士学位论文, 2016, 1(1):20-21
[12]李西娟,吴淑华,史媛媛,等.血液透析患者社会支持与应对方式的相关性分析[J].中华护理杂志, 2013, 48(5):442-443
[13]张颖君,熊晓红,袁怀红.维持性血液透析患者健康素养和社会支持的现状分析[J].重庆医学, 2018, 47(29):3792-3793
[14]史岩, 张卉悦, 陈长英,等.乳腺癌患者灵性需求现状及其影响因素[J].解放军护理杂志, 2019, 36(10):25-27
[15]薛丽娜,李香利,贺春熙,等.温州市某医院癌症患者灵性护理需求与社会支持度的相关分析[J].医学与社会, 2019, 32(1):113-115
[16]Ramezani M, Ahmadi F, Mohammadi E, et al.Spiritual care in in nursing: a concept analysis[J].Int Nurs Rev, 2014, 61(2):211-219
[17]Harold GK.Religion,spirituality,and health: a review and update[J].Advances in mind-body medicine, 2015, 29(3):19-26
[18]Hong SJ,Lee E.Korean hospice nursing interventions using the Nursing Interventions Classification system: a comparison with the USA[J].Nursing & Health Sciences, 2014, 16(4):434-441