目的 调查维持性腹膜透析(peritoneal dialysis，PD)患者的舒适状况并分析其影响因素。方法 采用方便抽样，选择2019年1月～2022年6月于中山大学附属第一医院随访的PD患者。采用自制的PD患者舒适量表评估患者的舒适状况，同时收集患者的人口学资料及临床数据。 结果 共有212例PD患者纳入本研究。入组患者的平均年龄(46.5±13.2)岁，男性占56.1%，中位PD龄28.6(10.3，64.0)月，基础肾脏病主要为肾小球肾炎(63.7%)。患者舒适量表总分为(93.2±11.2)分，各维度条目平均分显示生理维度最低为(3.3±0.5)分，其次是心理维度(3.5±0.5)分和社会维度条目(3.5±0.5)分，而环境维度条目平均得分较高为(3.8±0.4)分。多元线性回归结果显示较大的年龄(β=0.136，P=0.027)及较高的总肌酐清除指数(β=0.160，P=0.046)是PD患者舒适量表总分的独立保护因素。 结论 临床护理人员应在护理过程中改善维持性腹膜透析患者生理不适、注重心理护理及加强社会支持,同时对年纪较轻、总肌酐清除指数较低的患者给予更多的关注。
Objective This study investigated the comfort status of patients with maintenance peritoneal dialysis (PD) and analyzed its influence factors. Methods Convenience sampling was used to select patients with PD who were followed up in the First Affiliated Hospital of Sun Yat-sen University from January 2019 to June 2022. The comfort status of PD patients was evaluated by the self-made comfort scale of PD. Demographic data and clinical data were also collected. Results A total of 212 maintenance PD patients were included in this study. Their mean age was 46.5±13.2 years, 56.1% were male, the median duration of PD was 28.6 (10.3,64.0) months, and glomerulonephritis was the primary renal disease in 63.7% of the patients. The total score of comfort scale was 93.2±11.2 points, and the mean score of each dimension item showed that the mean score of physiological dimension was the lowest (3.3±0.5 points), followed by the mean score of psychological dimension and social dimension items (3.5±0.5 points and 3.5±0.5 points respectively); the mean score of environmental dimension item was higher (3.8±0.4 points). Multivariate linear regression showed that older age (β=0.136, P=0.027) and higher level of total creatinine clearance index (β=0.160, P=0.046) were the independent protective factors for the total score of comfort scale. Conclusions Clinical nurses should improve the physical discomfort of maintenance PD patients, strengthen psychological nursing and social support in the process of nursing, and pay more attention to the younger patients and patients with lower total creatinine clearance index.
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