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护理研究

维持性血液透析患者症状群及前哨症状的研究

  • 肖雯怡 ,
  • 陶馨 ,
  • 李娟娟 ,
  • 王丽娟 ,
  • 张淼 ,
  • 葛玉荣
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  • 750004 银川,1宁夏医科大学护理系
    750002 银川,宁夏回族自治区人民医院2血液净化中心 3教师发展与教学质量监控办公室

收稿日期: 2024-10-30

  修回日期: 2025-01-25

  网络出版日期: 2025-04-12

基金资助

宁夏自然科学基金(2023AAC03453)

Study on symptom group and sentinel symptom of maintenance hemodialysis patients

  • XIAO Wen-Yi ,
  • TAO Xin ,
  • LI Juan-Juan ,
  • WANG Li-Juan ,
  • ZHANG Miao ,
  • GE Yu-Rong
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  • Department of Nursing,Ningxia Medical University, 750004; 2 Blood Purification Center and 3Office of Teacher Development and Teaching Quality Monitoring,Ningxia People's Hospital, 750002

Received date: 2024-10-30

  Revised date: 2025-01-25

  Online published: 2025-04-12

摘要

目的  探讨维持性血液透析患者症状群及其前哨症状,为及早发现识别症状、简化症状群的管理及症状群精准化管理提供参考。 方法  采用便利抽样法选取宁夏回族自治区人民医院血液净化中心的维持性血液透析患者,运用主成分分析并联合最大方差正交旋转的方式来提取症状群,借助Apriori算法对前哨症状予以判定。 结果  共提取出5个透析期间症状群:尿毒症症状群、情绪症状群、电解质紊乱症状群、胃肠道不适症状群及睡眠障碍症状群,Cronbach’s α系数分别为0.853、0.923、0.850、0.797、0.898;Apriori关联分析及判定结果显示:皮肤干燥、忧虑、很难让腿静止不动、便秘、入睡困难依次为上述症状群的前哨症状。 结论  维持性血液透析患者在透析期间存在多种症状,每个症状群中均有前哨症状。建议医护人员日后可把前哨症状当作评估与管理症状群的的着手点,实施相应干预措施,提高症状管理效率,增加MHD患者治疗依从性,减少患者疾病负担,提高生活质量。

本文引用格式

肖雯怡 , 陶馨 , 李娟娟 , 王丽娟 , 张淼 , 葛玉荣 . 维持性血液透析患者症状群及前哨症状的研究[J]. 中国血液净化, 2025 , 24(04) : 348 -352 . DOI: 10.3969/j.issn.1671-4091.2025.04.019

Abstract

Objective  To explore the symptom clusters and their sentinel symptoms in patients undergoing maintenance hemodialysis, providing a reference for the early detection and identification of symptoms, the simplification of symptom cluster management, and the precise management of symptom clusters. Method  The convenience sampling method was adopted to select maintenance hemodialysis patients from the Blood Purification Center of the People's Hospital of Ningxia Hui Autonomous Region. Symptom clusters were extracted by using principal component analysis combined with the orthogonal rotation method of maximum variance. The Apriori algorithm was employed to determine the sentinel symptoms. Result  During dialysis, five symptom clusters were extracted from the patients: the uremic symptom cluster, the emotional symptom cluster, the electrolyte disorder symptom cluster, the gastrointestinal discomfort symptom cluster, and the sleep disorder symptom cluster. Their Cronbach's α coefficients were 0.853, 0.923, 0.850, 0.797, and 0.898, respectively. The results of Apriori correlation analysis and determination showed that skin dryness, anxiety, difficulty in keeping the legs still, constipation, and difficulty in falling asleep were the sentinel symptoms of the above-mentioned symptom clusters in sequence. Conclusion During the dialysis period, maintenance hemodialysis patients experience a variety of symptoms, and each symptom cluster contains sentinel symptoms. In light of this, it is recommended that medical staff in the future consider sentinel symptoms as the starting point for the assessment and management of symptom clusters. Subsequently, corresponding intervention measures can be implemented to enhance the efficiency of symptom management, improve the compliance of MHD patients, thereby reducing patients' disease burden and enhancing their quality of life.

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