维持性血液透析患者的应对方式、社会支持及情感状态

目的从多角度了解维持性血液透析患者的社会心理状况,为进一步提高其生活质量提供资料。方法287例维持性血液透析患者来自武汉市4家血液透析中心。用医学应对问卷(MCMQ),社会支持度评定量表及情绪状态问卷(POMS)来评价患者的社会心理状况,并用pearsons’相关分析了解各变量间的关系。结果70%的患者无工作,经济收入低于1000元/月,但80%的患者医疗费自付比例大于20%,近20%的患者为100%自费。其MCMQ问卷中屈服分值明显高于常模,且与POMS问卷中负性情感因素如紧张-焦虑(T),忧郁-沮丧(D),愤怒-敌意(A),疲惫-惰性(F)及困惑-迷茫(C)呈正相关,而与活力-好动(V)呈负相关。社会支持评定量表中对支持的利用度及社会支持总分与患者的情感状态相关。面对、屈服与客观支持和对支持的利用度呈正相关,而回避则与两者呈负相关。结论维持性血液透析患者经济负担重,易采取消极的应对方式,易产生消极的情感。而好的社会支持可改善其应对方式及情感状态。

Medical coping mode, social support and mood states in chronic hemodialysis patients

Objective To understand the social and psychologic status of maintenance hemodialysis patients for improving their quality of life. Methods Two hurndred and eighty sever chronic hemodialysis patients from four different hemodialysis center in Wuhan were evaluated. Their social and psychologic status were measured by following three questionnaires, medical coping mode questionnaire(MCMQ), social support questionnaire and profile of mood states(POMS), the relationships among variables were studied by Pearsons' correlation analysis. Results About 70% of the patients were out of work and their earnings were below 1000 RMB per month, but 80% of them had to bear at least 20% of total medical expenditure. Acceptance-resignation in chronic hemodialysis patients correlated positively with negative mood scores such as Tension-Anxiety, Depression-Dejection, Anger-Hostility, Fatigue-Inertia and Confrontation-Bewilderment, but it had negative correlation with Vigor-Activity. Social support scores also correlate with mood scores. Confrontation and Acceptance-Resignation correlated with Objective Support score and Support Using score, but Avoidance correlated negatively with them. Conclusion Chronic hemodialysis patients had heavy economic burden, they tended to negative medical coping mode and negative mood status. Good social support can improve their mood status and medical coping mode.