四平市某醫(yī)院血液透析患者生存質(zhì)量調(diào)查
本文選題:終末期腎衰竭 + 血液透析; 參考:《吉林大學(xué)》2014年碩士論文
【摘要】:終末期腎衰竭是一種不可逆的疾病。隨著醫(yī)療科學(xué)技術(shù)的不斷發(fā)展,血液凈化設(shè)備不斷更新,反滲透水處理系統(tǒng)的不斷完善,使透析用水進(jìn)一步凈化,治療技術(shù)水平不斷提高以及患者對(duì)疾病的認(rèn)識(shí)增加,腎衰竭患者的成活率不斷提高。對(duì)于血液透析患者,治療的目標(biāo)不僅是生命的延續(xù),他們需要一個(gè)更好的生存質(zhì)量。目前透析的觀念和目標(biāo)是,努力提高透析患者的長期生存率;努力改善透析患者的生存質(zhì)量,F(xiàn)階段透析患者長期生存率已經(jīng)有了明顯的提高,患者可以存活10年甚至20年,隨著患者生存期的延長,單一的生物醫(yī)學(xué)模式已難以全面衡量疾病的治療、護(hù)理效果,目前患者的生存質(zhì)量已成為透析療效指數(shù)更準(zhǔn)確的評(píng)價(jià)。發(fā)達(dá)國家的歐洲和美國、日本等對(duì)維持性血液透析患者生存質(zhì)量研究起步較早,進(jìn)行的更多。而在中國,透析醫(yī)護(hù)人員長期受傳統(tǒng)觀念影響只重視透析治療、重視透析效能而忽視透析患者的生存質(zhì)量。對(duì)維持性血液透析患者生存質(zhì)量的報(bào)道國內(nèi)研究較晚,開展的比較少。近幾年,隨著人們對(duì)生存質(zhì)量的重視,相關(guān)研究已成為臨床醫(yī)護(hù)人員關(guān)注的焦點(diǎn)。但吉林省四平市尚缺乏相應(yīng)的報(bào)道。 目的:評(píng)估本院維持性血液透析患者的生存質(zhì)量的現(xiàn)狀及其影響因素,為提高維持性血液透析患者的生存質(zhì)量提供依據(jù)。 方法:①2013年1月至2014年8月期間在四平市中心人民醫(yī)院接受血液透析治療的慢性腎衰竭的尿毒癥期患者400例作為研究對(duì)象。 ②采用訪談法。由接診醫(yī)生親自對(duì)病人或患者家屬進(jìn)行詢問,了解情況。事先設(shè)計(jì)好調(diào)查問卷,由接診醫(yī)生填寫調(diào)查表。采用EXCEL2003軟件建立統(tǒng)一數(shù)據(jù)庫,由專人將調(diào)查表數(shù)據(jù)錄入數(shù)據(jù)庫,對(duì)每份調(diào)查表逐一審核,發(fā)現(xiàn)問題及時(shí)核對(duì)、更正、補(bǔ)缺。采用SPSS19.0軟件進(jìn)行統(tǒng)計(jì)分析。 結(jié)果:本次調(diào)查發(fā)放了400份問卷,,收回有效問卷400份。其中男性234例,女性166例。原發(fā)病診斷糖尿病引起的腎病占40.3%(161例),高血壓引起的腎病占31%(124例),腎小球腎炎占20.3%(81例),藥物引發(fā)的腎病占5.3%(21例),其它占3.1%(13例)。患有乙型肝炎的患者占7%(28例),患有丙型肝炎的患者占8.7%(35例)。體質(zhì)指數(shù)(BMI)大于或等于28的患者占17.8%(71例)。貧血的患者占63%(252例),低蛋白的患者占68.5%(274例)。本院維持性血液透析患者生存質(zhì)量SF-36的總體評(píng)分為:48±15;颊叩哪挲g、原發(fā)病、家庭里有無配偶的支持、在職情況等因素與生存質(zhì)量有關(guān)。 結(jié)論:1患者年齡與生存質(zhì)量有關(guān)聯(lián),高年齡往往呈現(xiàn)低生存質(zhì)量,年齡越大生理功能越差,年齡越小生理功能越好。 2就業(yè)者生存質(zhì)量高于失業(yè)者。 3對(duì)于血液透析患者,家庭為主要的支持者,積極的家庭支持與患者的生存質(zhì)量呈正相關(guān)系。 4我院透析患者生存質(zhì)量狀況不是很理想,生存質(zhì)量受多種因素影響,醫(yī)療和護(hù)理人員在臨床實(shí)踐中除了應(yīng)重視透析患者的年齡、家庭支持、工作情況等直接影響透析患者生存質(zhì)量的因素外,還應(yīng)關(guān)注患者的性別、家庭人均收入、體育鍛煉、BMI、糖尿病病史、內(nèi)瘺手術(shù)次數(shù)、血漿白蛋白水平等因素。在對(duì)透析患者的生存質(zhì)量問題調(diào)查的基礎(chǔ)上,通過有效的醫(yī)療和護(hù)理干預(yù)來提高透析患者的生存質(zhì)量。
[Abstract]:End-stage renal failure is an irreversible disease. With the development of medical science and technology, blood purification equipment constantly updated, the reverse osmosis water treatment system of continuous improvement, the further purification of hemodialysis water treatment technology, and constantly improve the level of disease awareness increased in patients with renal failure, the survival rate continues to increase. For hemodialysis patients, the treatment goal is not only the continuation of life, they need a better quality of life. The dialysis concept and goal, and strive to improve the long-term survival rate of dialysis patients; to improve the quality of life in dialysis patients. At the present stage of dialysis patients long-term survival rate has been markedly improved, patients can survived for 10 years or even 20 years, along with the prolongation of survival, treatment effect, single biomedical model has been difficult to comprehensive measure of disease nursing, patient survival at present The quality evaluation of dialysis efficacy index has become more accurate. The developed countries of Europe and the United States, Japan and so on maintenance hemodialysis on quality of life in dialysis patients started earlier, the more. But in China, long-term dialysis staff affected by the traditional concept of only pay attention to the quality of life on dialysis, dialysis efficiency and ignore the importance of dialysis patients. To maintain the quality of life of patients with hemodialysis reported in domestic research later carried out less. In recent years, as people pay more attention to the quality of life, related research has become the focus of attention of the medical staff. But the Siping City of Jilin Province is lack of relevant reports.
Objective: To evaluate the quality of life and its influencing factors of maintenance hemodialysis patients in our hospital, so as to provide evidence for improving the quality of life of maintenance hemodialysis patients.
Methods: 1. From January 2013 to August 2014, 400 patients with chronic renal failure who were treated by hemodialysis in Siping Central People's hospital were selected as subjects.
The interviews were used by doctors. The patient in person or family members of patients were asked to understand the situation. The designed questionnaire, the questionnaire was filled by doctors. EXCEL2003 software was used to build a unified database, the questionnaire data for each questionnaire review, found problems in a timely manner to correct, check, fill a vacancy. SPSS19.0 software was used for statistical analysis.
Results: the survey provided 400 questionnaires, 400 valid questionnaires. There were 234 males and 166 females. The diagnosis of primary disease caused by diabetes nephropathy accounted for 40.3% (161 cases), hypertension induced nephropathy accounted for 31% (124 cases), glomerulonephritis accounted for 20.3% (81 cases), drug induced nephropathy accounted for 5.3% (21 cases), other 3.1% (13 cases). Patients with hepatitis B patients accounted for 7% (28 cases), suffering from hepatitis C patients accounted for 8.7% (35 cases). The body mass index (BMI) greater than or equal to 28 of the patients accounted for 17.8% (71 cases). Patients with anemia accounted for 63% (252 cases), low protein accounted for 68.5% of patients (274 cases). The score of SF-36 maintain the overall quality of life of patients with hemodialysis: 48 + 15. patients age, primary disease, there is no spouse to support the family, working conditions and other factors related to the quality of life.
Conclusion: the age of 1 is associated with the quality of life, the higher the age is, the lower the quality of life, the older the older the physiological function is, the smaller the age, the better the physiological function.
2 the quality of life of the workers is higher than that of the unemployed.
3 for hemodialysis patients, family as major supporters, positive family support and Cheng Zhengxiang relationship with the patient's quality of life.
4 our hospital dialysis survival condition is not ideal, the quality of life is affected by many factors, medical and nursing staff in clinical practice in dialysis patients should pay attention to the age, family support, working conditions and other direct factors that affect the quality of life in dialysis patients, but also should pay attention to patients' gender, family income, physical exercise, BMI, history of diabetes, the number of internal fistula surgery, plasma albumin level factors. Based on the quality of life survey in dialysis patients on dialysis, to improve the quality of life of patients by medical treatment and effective nursing intervention.
【學(xué)位授予單位】:吉林大學(xué)
【學(xué)位級(jí)別】:碩士
【學(xué)位授予年份】:2014
【分類號(hào)】:R692.5
【參考文獻(xiàn)】
相關(guān)期刊論文 前10條
1 張靜平,劉華容;家庭支持對(duì)血液透析病人生活質(zhì)量的影響[J];湖南醫(yī)科大學(xué)學(xué)報(bào);2001年04期
2 謝紅浪;劉志紅;季大璽;徐斌;黎磊石;;糖尿病腎病維持性血液透析長期生存率及其相關(guān)因素分析[J];腎臟病與透析腎移植雜志;2008年05期
3 劉志紅;;中國腎臟病診治三十年回顧與展望[J];中國實(shí)用內(nèi)科雜志;2012年01期
4 夏俊;;法國的烹飪之王——Auguste Escoffier[J];上海調(diào)味品;2007年07期
5 陳文華,吳克芬,金先橋;腎臟透析患者的運(yùn)動(dòng)療法[J];現(xiàn)代康復(fù);2001年05期
6 吳明方;慢性腎功能不全患者的運(yùn)動(dòng)處方[J];中國臨床康復(fù);2002年15期
7 中華醫(yī)學(xué)會(huì)腎臟病分會(huì)透析移植登記工作組 ,錢家麒,張偉明 ,徐筱琪;1999年度全國透析移植登記報(bào)告[J];中華腎臟病雜志;2001年02期
8 馬祖等,鄭智華,張滌華,郝元濤,葉任高,婁探奇,毛曉玲,劉巖,劉冠賢,朱起之,張?jiān)鋈A,汪華林,傅君舟,余學(xué)清;血液透析和腹膜透析患者生存質(zhì)量的多中心調(diào)查[J];中華腎臟病雜志;2004年06期
9 黃小妹,張英,張黎民,伊平,汪賢聰,常耀武,高明,唐雅文,李紅兵;武漢地區(qū)維持性血液透析患者生活質(zhì)量及影響因素[J];中華腎臟病雜志;2005年02期
10 李魯,王紅妹,沈毅;SF-36健康調(diào)查量表中文版的研制及其性能測(cè)試[J];中華預(yù)防醫(yī)學(xué)雜志;2002年02期
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