社会支持与自我效能对血液透析患者抑郁影响的研究.docVIP

社会支持与自我效能对血液透析患者抑郁影响的研究 孙 静 曹成琦 王丽娟 【摘要】 目的 了解持续性血液透析患者的抑郁状况，分析社会支持及自我效能对抑郁的影响，为临床更有针对性的改善患者的抑郁状况提供理论依据。方法 采用问卷调查法，对80例持续性血液透析患者进行问卷调查。结果 持续性血液透析患者抑郁发生率为60.0%，单因素分析发现女性抑郁得分高于男性（t=-2.11，P＜0.05）；自费患者抑郁得分高于医保和公费患者（F=3.68，P＜0.05），自我效能感（t=-3.637，P＜0.001）和社会支持(t=-2.089，P＜0.05)进入回归方程，R2值为0.273。结论 持续性血液透析患者抑郁发病率较高，与自我效能低、社会支持低有关。护理人员应有效识别抑郁的影响因素，采取针对性的护理措施，尤其是对自我效能感差、社会支持少的患者。 【关键词】 持续性血液透析；抑郁；自我效能；社会支持 Depression in persistent hemodialysis patients and its influencing factors Sun Jing, Cao Cheng-qi, Wang Li-juan 【Abstract】Objective To investigate the prevalence of depression in persistent hemodialysis patients, and to analyze the factors that influence depression, in order to provide theoretical basis for the improvement of clinical depression in persistent hemodialysis patients. Methods A questionnaire survey was conducted among 80 patients with persistent hemodialysis. Results Depression prevalence in persistent hemodialysis patients was 60.0%. Univariate analysis showed that female had higher depression scores than men (t=-2.11，P＜0.05); patients with health insurance had higher depression scores than their own expense and public patients (F = 3.68, P 0.05). Self-efficacy (t=﹣3.637, P 0.001) and social support (t=﹣2.089, P 0.05) entered the regression equation of depression, and the value of R2 was 0.273. Conclusion Persistent hemodialysis patients have a higher prevalence of depression due to low self-efficacy and low social support. Nurses should identify influencing factors of depression effectively and take appropriate care measures, especially for those patients with poor self-efficacy and fewer social supports. 【Key words】Persistent hemodialysis; Depression; Self-efficacy; Social support 维持性血液透析是终末期肾衰竭患者重要的肾脏替代疗法之一[1]。血透患者需要终身治疗，精神、精力以及经济上都要承受长期而巨大的压力，因此存在不同程度的心理问题。研究显示，抑郁是长期治疗患者最常见的心理问题之一[2]，国内外研究发现血透患者抑郁发病率在20%～70%之间[3-5]，且与患者疾病预后、生活质量有着密切的关系[6]。研究发现，慢性病患者自我管理能力、社会支持以及自我效能与抑郁情绪的缓解密切相关[7-8]。自我效能感指的是个体对自己是否有能力完成某一行为的推测和判断, 是个体对应付生活中各种困难和挑战的自信心，高自我效能感个体相信自己能够对外界环境