积极心理学视角下维持性血液透析患者生活质量现状及影响因素分析

目的 探讨维持性血液透析患者的生活质量现状及影响因素。方法 采用便利抽样方法抽取258例维持性血液透析患者，运用中文版慢性病自我效能量表、中文版简易心理弹性量表和中文版生活质量量表对其进行测量，采用多元线性回归分析生活质量影响因素。结果 维持性血液透析患者生活质量的8个维度得分均低于国内常模；多元线性回归分析结果显示，年龄、心理弹性和自我效能的症状管理维度可预测维持性血液透析患者的生理健康总评（调整R2=0.253,P<0.001）；每日尿量、医疗费用支付方式、心理弹性和自我效能的症状管理维度可预测维持性血液透析患者的心理健康总评（调整R2=0.375,P<0.001）。结论维持性血液透析患者的生活质量水平较低，且除一般资料中的年龄、每日尿量和医疗费用支付方式外，自我效能和心理弹性是其生活质量的重要预测因子。提示医护人员在临床工作中可提高对患者积极心理因素的关注，针对性采取措施改善其生活质量。

Current status of quality of life of maintenance hemodialysis patients from perspective of positive psychology and its influencing factors

Objective To explore the status quo of quality of life in maintenance hemodialysis patients and its influencing factors. Methods Convenient sampling was used to select 258 maintenance hemodialysis patients, and they were surveyed by using Self-efficacy for Managing Chronic Disease 6-item Scale, 10-item Connor-Davidson Resilience Scale and Short From of 36 Health Survey Questionnaire Scale. Multivariate linear regression analysis was used to analyze the influencing factors of quality of life. Results The score of eight dimensions of quality of life in maintenance hemodialysis patients was lower than the norm in China. Multivariate linear regression analysis showed that age, psychological resilience and symptom management could predict the physical component summary of maintenance hemodialysis patients (adjusted R²=0.253,P<0.001); and daily urine volume, medical expense payment, psychological resilience and symptom management could predict the mental component summary of maintenance hemodialysis patients (adjusted R²=0.375, P<0.001). Conclusion Maintenance hemodialysis patients have lower quality of life, and in addition to general information such as age, daily urine volume and medical expense payment, self-efficacy and psychological resilience are also important predictors of their quality of life. It is suggested more attention should be paid to positive psychological factors of patients in clinical practice, and targeted measures should be taken to improve their quality of life.