非医疗因素对长期腹膜透析患者生存质量的影响

目的研究可能影响长期腹膜透析患者生存质量的非医疗因素，旨在为临床工作中如何提高患者的生存质量提供依据。方法采用横断面研究方法调查79例慢性肾衰竭进行持续非卧床腹膜透析（CAPD）患者。记录患者的年龄、性别、工作状况、文化程度、医疗负担及家庭支持等情况。采用国际通用的KDQOL-SFTM1．2中的短表SF-36评估患者的生存质量。采用汉密尔顿焦虑抑郁量表评估患者的焦虑、抑郁指数。结果SF-36评估患者的生存质量提示：CAPD患者生存质量的8个方面得分均显著低于中国一般人群（P〈0．05或〈0．01）；在职患者和有医疗保障患者sF-36得分分别为（45．78±16．93）分和（49．62±13．20）分，明显高于非在职患者的（32．65±12．26）分和无医疗保障患者的（33．85±6．24）分（P〈0．05）；人均年收入越高的家庭，患者生存质量就越高；有子女和老伴共同照顾的患者生存质量最高，而由保姆或个人照顾的患者生存质量最低；79例患者中焦虑的发生率为54．4％（43/79），抑郁的发生率为15．2％（12/79），二者均与生存质量呈显著负相关。结论家庭支持、工作状况、医疗保障和心理障碍均对CAPD患者的生存质量产生重要影响。

The effect of non-medical factors on the quality of life in maintenance peritoneal dialysis patients

Objective To evaluate the quality of life （QOL） in continuous ambulatory peritoneal dialysis （CAPD） patients and analyze the non-medical factors influencing QOL in order to explore the possible way to improve QOL in peritoneal dialysis （PD） patients. Methods Seventy-nine chronic renal failure patients treated with PD included in the present study. Investigated their age, sex, working status, education, medical burden and family support. Patients＇ QOL was evaluated by international questionnaire KDQOUSF-36. Patients＇ anxiety/depression status was evaluated by Hamilton depression questionnaire. Results （ 1 ） The SF-36 with its eight scales of CAPD patients were markedly lower than ordinary people（P〈 0.05 or 〈 0.01 ）. （2） Comparing with those on work, the patients without work got lower SF-36 scores （45.78 ± 16.93 ） scores vs （32.65 ± 12.26） scores, P 〈 0.05 ]. Comparing with those who had medical care, the patients without medical care got much lower SF-36 scores （49.62 ± 13.20）scores vs （33.85 ± 6.24）scores, P〈O.05]. Patients with higher income had better QOL. （3） Patients cared by their children and companion had the highest SF-36 （68.33 ± 14.73） scores], while those cared by nursemaid or themselves had the lowest （27.98 ± 15.77） scores ]. （4） Among the 79 patients, 43 patients （54.4%） were anxiety and 12 patients （15.2%） were depression. QOL was negatively correlated with anxiety index and depression index. Conclusion The QOL of CAPD patients are remarkably low, which is deeply influenced by many non-medical factors such as working status, medical burden, family support and emotional status.