维持性血液透析患者社会支持、职业对遵医行为影响研究

目的了解维持性血液透析患者社会支持状况与遵医行为关系。方法采用社会支持评定量表（SSRS）和自行设计调查问卷对百色市人民医院2011年11月～2012年11月100例维持性血液透析患者进行调查分析。结果SSRS高支持组与低支持组社会支持总得分、客观支持、主观支持、社会支持利用度得分比较高支持组：（43．36±4．85）分、（11.29±2．81）分、（23．45±3．92）分、（8．62±1．81）分；低支持组：（32．07±4．08）分、（9．02±1．63）分、（16．73±3．45）分、（6.31±1．82）分1，差异均有统计学意义（均P〈0．05）。高支持组患者完全（63．64％）和不完全按时血透治疗（36．36％）、完全不遵照日常饮食指导进食（18．18％）与低支持组（26．67％、73.33％、40．00％）比较，差异均有统计学意义（P〈0．05）；完全（30．91％）和不完全遵照日常饮食指导（50．91％）与低支持组（15．55％、44．44％）比较，差异均无统计学意义（P〉0．05）。两组患者均无一例完全不按时血透治疗。其他职业组SSRS总得分（40．54±7．32）分]、客观支持（10．82±3．05）分]、主观支持（21．89±4．81）分]、完全（59．65％）和不完全（40．35％）按时血透治疗与农民组（35．28±5．93）分、（9．53±1．59）分、（18．49±4．61）分、30．23％、69．77％]比较，差异均有统计学意义（P〈0．05）；两组社会支持利用度得分、完全、不完全和完全不遵照日常饮食指导进食比较其他职业组：（7．82±1．96）分、29。82％、49．12％、21．05％；农民组：（7．26±2．35）分、16．28％、46．51％、37．21％]，差异无统计学意义（P〉0．05）。结论社会支持对血液透析患者遵医行为有明显促进作用，医护人员通过加强对血液透析患者社会支持的一系列有效措施，可以提高其遵医行为，对延长患者生命及提高生活质量具有重要的现实意义。

Influence of social support and occupation on compliance behaviors of maintenance hemodialysis patients

Objective To understand the relationship between social support and compliance behaviors of maintenance hemodialysis patients. Methods Social support rating scale （SSRS） and self-designed questionnaire were used to in- vestigate 100 maintenance hemodialysis patients from November 2011 to November 2012 in Baise People＇s Hospital. Results The SSRS high support group and the low support group were different in the total score of social support, ob- jective support, subjective support and utilization of social support high support group： （43.36±4.85） scores, （11.29± 2.81） scores, （23.45±3.92） scores, （8.62±1.81） scores; low support group： （32.07±4.08） scores, （9.02±1.63） scores, （16.73±3.45） scores, （6.31±1.82） scores], with statistically significant differences （all P 〈 0.05）. In the high support group, 63.64% patients completely followed the hemodialysis time schedule, 36.36% patients did not completely follow the hemodialysis time schedule and 18.18% patients completely did not in accordance with the diet guidance, which were different from those of the low support group （26.67%, 73.33 and 40.00% respectively）, with statistieally siguifi cant differences （P 〈 0.05）. In the high support group, 30.91% patients completely and 50.91%patients did not completely in aecordance with the diet guidance, which had no statistically different from those of the low support group （15.55% and 44.44% respectively） （P 〉 0.05）. There was no patient completely not following the hemodialysis time sehedule in either group. The total score of SSRS score （40.54±7.32） scores], objective support （10.82±3.05） seores], subjective support （21.89±4.81） scores], patients eompletely following （59.65%） and not eompletely following the hemodialysis treatment （40.35%） in the other occupation group were different from those in the farmer group （35.28±5.93） scores, （9.53±1.59） scores, （18.49±4.61） scores, 30.23%, 69.77% respectively], with statistically sig- nificant differences （P 〈 0.05）, but the utilization of social support, and the patients completely, not completely and completely not in accordance with the diet guidance were not statistically different between the two group the other occupation group： （7.82±1.96） scores, 29.82%, 49.12%, 21.05%; farmer group： （7.26±2.35） scores, 16.28%, 46.51%, 37.21%] （P 〉 0.05）. Conclusion Social support obviously promotes compliance behaviors of hemodialysis patients, medical staffs can promote their compliance behaviors through enhancing their social support with a series of effective mea- sures, which has imoortant practical significance to prolong the patients＂ life and improve their quality of life.