心理干预对维持性血液透析患者精神状况和生活质量的影响

目的探讨维持性血液透析（MHD）患者精神状况与生活质量的相关性，并进行针对性的心理干预，旨在改善其患者的精神状况及生活质量。方法将具有完整生活质量评定资料的180例男性MHD患者随机分为精神症状组（A组）104例和非精神症状组（B组）76例。采用健康相关生活质量量表（SF-36）评估180例MHD患者生活质量；分别用Beck抑郁问卷（BDI）并制成量表、汉密尔顿焦虑量表（HAMA）评估患者抑郁、焦虑症状，比较2组间生活质量的差异。结果MHD患者抑郁、焦虑症状的发生率分别为18．89％（34／180）和38．89％（70／180）。精神症状评分与生活质量8项指标中7项呈负相关，A组的生活质量明显低于B组患者（P〈0．05）。心理干预治疗后，心理干预组（A1组）的生活质量明显高于非心理干预组（A2组）（P〈0．05）。结论血液透析患者精神症状发生率较高，与患者生活质量密切相关。针对性的心理干预治疗可明显改善MHD患者的精神症状，提高其患者的生活质量。

Effect of psychological intervention on psychiatric symptoms and quality of life in hemodialysis patients

Objective To explore the correlation between psychiatric symptoms and quality ot life in maintenance hemodialysis （MHD） patients, and use the corresponding psychological intervention to improve the quality of life. Methods Quality of life in 180 MHD patients were evaluated by using the 36-item short form health survey questionnaire （SF-36）, and depression and anxiety were estimated by Beck Depression Inventory （BDI） and Hamilton Anxiety Rating Scale （HAMA） respectively. All the patients were divided into psychiatric symptoms group and non-psychiatric symptoms group. Quality of life was compared between two groups. The patients in psychiatric symptoms group were divided randomly into psychological intervention subgroup and non-psychological intervention subgroup. Psychological intervention subgroup was subjected to psychological imervention. Quality of life was compared between two subgroups. Results Despite 18. 81 % （34/180） patients of PD with depression and 38.89%（70/180） with anxiety, depression and anxiety scores were negatively correlated with 7 out of 8 factors from SF-36 questionnaire. Quality of life scores in psychiatric symptoms group were lower than those in non-psychiatric symptoms group （P〈0. 05）. Psychological intervention subgroup had significantly higher scores in bodily pain, emotional well-being and role limitations caused by emotional problems than non-psychological intervention subgroup. Quality of life in psychological intervention subgroup was more significantly than in non-psychological intervention subgroup. Conclusions This study has demonstrated that psychiatric symptoms are commonly encountered in PD patients and may be higher risk factors of quality of Life. The corresponding psychological intervention can obviously alleviate the psychiatric symptoms, and improve quality of life in PD patients.