老年维持性血液透析患者希望影响因素的路径分析

目的探讨影响老年维持性血液透析患者希望水平及其直接因素及间接因素,为制定干预措施提供依据。方法采用自行设计的患者一般情况调查表、中文版Herth希望量表、简易应对方式问卷、社会支持量表对广州市3所三级甲等医院血液透析中心的103例老年维持性血液透析患者进行调查。对希望影响因素进行路径分析。结果患者希望总均分(31.27±3.59)分,75岁及以上患者希望水平总均分显著低于60～64岁患者及65～74岁患者(均P<0.05);社会支持是希望水平的直接保护因素(P<0.01),积极应对方式(P<0.01)、家庭收入水平(P<0.01)是希望水平的间接保护因素,消极应对方式是希望水平的间接危险因素(P<0.01)。结论患者希望整体水平中等,但75岁以上患者希望水平偏低。社会支持通过直接路径影响希望水平,家庭收入通过积极、消极应对方式及社会支持间接影响患者希望水平。应根据希望影响因素作用模式制定干预措施,提升患者希望水平。

Influencing factors of hope among elderly patients treated with maintenance hemodialysis:a path analysis

Objective To explore hope level among elderly patients treated with maintenance hemodialysis,to analyze direct and indirect influencing factors on hope,and to provide reference for taking interventions. Methods A total of 103 elderly patients treated with maintenance hemodialysis were recruited from dialysis centers of 3 top-notch hospitals in Guangzhou city and were investigated by using a self-designed demographic information questionnaire,the Herth Hope Scale,the Simplified Coping Scale,and the Social Support Scale.Influencing factors on hope were obtained by path analysis. Results The total score of hope in elderly patients recei-ving maintenance hemodialysis averaged 31.27±3.59.The score of patients 75 years and older was significantly lower than that of patients aged 60-64 years and 65-74 years(P<0.05 for both).Social support was a direct protective factor of hope(P<0.01);positive coping style and family financial status were indirect protective factors(P<0.01 for both).Negative coping style was an indirect risk factor(P<0.01). Conclusion Hope of elderly patients treated with maintenance hemodialysis is at moderate level,and hope level of patients 75 years and older is relatively low.Social support exerts direct effect on hope,and family financial status has indirect effect on hope via positive and negative coping style and social support.Interventions developed on the basis of influencing factors of hope should be applied to improve patients′ hope level.