腹膜透析患者容量管理行为的异质性及影响因素分析

目的 探索腹膜透析患者容量管理行为的群体异质性，并分析其人群特征和影响因素，为实施精准护理干预提供参考。方法 以便利抽样法招募266例腹膜透析患者，采用一般资料调查表、持续非卧床腹膜透析患者容量管理行为量表、医院焦虑抑郁量表、家庭关怀度指数问卷进行调查。运用潜在剖面分析进行异质性检验，探索腹膜透析患者容量管理行为的潜在分类，采用无序多分类logistic回归分析进一步探讨潜在类别的影响因素。结果 腹膜透析患者容量管理行为存在3种潜在类别，即容量管理消极型（15.8%）、容量管理普通型（46.6%）、容量管理积极型（37.6%）。无序多分类logistic回归分析结果显示，文化程度偏低、透析频率＞3袋/d的患者归属于容量管理普通型的概率更高；居住在城市、无焦虑抑郁症状、家庭功能良好的患者更倾向于发展为容量管理积极型（均P＜0.05）。结论 腹膜透析患者容量管理行为存在明显的群体异质性，医护人员可根据人口学和疾病特征识别不同群体患者，并针对各群体特征和影响因素进行精准护理干预，改善居家腹膜透析患者容量超负荷，提高透析效果。

Analysis of heterogeneity and influencing factors of volume management behavior in peritoneal dialysis patients

Objective To explore the group heterogeneity of volume management behaviors in peritoneal dialysis patients and analyze the characteristics and influencing factors of different categories, to provide a reference for the implementation of precise nursing interventions. Methods Two hundred and sixty-six peritoneal dialysis patients were recruited by convenience sampling method. The survey instruments included a general information questionnaire, the Continuous Ambulatory Peritoneal Dialysis Volume Management Behavior Scale, the Hospital Anxiety and Depression Scale (HADS), and the Family APGAR Index (APGAR). A heterogeneity test was conducted using latent profile analysis to explore the potential classification of volume management behaviors of peritoneal dialysis patients, and unordered multinomial logistic regression analysis was performed to further explore the influencing factors of latent profiles. Results Three potential categories of volume management behaviors existed in peritoneal dialysis patients:volume management negative type (15.8%), volume management ordinary type (46.6%), and volume management positive type (37.6%). Unordered multinomial logistic regression analysis results showed that, patients with a lower level of education and a dialysis frequency of >3 bags/day had a higher probability of belonging to the volume management ordinary type; patients who living in the city, had no symptoms of anxiety or depression, and had good family function were more inclined to develop the volume management positive type (all P<0.05). Conclusion There is significant group heterogeneity in volume management behaviors among peritoneal dialysis patients.Healthcare professionals should identify different groups of patients through different demographic and disease characteristics, and develop precise nursing interventions based on the characteristics and influencing factors of each group to improve the volume overload and the dialysis effectiveness of home-based peritoneal dialysis patients.