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目的 以武汉市中心医院为定点医院的腹膜透析(peritoneal dialysis,PD)患者为研究对象进行调查,收集患者选择PD为初始透析方式的影响因素,为当前地区及其他区域进一步推广PD提供可行的建议和措施。方法 选取以武汉市中心医院为定点医院、初始透析方式为PD、且无血液透析(hemodialysis,HD)禁忌症的PD患者,通过调查问卷的方式收集影响患者选择PD为初始透析方式的因素,以及患者透析前教育情况、家庭支持情况,调查问卷的发放时间为2020年11月1日,回收截止时间为2020年11月30日。结果 发放问卷100份,收回有效问卷92份。初始选择PD各影响因素统计结果:认同PD花费较少64人(69.6%),认同PD疗效良好71人(77.1%),认同PD不需要频繁往返医院,更方便易行75人(81.5%),认同PD治疗与生活的时间安排更灵活76人(82.6%),认同PD不需太多额外照料,减轻家庭负担76人(82.6%),认同PD操作易掌握85人(92.4%),完全听取医生意见54人(58.7%);透析前教育情况:认同进入透析治疗前已了解所患疾病及其预后80人(87.0%),对透析治疗有所预料并已提前做好准备72人(78.3%),患者或家属在透析前已了解两种透析治疗方式的特点认同76人(82.6%);家庭支持情况:支持率高的有61人(66.3%),支持率一般的有29人(31.5%),支持率差的有2人(2.2%)。结论 推广PD作为透析治疗的首要选择,可在保证治疗效果的前提下降低治疗成本、提升患者生活质量,用有限的资源挽救更多的患者。在实际推广过程中,取得专科医生的认可和支持,通过医务人员宣传和推广PD是目前最有效的措施。同时,在宣传中强调PD治疗的经济性,治疗的良好效果,对工作、生活质量等方面的益处,较轻的家庭负担,操作的简单易学,可有效引导患者及家属对PD的选择,并获得患者家庭的支持。最后还可以通过早期、定期的身体健康检测及健康宣教,更多地了解PD相关知识的途径,精心地设计透析前教育计划,增强患者的自我管理能力,消除患者疑虑,克服恐惧心理,促进患者选择PD。
Abstract：Objective This study investigates the peritoneal dialysis(PD)patients who chose Wuhan Central Hospital for the designated hospital to understand the factors affecting patients′ choice of PD as the initial dialysis method and provides feasible suggestions and measures for further promotion of PD in the current and other regions. Methods We selected PD patients who chose Wuhan Central Hospital as the designated hospital,PD as the initial dialysis method, and had no hemodialysis(HD) contraindications. Then we sent out questionnaires to patients to collect the factors that affect patients to choose PD as the initial dialysis method,the patient′s pre-dialysis education,and family support. The questionnaire was issued on November 1,2020,and the deadline for the collection was November 30,2020. Results We distributed 100 questionnaires and recovered 92 valid questionnaires.Statistical results of all influencing factors of the initial selection of PD:64 people agreed that PD spent less(69. 6%),71 people(77. 1%)agreed that PD had a good effect,75 people(81. 5%) agreed that PD did not require frequent trips to the hospital,76 people(82. 6%)agreed that the schedule of PD treatment and life was more flexible,76 people(82. 6%) agreed PD did not require too much extra care and reduce the burden on their families,85 people(92. 4%)agreed that the PD operation was easy to handle,54 people(58. 7%) thoroughly listened to doctors′ opinions. Pre-dialysis education: 80 people(87. 0%) agreed that they knew the disease and its prognosis before entering the dialysis treatment,and 72 people(78. 3%) had anticipation of the dialysis treatment and were preparing in the future,76 people(82. 6%) or their family members had understood the characteristics of the two dialysis treatment methods before dialysis. Family support:61 people(66. 3%)highly supported,29 people(31. 5%)moderately supported,and 2 people(2. 2%)poorly supported. Conclusion Driving PD as the first choice for dialysis treatment could ensure the treatment effect, reduce treatment costs, improve the life quality of patients, and save more patients with limited resources. In the actual process of PD promotion,getting the approval and support of specialists,publicizing and promoting PD through medical staff are the most effective measures. Simultaneously,in the process,the economics of PD treatment,the good results of the treatment,the benefits to work and life,the lighter family burden,and the easy-to-learn operation could effectively guide patients and their families to choose PD and obtain patients family support. Finally,by early and regular physical health testing and health education,providing patients with more ways to understand PD-related knowledge,a well-designed pre-dialysis education plan could enhance patients′ self-management ability,eliminate patients′ doubts,overcome fears,and encourage patients to choose PD.
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基本信息:
DOI：10.16389/j.cnki.cn42-1737/n.2022.01.008
中图分类号:R692.5
引用信息:
[1]李天宇,陈文莉,刘昌璇.影响患者选择腹膜透析因素的单中心描述性研究[J].江汉大学学报(自然科学版),2022,50(01):55-64.DOI:10.16389/j.cnki.cn42-1737/n.2022.01.008.
基金信息: