CAJ | 학술논문

背景:维持性血液透析患者普通存在着饮水控制依从困难的问题,影响病情的转归,心理问题对饮水控制依从性有着重大的影响.目的:分析合理情绪疗法对维持性血液透析患者饮水控制依从性的影响.方法:将维持性血液透析患者100例随机分为干预组和对照组,每组 50例.对照组接受常规的血液透析治疗;干预组在此基础上,接受为期3个月的合理情绪治疗.干预前和干预后分别用医学应对问卷和症状自评量表对两组患者进行评定;分别在干预前和干预结束时连续3次测定与饮水控制依从性相关的临床指标,求每项指标的平均值.结果与结论:共92例患者(干预组48例,对照组44例)完成研究.干预后,干预组患者在医学应对问卷的面对和回避两大分量表得分量著高于对照组,屈服分量表的得分、症状自评量表问卷的总均分及躯体化、强迫、人际关系敏感、抑郁、焦虑、敌对、恐怖和附加因子的得分、4项与饮水控制依从性相关的临床指标(透析间期体质量的平均增加量与干体质量的比值、透析前的平均收缩压、透析前的平均舒张压、平均超滤量)均显著低于对照组(P<0 05)提示合理情绪疗法能增强患者的应对能力,改善基心理健康水平,提高其饮水控制依从性.
배경:유지성혈액투석환자보통존재착음수공제의종곤난적문제,영향병정적전귀,심리문제대음수공제의종성유착중대적영향.목적:분석합리정서요법대유지성혈액투석환자음수공제의종성적영향.방법:장유지성혈액투석환자100례수궤분위간예조화대조조,매조 50례.대조조접수상규적혈액투석치료;간예조재차기출상,접수위기3개월적합리정서치료.간예전화간예후분별용의학응대문권화증상자평량표대량조환자진행평정;분별재간예전화간예결속시련속3차측정여음수공제의종성상관적림상지표,구매항지표적평균치.결과여결론:공92례환자(간예조48례,대조조44례)완성연구.간예후,간예조환자재의학응대문권적면대화회피량대분량표득분량저고우대조조,굴복분량표적득분、증상자평량표문권적총균분급구체화、강박、인제관계민감、억욱、초필、활대、공포화부가인자적득분、4항여음수공제의종성상관적림상지표(투석간기체질량적평균증가량여간체질량적비치、투석전적평균수축압、투석전적평균서장압、평균초려량)균현저저우대조조(P<0 05)제시합리정서요법능증강환자적응대능력,개선기심리건강수평,제고기음수공제의종성.
BACKGROUND: Non-adherence to fluid restrictions is common in patients maintained on hemodialysis prior to and after kidney transplantation,which has a profound influence on the development and transfer of illness of the patients.Mental factors have great influences on adherence to fluid restrictions.OBJECTIVE: To investigate the effects of rational-emotive therapy on adherence to fluid restrictions of patients maintained on hemodialysis prior to and after kidney transplantation.METHODS: In total 100 patients maintained on hemodialysis were randomly assigned to an intervention group(n = 50)and a control group(n = 50).The control group received the conventional therapy.At the same time,the intervention group received the conventional therapy combined with rational-emotive therapy.All cases were assessed with the Symptom Checklist 90(SCL-90)and Medical Coping Modes Questionnaire(MCMQ)prior to and after intervention.Clinical indices related to adherence to fluid restrictions were measured three successive times and the average score of each index was calculated.RESULTS AND CONCLUSION: Forty-eight patients from the intervention group and 44 patients from the control group accomplished the study.After intervention,the scores of the two subscales,confronce and avoidance,were significantly higher than those in the control group(P < 0.05).However,some scores were significantly lower than those in the control group,including the score of acceptance/resignation subscale of MCMQ,total average score of SCL-90,the score of somatization,obsessive-compulsive,interpersonal sensitivity,depression,anxiety,hostility,photic anxiety and additional items,and the score of four clinical indices related to adherence to fluid restrictions(the ratio of interdialysis weight gain to dry weight,mean systolic blood pressure,mean diastolic blood pressure,and mean ultrafiltration volume prior to hemodialysis)(P < 0.05).All these findings suggest that rational-emotive therapy can effectively amend the coping modes and the mental states of the patients,and then improve their adherence to fluid restrictions.