Takaki Jiro, Nishi Tadahiro, Shimoyama Hiromi, Inada Toshio, Matsuyama Norimasa, Sasaki Tadashi, Kumano Hiroaki, Kuboki Tomifusa
Department of Psychosomatic Medicine, Tokyo University Hospital, Faculty of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, 113-8655, Tokyo, Japan.
J Psychosom Res. 2003 Dec;55(6):525-9. doi: 10.1016/s0022-3999(03)00020-5.
The aim of this study was to assess the possible variances of blood urea nitrogen (BUN), serum potassium (SK) and serum phosphorus (SPO(4)) levels and interdialytic weight gain (IWG) accounted for compliance of uremic patients on hemodialysis (HD).
BUN, SK and SPO(4) levels and IWG of uremic patients (n=310) regularly undergoing three HD sessions per week for more than 1 year in Japan were assessed. Patients suffering from problems influencing dietary intake and those with malnutrition were excluded. The variances accounted for self-efficacy for health-related behavior and avoidance-oriented coping (AOC) with stress were assessed by hierarchical multiple regression analyses.
BUN and SPO(4) levels were not significantly (P<.05) associated with self-efficacy or AOC. SK levels and IWG were significantly (P<.05) associated with self-efficacy and/or AOC. The variances of SK levels and IWG accounted for self-efficacy and/or AOC, independent of age, sex, duration of HD and facilities, were 1.6% and 5.0%, respectively.
Although the variances of SK levels and IWG accounted for self-efficacy and/or AOC were rather small, the significance of their relationships may suggest that intervention for self-efficacy or AOC could improve compliance and reduce SK levels and IWG of uremic patients on HD.
本研究旨在评估血液尿素氮（BUN）、血清钾（SK）和血清磷（SPO₄）水平的可能差异，以及透析间期体重增加（IWG）对接受血液透析（HD）的尿毒症患者依从性的影响。
对在日本每周定期进行3次HD治疗超过1年的310例尿毒症患者的BUN、SK和SPO₄水平以及IWG进行评估。排除饮食摄入受影响和存在营养不良问题的患者。通过分层多元回归分析评估与健康相关行为的自我效能感和应激回避导向应对（AOC）所解释的差异。
BUN和SPO₄水平与自我效能感或AOC无显著（P<0.05）关联。SK水平和IWG与自我效能感和/或AOC显著（P<0.05）相关。独立于年龄、性别、HD时长和治疗机构，由自我效能感和/或AOC所解释的SK水平和IWG的差异分别为1.6%和5.0%。
尽管由自我效能感和/或AOC所解释的SK水平和IWG的差异较小，但其关系的显著性可能表明，针对自我效能感或AOC的干预可提高接受HD的尿毒症患者的依从性，并降低其SK水平和IWG。
