Ponz Clemente E, Martínez Ocaña J C, Marquina Parra D, Blasco Cabañas C, Grau Pueyo G, Mañé Buixó N, García García M
Servicio de Nefrología, Corporación Sanitaria Parc Taulí, Sabadell, Bareclona, Institut Universitari Parc, Taulí (UAB).
Nefrologia. 2010;30(2):195-201. doi: 10.3265/Nefrologia.pre2010.Feb.10235.
Peritoneal dialysis (PD) is not frequently used in our setting.
To analyze the psychological factors involved in the choice of renal replacement therapy (RRT).
A prospective observational study of stable patients without cognitive or sensory deficits who were informed about RRT from January 2004 to July 2006 and agreed to participate. The patients were given and completed the Beck Depression Inventory and the Eysenck personality questionnaire. Clinical and sociodemographic data and RRT choice were recorded. End of follow-up: 2007/10/31.
44 patients were studied: age, 65.4 +/- 13.1 years, 48% male, 34% diabetic. When choosing RRT, 36% of patients had symptoms of depression. Neither depression symptoms nor personality traits were related to the choice of dialysis type. The youngest patients chose PD (41%). After a mean followup of 8 +/- 8 months, 70% of patients started RRT (68% haemodialysis [HD], 32% PD). None of the patients who chose HD changed their mind, but 3 of the 13 patients (23%) who chose PD finally commenced HD, usually in the context of a worsening of the disease. Half of the patients with depression symptoms when choosing PD and a third of the patients with higher levels of neuroticism changed their decision and finally opted for HD.
When choosing RRT, the prevalence of depression symptoms is high. Neither depression nor personality traits influenced the initial choice of RRT, although these factors may be involved in subsequent changes to the decision.
在我们的医疗环境中,腹膜透析(PD)的使用并不频繁。
分析肾替代治疗(RRT)选择过程中涉及的心理因素。
对2004年1月至2006年7月期间被告知RRT且无认知或感觉缺陷的稳定患者进行前瞻性观察研究,这些患者同意参与研究。患者接受并完成了贝克抑郁量表和艾森克人格问卷。记录临床和社会人口学数据以及RRT选择情况。随访结束时间:2007年10月31日。
共研究了44例患者:年龄65.4±13.1岁,男性占48%,糖尿病患者占34%。在选择RRT时,36%的患者有抑郁症状。抑郁症状和人格特质均与透析类型的选择无关。最年轻的患者选择了PD(41%)。平均随访8±8个月后,70%的患者开始接受RRT(68%为血液透析[HD],32%为PD)。选择HD的患者无人改变主意,但选择PD的13例患者中有3例(23%)最终改为接受HD,通常是在病情恶化的情况下。选择PD时伴有抑郁症状的患者中有一半以及神经质水平较高的患者中有三分之一改变了决定,最终选择了HD。
在选择RRT时,抑郁症状的患病率较高。抑郁和人格特质均未影响RRT的初始选择,尽管这些因素可能与后续决策的改变有关。