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接受维持性血液透析的终末期肾病患者的焦虑、控制源和应对策略。

Anxiety, locus of control, and coping strategies among end-stage renal disease patients undergoing maintenance hemodialysis.

作者信息

Kohli S, Batra P, Aggarwal H K

机构信息

Department of Psychology, MD University, Rohtak, Haryana, India.

出版信息

Indian J Nephrol. 2011 Jul;21(3):177-81. doi: 10.4103/0971-4065.83729.

Abstract

End-stage kidney disease (ESKD) patients on maintenance hemodialysis (MHD) have a lot of anxiety. Anxiety and coping are associated with the locus of control; the present investigation aimed to study the state and trait anxiety, locus of control, and active and passive coping among patients on MHD. Thirty MHD patients and 30 controls were administered State-Trait Anxiety Inventory, Rotter's Locus of Control Scale, and Coping Responses Inventory. There were significantly higher scores on state and trait anxiety, respectively (67.53 ± 10.89 vs. 59.40 ± 6.97, P < 0.01, and 62.97 ± 8.45 vs. 58.07 ± 7.06, P < 0.05), and locus of control (11.27 ± 3.55 vs. 9.04 ± 1.86, P < 0.01) in patients as compared to controls. On coping responses, patients and controls differed on positive reappraisal (54.33 ± 4.67 vs. 51.17 ± 3.12, P < 0.01), seeking guidance and support (58.07 ± 5.51 vs. 53.27 ± 4.22, P < 0.01), problem solving (51.03 ± 4.70 vs. 47.57 ± 4.73, P < 0.01), cognitive avoidance (60.27 ± 6.76 vs. 56.80 ± 4.08, P < 0.05), acceptance or resignation (61.67 ± 6.30 vs. 58.83 ± 4.23, P < 0.01), emotional discharge (68.07 ± 6.78 vs. 64.30 ± 4.50, P < 0.05), approach coping (205.57 ± 10.55 vs. 189.70 ± 11.37, P < 0.01), and avoidance coping (255.30 ± 16.45 vs. 241.10 ± 10.50, P < 0.01). A higher prevalence of anxiety trait could be the cause of anxiety in MHD patients besides the medical problems. The locus of control among patients though a mixed one was significantly more toward externalism. Thus, there is a need to identify this group well in advance and prepared not only medically but also psychologically for MHD.

摘要

接受维持性血液透析(MHD)的终末期肾病(ESKD)患者存在诸多焦虑情绪。焦虑与应对方式和控制点相关;本研究旨在探讨MHD患者的状态焦虑、特质焦虑、控制点以及主动和被动应对方式。对30例MHD患者和30名对照者进行了状态-特质焦虑量表、罗特控制点量表和应对反应量表测试。结果显示,患者的状态焦虑和特质焦虑得分分别显著高于对照者(67.53±10.89对59.40±6.97,P<0.01;62.97±8.45对58.07±7.06,P<0.05),控制点得分也显著高于对照者(11.27±3.55对9.04±1.86,P<0.01)。在应对反应方面,患者和对照者在积极重新评价(54.33±4.67对51.17±3.12,P<0.01)、寻求指导和支持(58.07±5.51对53.27±4.22,P<0.01)、解决问题(51.03±4.70对47.57±4.73,P<0.01)、认知回避(60.27±6.76对56.80±4.08,P<0.05)、接受或顺从(61.67±6.30对58.83±4.23,P<0.01)、情绪宣泄(68.07±6.78对64.30±4.50,P<0.05)、接近应对(205.57±10.55对189.70±11.37,P<0.01)和回避应对(255.30±16.45对241.10±10.50,P<0.01)等方面存在差异。除了医疗问题外,较高的特质焦虑患病率可能是MHD患者焦虑的原因。患者的控制点虽然是混合的,但显著更倾向于外部控制。因此,有必要提前准确识别这一群体,并不仅在医疗方面,而且在心理方面为MHD做好准备。

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本文引用的文献

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Psychiatric issues in renal failure and dialysis.肾衰竭与透析中的精神问题
Indian J Nephrol. 2008 Apr;18(2):47-50. doi: 10.4103/0971-4065.42337.
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What is psychonephrology?什么是心理肾脏学?
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Depression and anxiety in urban hemodialysis patients.城市血液透析患者的抑郁和焦虑
Clin J Am Soc Nephrol. 2007 May;2(3):484-90. doi: 10.2215/CJN.00040107. Epub 2007 Apr 4.
10
Coping strategies and stressors in patients with hemodialysis.血液透析患者的应对策略与压力源
Psychosom Med. 2007 Feb-Mar;69(2):182-90. doi: 10.1097/PSY.0b013e318031cdcc. Epub 2007 Feb 8.

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