International Medical Service, Peking Union Medical College Hospital, 1 Shuaifuyuan Wangfujing, Beijing 100730, China.
School of Nursing, Peking Union Medical College, Beijing, China.
Int J Nurs Stud. 2014 Feb;51(2):208-16. doi: 10.1016/j.ijnurstu.2013.05.012. Epub 2013 Jun 12.
Improving the level of self-management by people undergoing hemodialysis is an effective way to reduce the incidence of mortality and complications and improve quality of life. A better understanding of what influences an individual's level of self-management can help nurses find appropriate ways to improve self-management.
To examine self-management levels, and discuss the factors influencing self-management, in a sample of patients undergoing hemodialysis in Beijing.
A descriptive study design was chosen.
A convenience sample of 216 patients undergoing hemodialysis was recruited from dialysis centers in three tertiary hospitals in Beijing from September 2010 to January 2011. Questionnaires were used to examine the variables: level of self-management; knowledge of hemodialysis; self-efficacy; anxiety and depression; and social support. Data analysis involved descriptive statistics, including frequency, percentage, mean and standard deviations, while Spearman correlation, non-parametric Z and χ(2) and multiple linear regression were used for comparative purposes.
The number of returned questionnaires was 198 (91.67% response rate). The overall score of self-management was 56.01 (SD=10.75). The average item scores for each of the four self-management subscales were 3.02 for partnership, 2.98 for problem-solving skills, 2.74 for self-care and 2.47 for emotional management. Multiple linear regression analyses for overall self-management and the four subscales indicated that knowledge, self-efficacy, the availability of social support and depression were the main influencing factors which explained 34.1% of the variance of self-management.
The level of self-management by those undergoing hemodialysis in this study was less than ideal, varying from 'rare' to 'sometimes' for use of self-management behaviors. For the different subscales of self-management, partnership was the most used and emotional management the least used strategy. Patients' knowledge, self-efficacy, the availability of social support and depression were the main factors influencing self-management.
提高血液透析患者的自我管理水平是降低死亡率和并发症发生率、提高生活质量的有效途径。更好地了解影响个体自我管理水平的因素可以帮助护士找到提高自我管理的适当方法。
探讨北京血液透析患者的自我管理水平，并探讨影响自我管理的因素。
选择描述性研究设计。
2010 年 9 月至 2011 年 1 月，采用便利抽样法，从北京 3 家三级医院的透析中心招募 216 名血液透析患者。采用问卷法调查患者的自我管理水平、血液透析知识、自我效能、焦虑抑郁状况和社会支持情况。采用描述性统计方法分析资料，包括频数、百分比、均数和标准差，采用 Spearman 相关分析、非参数 Z 检验、χ(2)检验和多元线性回归分析进行比较分析。
共收回问卷 198 份（有效回收率 91.67%）。自我管理总分为 56.01（SD=10.75）分，4 个维度的平均分分别为：伙伴关系 3.02 分、解决问题能力 2.98 分、自我护理 2.74 分、情绪管理 2.47 分。多元线性回归分析显示，知识、自我效能、社会支持和抑郁是影响自我管理的主要因素，对自我管理总水平和 4 个维度的解释率为 34.1%。
本研究中血液透析患者的自我管理水平不理想，自我管理行为的应用程度为“偶尔”至“很少”。在自我管理的不同维度中，患者最常应用的是伙伴关系维度，最不常应用的是情绪管理维度。患者的知识、自我效能、社会支持和抑郁是影响自我管理的主要因素。
