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社会支持和家庭环境与腹膜透析患者认知功能的关联

Association of Social Support and Family Environment with Cognitive Function in Peritoneal Dialysis Patients.

作者信息

Wang Qin, Yang Zhi-Kai, Sun Xiu-Mei, Du Yun, Song Yi-Fan, Ren Ye-Ping, Dong Jie

机构信息

Department of Nephrology, Second Affiliated Hospital of Harbin Medical University, Heilongjiang, China.

Department of Nephrology, Renal Division, Department of Medicine, Peking University First Hospital; Institute of Nephrology, Peking University; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing, China.

出版信息

Perit Dial Int. 2017;37(1):14-20. doi: 10.3747/pdi.2016.00084.

Abstract

♦ BACKGROUND: Cognitive impairment (CI) is a common phenomenon and predictive of high mortality in peritoneal dialysis (PD) patients. This study aimed to analyze the association of social support and family environment with cognitive function in PD patients. ♦ METHODS: This is a cross-sectional study of PD patients from Peking University First Hospital and the Second Affiliated Hospital of Harbin Medical University. Global cognitive function was measured using the Modified Mini-Mental State Examination (3MS), executive function was measured by the A and B trail-making tests, and other cognitive functions were measured by the Repeatable Battery for the Assessment of Neuropsychological Status. Social support was measured with the Social Support Scale developed by Xiaoshuiyuan and family environment was measured with the Chinese Version of the Family Environment Scale (FES-CV). ♦ RESULTS: The prevalence of CI and executive dysfunction among the 173 patients in the study was, respectively, 16.8% and 26.3%. Logistic regression found that higher global social support (odds ratio [OR] = 1.09, 1.01 - 1.17, p = 0.027) and subjective social support predicted higher prevalence of CI (OR = 1.13, 1.02 - 1.25, p = 0.022), adjusting for covariates. Analyses of the FES-CV dimensions found that greater independence was significantly associated with better immediate memory and delayed memory. Moreover, higher scores on achievement orientation were significantly associated with poorer language skills. ♦ CONCLUSIONS: Our findings indicate that social support is negatively associated with the cognitive function of PD patients and that some dimensions of the family environment are significantly associated with several domains of cognitive function.

摘要

♦ 背景:认知障碍(CI)是腹膜透析(PD)患者中常见的现象,且预示着高死亡率。本研究旨在分析社会支持和家庭环境与PD患者认知功能的关联。♦ 方法:这是一项对来自北京大学第一医院和哈尔滨医科大学附属第二医院的PD患者的横断面研究。使用改良简易精神状态检查表(3MS)测量整体认知功能,通过A和B连线测验测量执行功能,通过可重复神经心理状态评估量表测量其他认知功能。使用肖水源编制的社会支持量表测量社会支持,使用家庭环境量表中文版(FES-CV)测量家庭环境。♦ 结果:研究中的173例患者中,CI和执行功能障碍的患病率分别为16.8%和26.3%。逻辑回归发现,在调整协变量后,较高的整体社会支持(优势比[OR]=1.09,1.01 - 1.17,p = 0.027)和主观社会支持预示着CI的患病率较高(OR = 1.13,1.02 - 1.25,p = 0.022)。对FES-CV维度的分析发现,更大的独立性与更好的即时记忆和延迟记忆显著相关。此外,成就取向得分较高与较差的语言技能显著相关。♦ 结论:我们的研究结果表明,社会支持与PD患者的认知功能呈负相关,家庭环境的某些维度与认知功能的多个领域显著相关。

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