Jankowska-Polanska Beata, Uchmanowicz Izabella, Wysocka Agata, Uchmanowicz Bartosz, Lomper Katarzyna, Fal Andrzej M
Department of Clinical Nursing, Wroclaw Medical University, Poland.
Department and Clinic of Nephrology and Transplantation Medicine, Wroclaw, Poland.
Eur J Public Health. 2017 Apr 1;27(2):262-267. doi: 10.1093/eurpub/ckw193.
Patients on hemodialysis must adjust their life plans to the treatment. They are aware of losing their health and independence. Therefore, acceptance of illness (AI) is important and allows the patient to adjust to new situation and alleviates negative emotions.
The aim of study was to assess the impact of AI and other socioclinical variables on hemodialysis patients' quality of life (QoL). The study included 100 patients aged 20-85 (M = 57), treated with hemodialysis for at least 2 years. Two validated instruments were used: the Acceptance of Illness Scale (AIS) and the World Health Organization Quality of Life questionnaire.
High, moderate and low level of AI was found for 15, 61 and 24 patients, respectively. The QoL increased with the AI score. In physical domain, it reached 69.8 ± 12.4 in the high AIS group, 54.2 ± 15.3 in the moderate AIS group and 42.7 ± 12.3 in the low AIS group ( P < 0.001). The psychological domain scores were 70.3 ± 12.8, 57.2 ± 15.0 and 49.7 ± 11.8 ( P < 0.001), respectively. The environmental domain scores were 68.8 ± 13.3,59.0 ± 12.6 and 53.0 ± 11.6 ( P < 0.001), respectively. AIS scores were positively correlated with QoL in three domains: physical ( r = 0.549; P < 0.0001), psychological ( r = 0.505; P < 0.0001) and environmental ( r = 0.444; P < 0.0001). In multiple-factor analysis, AI was independent predictors in physical domains (β = +0.210), psychological domain (β = +0.402) and environmental domain (β = +0.204). No correlation or predictive value was found for the social relationship domain, however.
Patients on dialysis have moderate-to-low AI. AI is an independent predictor positively correlated with QoL in all domains except for social relationships. The social and psychological support for dialyzed patient might improve their HRQoL and illness acceptance.
接受血液透析的患者必须根据治疗调整他们的生活计划。他们意识到自己正在失去健康和独立性。因此，疾病接纳度（AI）很重要，它能让患者适应新情况并减轻负面情绪。
本研究旨在评估疾病接纳度及其他社会临床变量对血液透析患者生活质量（QoL）的影响。该研究纳入了100名年龄在20 - 85岁（平均年龄57岁）、接受血液透析至少2年的患者。使用了两种经过验证的工具：疾病接纳度量表（AIS）和世界卫生组织生活质量问卷。
分别有15名、61名和24名患者的疾病接纳度处于高、中、低水平。生活质量随疾病接纳度得分升高而提高。在身体领域，高AIS组得分为69.8±12.4，中等AIS组为54.2±15.3，低AIS组为42.7±12.3（P<0.001）。心理领域得分分别为70.3±12.8、57.2±15.0和49.7±11.8（P<0.001）。环境领域得分分别为68.8±13.3、59.0±12.6和53.0±11.6（P<0.001）。AIS得分在身体（r = 0.549；P<0.0001）、心理（r = 0.505；P<0.0001）和环境（r = 0.444；P<0.0001）三个领域与生活质量呈正相关。在多因素分析中，疾病接纳度是身体领域（β = +0.210）、心理领域（β = +0.402）和环境领域（β = +0.204）的独立预测因素。然而，未发现社会关系领域存在相关性或预测价值。
透析患者的疾病接纳度为中低水平。疾病接纳度是除社会关系外所有领域与生活质量呈正相关的独立预测因素。对透析患者的社会和心理支持可能会改善他们的健康相关生活质量和疾病接纳度。
