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在说法语的瑞士,接受血液透析的患者的症状、生活质量和补充替代药物使用之间的关系。

Relationship among symptoms, quality of life, and complementary and alternative medicines use among patients undergoing hemodialysis in French-speaking Switzerland.

机构信息

University of Lausanne, Lausanne, Switzerland.

La Source School of Nursing, University of Applied Arts and Sciences Western Switzerland - HES-SO, Lausanne, Switzerland.

出版信息

BMC Complement Med Ther. 2023 May 31;23(1):174. doi: 10.1186/s12906-023-04001-z.

Abstract

BACKGROUND

Chronic renal disease is considered a main public health problem due to its high prevalence in the population. The solution of choice currently available is kidney transplantation but when this option is not available, blood purification treatments, notably haemodialysis (HD), are necessary. The presence of chronic renal disease combined with this demanding medical procedure leads to a hard symptomatology. To face this situation, HD patients often resort to complementary and alternative medicines (CAM) as they perceive that the healthcare professionals aren't paying enough attention to their quality of life. Given this background, we aim to describe the prevalence and the type of the CAM used among HD patients and their possible relations with patients' symptomatology and quality of life.

METHODS

We interviewed 88 patients, undergoing hemodialysis in three hemodialysis centers in French-speaking Switzerland, about the presence of symptoms, their quality of life, and the possible use of CAM. Cluster analysis was used to create patients' profiles about CAM use and regression analysis to explore the links between symptoms' presence, patients' quality of life, and CAM use.

RESULTS

Our results show a large use of CAM: almost two HD patients out of three uses at least one CAM. Using cluster analysis, we were able to identify five patients' profiles: non-users (37.5% of our sample), users of herbal medicine (20.5%), users of prayer-based practices (18.2%), people mainly using massages (9.1%), and a residual group including the users of other CAMs, with a predominance of meditation (14.8%). As expected, we observe a negative relation between the number of declared symptoms and patients' quality of life. Contrarily, we observe no relation between the use of CAM and the presence of symptoms. Our results show a positive relationship between the use of CAM and patients' overall perception of health as well as the psychological dimension of their quality of life. No relationship is observed with other dimensions of quality of life, notably the physical dimension.

CONCLUSIONS

Our results suggests that CAMs aren't used as a substitute of official medicine but as a parallel support to HD patients' quality of life.

摘要

背景

慢性肾病因其在人群中的高患病率而被视为主要的公共卫生问题。目前可供选择的解决方案是肾移植,但当这种选择不可用时,血液净化治疗,特别是血液透析(HD),是必要的。慢性肾病的存在加上这种苛刻的医疗程序导致了严重的症状。为了应对这种情况,HD 患者经常诉诸于补充和替代药物(CAM),因为他们认为医疗保健专业人员没有足够关注他们的生活质量。鉴于这种背景,我们旨在描述 HD 患者中使用的 CAM 的流行率和类型,以及它们与患者症状和生活质量的可能关系。

方法

我们对瑞士法语区的三家血液透析中心的 88 名正在接受血液透析的患者进行了采访,询问了他们的症状存在情况、生活质量和可能使用的 CAM。我们使用聚类分析来创建患者关于 CAM 使用的特征,并使用回归分析来探讨症状存在、患者生活质量和 CAM 使用之间的联系。

结果

我们的结果显示,CAM 的使用非常广泛:近三分之二的 HD 患者至少使用一种 CAM。通过聚类分析,我们能够识别出五种患者特征:非使用者(我们样本的 37.5%)、草药使用者(20.5%)、基于祈祷的实践使用者(18.2%)、主要使用按摩的人(9.1%)和一个包括使用其他 CAM 的剩余组,以冥想为主(14.8%)。正如预期的那样,我们观察到宣称的症状数量与患者的生活质量呈负相关。相反,我们观察到 CAM 的使用与症状的存在之间没有关系。我们的结果表明,CAM 的使用与患者对健康的总体感知以及生活质量的心理维度之间存在正相关。与生活质量的其他维度,特别是身体维度,没有关系。

结论

我们的结果表明,CAM 不是作为正规医学的替代品使用,而是作为 HD 患者生活质量的平行支持。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c63/10230675/a27ab2d5f48e/12906_2023_4001_Fig1_HTML.jpg

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