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探讨认知障碍对持续不卧床腹膜透析(CAPD)患者治疗依从性和生活质量的影响。

Exploring the impact of cognitive impairments on treatment compliance and quality of life in patients with Continuous Ambulatory Peritoneal Dialysis (CAPD).

机构信息

Department of Nephrology, Lianshui People's Hospital, Kangda College of Nanjing Medical University, Huai'an City, China.

Jiangsu College of Nursing, Huai'an City, China.

出版信息

Medicine (Baltimore). 2023 Oct 27;102(43):e35813. doi: 10.1097/MD.0000000000035813.

Abstract

The aim of this study is to investigate the impact of cognitive impairments on treatment compliance and quality of life in patients with Continuous Ambulatory Peritoneal Dialysis (CAPD). A cross-sectional study was conducted among patients with CAPD at the Department of Nephrology, Lianshui People's Hospital from October 2021 to May 2022. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), and the End-Stage Renal Disease Adherence Questionnaire was used to evaluate treatment compliance. Quality of life was assessed using the SF-36 questionnaire. Scores from all the questionnaires and demographic data were recorded. A total of 98 patients were enrolled, and the prevalence of cognitive impairment among CAPD patients was 69.39% (MoCA score < 26). Patients were divided into 2 groups: one group with normal cognitive function (MoCA score ≥ 26) and the other with cognitive impairments. There were statistically significant differences in age, dialysis age, education, urea clearance index, history of high blood pressure, and diabetes between the 2 groups (all P < .05). Patients with cognitive impairments had lower compliance levels in terms of diet fluid restriction, medication therapeutic regimens, and dialysis regimen (all P < .05). Patients with cognitive impairments also had lower quality of life scores in the dimensions of physical function, general health, social function, emotional function, and mental health (all P < .05). Cognitive impairment appears to be common among CAPD patients and may adversely affect both their treatment adherence and overall quality of life. A more comprehensive understanding of the underlying mechanisms necessitates further study.

摘要

本研究旨在探讨认知障碍对持续非卧床腹膜透析(CAPD)患者治疗依从性和生活质量的影响。本研究采用横断面研究方法,于 2021 年 10 月至 2022 年 5 月在涟水县人民医院肾病科对 CAPD 患者进行研究。采用蒙特利尔认知评估量表(MoCA)评估认知功能,采用终末期肾病依从性问卷评估治疗依从性,采用 SF-36 问卷评估生活质量。记录所有问卷评分和人口统计学数据。共纳入 98 例患者,CAPD 患者认知障碍的患病率为 69.39%(MoCA 评分<26)。患者分为两组:一组为认知功能正常(MoCA 评分≥26),另一组为认知障碍。两组在年龄、透析年龄、教育程度、尿素清除指数、高血压史和糖尿病史方面存在统计学差异(均 P<.05)。认知障碍患者在饮食液体限制、药物治疗方案和透析方案方面的依从性较低(均 P<.05)。认知障碍患者在生理功能、一般健康、社会功能、情感功能和心理健康等维度的生活质量评分也较低(均 P<.05)。认知障碍在 CAPD 患者中较为常见,可能对其治疗依从性和整体生活质量产生不利影响。需要进一步研究以更全面地了解其潜在机制。

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