Lin Chia-Hui, Chiang Yi-Chien, Li Wen-Yi, Chu Tsung-Lan, Hsiao Ya-Chu
Nurse practitioner in the Hemodialysis, Department of National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan.
Department of Nursing, Chang Gung University of Science and Technology, Division of Pediatric Hematology and Oncology, Chang Gung Memorial Hospital Linkou Main Branch, Taiwan.
Int J Nurs Stud Adv. 2025 Jan 3;8:100288. doi: 10.1016/j.ijnsa.2024.100288. eCollection 2025 Jun.
Long-term haemodialysis patients often experience physical symptom distress (PSD) and varying levels of demoralization. Spirituality and self-compassion can help patients to cope these challenges. However, the interrelations between these variables remain underexplored, necessitating further investigation.
To examine the effect of PSD on demoralization among haemodialysis patients and to determine whether spirituality and self-compassion mediate these relationships.
A cross-sectional correlational study.
A convenience sample was used to recruit from two haemodialysis clinics.
Self-report questionnaires were the Physical Symptom Distress Scale, Demoralization Scale, Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale-12, and Self-Compassion Scale. Relationships and mediators were examined with Pearson's correlations and multiple linear regression analysis, respectively.
A total of 156 participants participated. Mean age of participants was 61.3 years ( = 11.3). Most participants were male (66 %) and had received dialysis for ≥ 5 years (61.5 %). Pearson's correlation indicated higher scores for PSD were significantly associated with lower levels of spirituality and self-compassion and higher levels of demoralization. There was a significant total and direct effect of PSD on demoralization. Mediation analysis indicated that the relationship between PSD and demoralization was partially and significantly mediated by spirituality and self-compassion. Demoralization can be explained by 46.83 % variance accounted by these predictors in the mediation model.
Long-term haemodialysis can cause chronic symptom distress and feelings of demoralization. The mediating effects of spirituality and self-compassion on PSD and demoralization suggest that these qualities may act as emotional regulators that enable haemodialysis patients to be more accepting of symptom distress, which results in lower levels of demoralization. Our findings imply that developing strategies to increase spirituality and self-compassion could help patients manage chronic symptom distress associated with haemodialysis, reduce demoralization, and ultimately improve their quality of life.
长期血液透析患者经常经历身体症状困扰（PSD）和不同程度的士气低落。精神性和自我同情有助于患者应对这些挑战。然而，这些变量之间的相互关系仍未得到充分探索，需要进一步研究。
研究PSD对血液透析患者士气低落的影响，并确定精神性和自我同情是否介导这些关系。
横断面相关性研究。
采用便利抽样法从两家血液透析诊所招募患者。
采用自我报告问卷，包括身体症状困扰量表、士气低落量表、慢性病治疗功能评估-精神幸福感量表-12和自我同情量表。分别用Pearson相关性分析和多元线性回归分析来研究关系和中介作用。
共有156名参与者。参与者的平均年龄为61.3岁（标准差=11.3）。大多数参与者为男性（66%），且已接受透析≥5年（61.5%）。Pearson相关性分析表明，PSD得分越高与精神性和自我同情水平越低以及士气低落水平越高显著相关。PSD对士气低落有显著的总体和直接影响。中介分析表明，PSD与士气低落之间的关系部分且显著地由精神性和自我同情介导。在中介模型中，这些预测因素可解释46.83%的士气低落变异。
长期血液透析可导致慢性症状困扰和士气低落感。精神性和自我同情对PSD和士气低落的中介作用表明，这些特质可能作为情绪调节器，使血液透析患者更能接受症状困扰，从而降低士气低落水平。我们的研究结果表明，制定提高精神性和自我同情的策略可能有助于患者应对与血液透析相关的慢性症状困扰，减少士气低落，最终改善他们的生活质量。
