Ge W W, Zhang H L, Liu P, Yin L X
Department of Nursing, The Affiliated Lianyungang Hospital of Xuzhou Medical University, The First People's Hospital of Lianyungang, No. 6 Zhenhua East Road, Lianyungang, Jiangsu, 222061, China.
Office of Quality and Safety, The Affiliated Lianyungang Hospital of Xuzhou Medical University, The First People's Hospital of Lianyungang, Lianyungang, Jiangsu, 222061, China.
BMC Nephrol. 2025 Mar 5;26(1):116. doi: 10.1186/s12882-025-04044-z.
Maintenance haemodialysis (MHD) has emerged as a primary treatment modality in individuals with end-stage kidney disease. However, haemodialysis not only affects physiological well-being but also significantly influences patients' social engagement and quality of life. Consequently, investigating the present status and repercussions on social participation among individuals undergoing MHD has evolved as a crucial area of research. This study aimed to investigate the current status of social participation among patients undergoing MHD and analyse the influencing factors, providing a theoretical basis for clinical intervention.
This cross-sectional study utilised a convenience sampling method to select 441 patients undergoing maintenance haemodialysis (MHD) at seven tertiary hospitals in Lianyungang between January and May 2024 as survey participants. The study employed a general information questionnaire along with several assessment tools, including the Chinese version of the Impact on Participation and Autonomy; Social Support Rating Scale; Hospital Anxiety and Depression Scale; Pittsburgh Sleep Quality Index; Chinese version of the Functional Assessment of Chronic Illness Therapy-Fatigue; and Medical Outcomes Study Health Status Short Form. Patients with end-stage renal disease aged ≥ 18 years and undergoing MHD for ≥ 3 months were included. Those with other severe illnesses, psychiatric disorders, personality disorders, or inability to cooperate with the study were excluded. Multivariate linear regression analysis was used to identify factors influencing social participation in MHD patients.
The total score of social participation among patients on MHD was 54. Multiple linear regression analysis indicated that, based on the International Classification of Functioning, Disability, and Health framework, total scores of depression, total scores of social support, age, total scores of the fatigue scale, smoking history, and employment status were the main influencing factors of social participation in patients on MHD (P < 0.05).
The level of social participation among patients on MHD was moderate and in need of enhancement. Healthcare providers should prioritise older, unemployed patients and improve their social participation and quality of life by addressing issues such as fatigue, depression, and enhancing social support.
维持性血液透析（MHD）已成为终末期肾病患者的主要治疗方式。然而，血液透析不仅影响生理健康，还会显著影响患者的社交参与和生活质量。因此，研究接受MHD治疗的个体的社会参与现状及其影响已成为一个关键的研究领域。本研究旨在调查接受MHD治疗患者的社会参与现状并分析影响因素，为临床干预提供理论依据。
本横断面研究采用便利抽样法，选取2024年1月至5月在连云港市7家三级医院接受维持性血液透析（MHD）的441例患者作为调查对象。本研究使用了一份一般信息问卷以及几种评估工具，包括中文版的《参与和自主能力影响量表》；社会支持评定量表；医院焦虑抑郁量表；匹兹堡睡眠质量指数；中文版《慢性病治疗功能评估-疲劳量表》；以及医学结局研究健康状况简表。纳入年龄≥18岁且接受MHD治疗≥3个月的终末期肾病患者。排除患有其他严重疾病、精神障碍、人格障碍或无法配合研究的患者。采用多元线性回归分析确定影响MHD患者社会参与的因素。
接受MHD治疗患者的社会参与总分为54分。多元线性回归分析表明，基于国际功能、残疾和健康分类框架，抑郁总分、社会支持总分、年龄、疲劳量表总分、吸烟史和就业状况是影响MHD患者社会参与的主要因素（P<0.05）。
接受MHD治疗患者的社会参与水平中等，需要提高。医疗服务提供者应优先关注年龄较大、失业的患者，并通过解决疲劳、抑郁等问题以及加强社会支持来提高他们的社会参与度和生活质量。
