Lv Xiangying, Zhang Hong, Yang Lan, Xing Xinmei, Huang Yao
Department of Nephrology, Baoding No. 1 Central Hospital, Baoding Great Wall North Street No. 320, Baoding, Hebei, 071000, China.
BMC Nephrol. 2025 May 29;26(1):265. doi: 10.1186/s12882-025-04191-3.
This multi-center study aimed to investigate the correlation between vascular access satisfaction (VAS) and demoralization syndrome (DS) in elderly patients undergoing maintenance hemodialysis (MHD). Secondary objectives included identifying predictors of VAS and comparing DS severity between patients with high and low VAS scores.
A retrospective analysis was conducted from April 2024 to October 2024, involving 350 elderly MHD patients from three tertiary hospitals in China. Participants were stratified into two groups based on VAS scores: the VA dissatisfaction group (n = 220) and the VA satisfaction group (n = 130). Data collection utilized the Short Form Vascular Access Questionnaire (VAQ) and the Chinese Version of the Demoralization Syndrome Scale. Binary logistic regression and independent t-tests were employed to analyze predictors of VAS and DS scores.
Significant differences in VAS scores were observed between the dissatisfaction and satisfaction groups (p < 0.001). Multivariate analysis identified living alone (OR = 2.1, 95% CI 1.4-3.2), prolonged dialysis duration (OR = 1.8, 95% CI 1.2-2.7), and elevated parathyroid hormone (PTH) levels (OR = 1.5, 95% CI 1.1-2.0) as independent risk factors for VAS, while higher hemoglobin levels (OR = 0.6, 95% CI 0.4-0.9) served as a protective factor. Notably, the dissatisfaction group exhibited markedly higher DS scores (73.6 ± 8.7 vs. 51.2 ± 6.9, p < 0.01), indicating a strong association between VAS and psychological distress.
This study underscores a robust correlation between VAS and DS in elderly MHD patients. Interventions targeting social support optimization, anemia management, and mineral metabolism regulation may improve vascular access outcomes and mitigate demoralization, thereby enhancing quality of life.
Not applicable.
本多中心研究旨在调查维持性血液透析（MHD）老年患者的血管通路满意度（VAS）与失志综合征（DS）之间的相关性。次要目标包括确定VAS的预测因素，并比较高VAS评分和低VAS评分患者之间的DS严重程度。
对2024年4月至2024年10月期间来自中国三家三级医院的350例老年MHD患者进行回顾性分析。参与者根据VAS评分分为两组：血管通路不满意组（n = 220）和血管通路满意组（n = 130）。数据收集采用简短血管通路问卷（VAQ）和失志综合征量表中文版。采用二元逻辑回归和独立t检验分析VAS和DS评分的预测因素。
不满意组和满意组的VAS评分存在显著差异（p < 0.001）。多变量分析确定独居（OR = 2.1，95%CI 1.4 - 3.2）、透析时间延长（OR = 1.8，95%CI 1.2 - 2.7）和甲状旁腺激素（PTH）水平升高（OR = 1.5，95%CI 1.1 - 2.0）是VAS的独立危险因素，而较高的血红蛋白水平（OR = 0.6，95%CI 0.4 - 0.9）是保护因素。值得注意的是，不满意组的DS评分明显更高（73.6 ± 8.7 vs. 51.2 ± 6.9，p < 0.01），表明VAS与心理困扰之间存在密切关联。
本研究强调了老年MHD患者VAS与DS之间的密切相关性。针对优化社会支持、管理贫血和调节矿物质代谢的干预措施可能改善血管通路结局并减轻失志情绪，从而提高生活质量。
不适用。
