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年龄在塑造血液透析患者认知、身体和心理社会结局中的作用:一项横断面研究。

The Role of Age in Shaping Cognitive, Physical, and Psychosocial Outcomes in Hemodialysis Patients: A Cross-Sectional Study.

作者信息

Sułkowski Leszek, Matyja Andrzej, Matyja Maciej

机构信息

Department of General Surgery, Regional Specialist Hospital, 42-218 Częstochowa, Poland.

2nd Department of General Surgery, Jagiellonian University Medical College, 30-688 Kraków, Poland.

出版信息

Medicina (Kaunas). 2025 Jul 18;61(7):1295. doi: 10.3390/medicina61071295.

Abstract

Chronic kidney disease frequently progresses to end-stage renal disease, requiring dialysis, which imposes significant physical, psychological, and social burdens. Age is a key factor influencing symptom experience and quality of life in dialysis patients, yet findings on its impact remain mixed. This study aimed to examine how age relates to a broad range of health domains-including fatigue, pain, cognition, mental health, sexual satisfaction, bowel control, visual impairment, social support, and quality of life-among hemodialysis patients. A cross-sectional study was conducted at a single dialysis center in Poland, involving 79 adult patients undergoing maintenance hemodialysis. Standardized, validated psychometric instruments were used, including the Modified Fatigue Impact Scale (MFIS), Perceived Deficits Questionnaire (PDQ), Pain Effects Scale (PES), Mental Health Inventory (MHI), Modified Social Support Survey (MSSS), Sexual Satisfaction Scale (SSS), Bowel Control Scale (BWCS), Impact of Visual Impairment Scale (IVIS), and WHOQOL-BREF for quality of life. Spearman's or Pearson's correlation coefficients were used to evaluate relationships between age and scale scores. Full and abbreviated versions of scales were also compared. Age showed moderate positive correlations with fatigue (ρ = 0.44-0.53), cognitive deficits (ρ = 0.37-0.45), pain (r = 0.41), bowel control issues (ρ = 0.32), and visual impairment (ρ = 0.37), all statistically significant ( < 0.01). No significant associations were observed between age and mental health (MHI), perceived social support (MSSS), or quality of life (WHOQOL-BREF). Abbreviated versions of the scales showed strong correlations with their full versions (ρ > 0.9). While age is linked to increased symptom burden in select domains such as cognition, fatigue, and pain, it does not significantly affect mental health, perceived social support, or overall quality of life in hemodialysis patients. These findings support the use of age-sensitive, multidimensional assessments to inform individualized care strategies.

摘要

慢性肾脏病常进展为终末期肾病,需要进行透析,这会带来巨大的身体、心理和社会负担。年龄是影响透析患者症状体验和生活质量的关键因素,但其影响的研究结果仍存在分歧。本研究旨在探讨年龄与血液透析患者广泛的健康领域(包括疲劳、疼痛、认知、心理健康、性满意度、肠道控制、视力损害、社会支持和生活质量)之间的关系。在波兰的一个透析中心进行了一项横断面研究,纳入79例接受维持性血液透析的成年患者。使用了标准化、经过验证的心理测量工具,包括改良疲劳影响量表(MFIS)、感知缺陷问卷(PDQ)、疼痛影响量表(PES)、心理健康量表(MHI)、改良社会支持调查(MSSS)、性满意度量表(SSS)、肠道控制量表(BWCS)、视力损害影响量表(IVIS)以及用于生活质量的世界卫生组织生活质量简表(WHOQOL - BREF)。采用Spearman或Pearson相关系数评估年龄与量表得分之间的关系。还比较了量表的完整版本和缩写版本。年龄与疲劳(ρ = 0.44 - 0.53)、认知缺陷(ρ = 0.37 - 0.45)、疼痛(r = 0.41)、肠道控制问题(ρ = 0.32)和视力损害(ρ = 0.37)呈中度正相关,均具有统计学意义(<0.01)。未观察到年龄与心理健康(MHI)、感知社会支持(MSSS)或生活质量(WHOQOL - BREF)之间存在显著关联。量表的缩写版本与完整版本显示出强相关性(ρ > 0.9)。虽然年龄与认知、疲劳和疼痛等特定领域的症状负担增加有关,但它对血液透析患者的心理健康、感知社会支持或总体生活质量没有显著影响。这些发现支持使用对年龄敏感的多维评估来指导个体化护理策略。

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