Aoki K, Muraoka K
Kango Kenkyu. 1993;26(6):553-62.
The purpose of this study is to clarify stressors resulting from continuous ambulatory peritoneal dialysis (CAPD) in CAPD patients and to discuss adaptation to daily life. With reference to the dialysis stressor scale used by Baldree and Masaki et al., a scale for CAPD stressors, consisting of 42 items, was devised, and the stressors were investigated in 56 patients, with the following results: 1) The items rated as high CAPD stressors included the frequency of bag exchange, itch, fatigue, anxiety about the future, and restricted physical activities. Restriction of meal and fluid intake, which are highly-rated stressors in patients on hemodialysis (HD) were not highly-rated stressors in these 56 CAPD patients. Thus, there was a difference between HD and CAPD. 2) The degree of cognition of CAPD stressors increased according to an individual's situation. (1) The presence or absence of an occupation had the greatest effect on the cognition of CAPD stressors. (2) The degrees of cognition of anxiety about the future and work-related difficulties as stressors were high in patients under 60 years of age. (3) The degree of cognition of items related to work as stressors was high in male patients while that of items related to body image as stressors was high in female patients. (4) There was a qualitative difference in stressor congnition between patients with a history of CAPD of shorter than 3 months and those whose history was 3 months or longer. (5) The degree of congnition of infection was also low in patients who suffered from peritonitis. (6) The degree of congnition of symptoms causing physical discomfort was high in patients with diabetic nephropathy. (7) There were significant differences in several variables, in terms of the degree of congnition, among patients with regard to work difficulties and the absence of familial cooperation. On the basis of these results, guidance for patients and their families is necessary.
本研究旨在阐明持续性非卧床腹膜透析（CAPD）患者因CAPD产生的应激源，并探讨其对日常生活的适应情况。参考Baldree以及Masaki等人使用的透析应激源量表，设计了一个由42个项目组成的CAPD应激源量表，并对56例患者的应激源进行了调查，结果如下：1）被评为高CAPD应激源的项目包括换袋频率、瘙痒、疲劳、对未来的焦虑以及身体活动受限。在血液透析（HD）患者中被评为高应激源的饮食和液体摄入限制，在这56例CAPD患者中并非高应激源。因此，HD和CAPD之间存在差异。2）CAPD应激源的认知程度因个体情况而异。（1）是否有工作对CAPD应激源的认知影响最大。（2）60岁以下患者对未来焦虑和工作相关困难作为应激源的认知程度较高。（3）男性患者对与工作相关项目作为应激源的认知程度较高，而女性患者对与身体形象相关项目作为应激源的认知程度较高。（4）CAPD病史短于3个月的患者与病史为3个月或更长时间的患者在应激源认知上存在质的差异。（5）患有腹膜炎的患者对感染的认知程度也较低。（6）糖尿病肾病患者对引起身体不适症状的认知程度较高。（7）在工作困难和缺乏家庭合作方面，患者在认知程度的几个变量上存在显著差异。基于这些结果，有必要对患者及其家属进行指导。
