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接受透析治疗的老年患者的精神和社会心理状况

Psychiatric and psychosocial status of elderly patients undergoing dialysis.

作者信息

Iordanidis P, Alivanis P, Iakovidis A, Dombros N, Tsagalidis I, Balaskas E, Derveniotis V, Ierodiakonou C, Tourkantonis A

机构信息

Third Department of Psychiatry, Aristotelian University of Thessaloniki, AHEPA Hospital, Greece.

出版信息

Perit Dial Int. 1993;13 Suppl 2:S192-5.

PMID:8399563
Abstract

We investigated the psychiatric and psychosocial status of 31 elderly (age > 65 years) end-stage renal disease patients undergoing hemodialysis (HD) (17 patients) and continuous ambulatory peritoneal dialysis (CAPD) (14 patients). There was no difference between the two groups in terms of age (67.3 +/- 2.3 and 68.5 +/- 4.3 in HD and CAPD groups, respectively), duration of dialysis treatment, and biochemical profile. The psychiatric and psychosocial status of the patients was assessed using the standardized psychiatric interview (SPI), Hamilton's depression scale (HRS-D), and a questionnaire for the evaluation of the psychosocial impact of the method of treatment. Sixteen of 31 patients presented with psychiatric morbidity (9 mild, 5 moderate, 2 severe). However, there was no significant relationship between psychiatric morbidity and method of dialysis (HD or CAPD). The mean values of SPI (21.47 +/- 16.38 and 17.14 +/- 13) and HRS-D (20.91 +/- 17.33 and 15.41 +/- 13.13) scores for the HD and CAPD groups, respectively, did not differ significantly. The analysis of the results of the questionnaire regarding the impact of the method of treatment on psychosocial status indicated that the HD patients felt that their lives were more dependent on factors that they could not influence (i.e., the dialysis equipment, etc.). Our findings suggest that the psychiatric status of elderly patients undergoing chronic dialysis treatment is not affected by the method of treatment, a factor that should be taken into consideration when deciding the proper dialysis treatment for these patients.

摘要

我们调查了31名老年(年龄>65岁)终末期肾病患者的精神和心理社会状况,这些患者正在接受血液透析(HD)(17例)和持续性非卧床腹膜透析(CAPD)(14例)。两组在年龄(HD组和CAPD组分别为67.3±2.3和68.5±4.3)、透析治疗时间和生化指标方面没有差异。使用标准化精神科访谈(SPI)、汉密尔顿抑郁量表(HRS-D)以及一份用于评估治疗方法对心理社会影响的问卷,对患者的精神和心理社会状况进行了评估。31名患者中有16名存在精神疾病(9例轻度,5例中度,2例重度)。然而,精神疾病与透析方法(HD或CAPD)之间没有显著关系。HD组和CAPD组的SPI平均得分(分别为21.47±16.38和17.14±13)和HRS-D平均得分(分别为20.91±17.33和15.41±13.13)没有显著差异。对关于治疗方法对心理社会状况影响的问卷结果分析表明,HD患者觉得他们的生活更多地依赖于他们无法影响的因素(即透析设备等)。我们的研究结果表明,接受慢性透析治疗的老年患者的精神状况不受治疗方法的影响,这一因素在为这些患者确定合适的透析治疗时应予以考虑。

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