中日友好医院学报2024，Vol.38Issue(1) ：25-30.DOI:10.3969/j.issn.1001-0025.2024.01.006

老年血液透析患者日常生活活动能力的影响因素调查分析

Investigation of self-care ability and frailty of daily living activities in elderly hemodialysis patients and risk factor assessment

杨柳 何雯雯 郝旭磊 张茜茜 王海燕 宋田雪 田志永 贾婉宁 王永娥
中日友好医院学报2024，Vol.38Issue(1) ：25-30.DOI:10.3969/j.issn.1001-0025.2024.01.006
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  • 维普
  • 万方数据

老年血液透析患者日常生活活动能力的影响因素调查分析

Investigation of self-care ability and frailty of daily living activities in elderly hemodialysis patients and risk factor assessment

杨柳 1何雯雯 1郝旭磊 1张茜茜 1王海燕 1宋田雪 1田志永 1贾婉宁 1王永娥1
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作者信息

  • 1. 中日友好医院 血液净化中心,北京 100029
  • 折叠

摘要

目的:评价老年维持性血液透析(MHD)患者日常生活活动(ADL)自理能力,探讨其影响因素.方法:纳入中日友好医院血液净化中心228例老年MHD患者,采用老年人生活自理能力评估表和衰弱筛查量表进行现况调查,并进行相关性、单因素及多因素回归分析.结果:本组患者平均年龄70.9±7.2岁,男性占51％,23.7％的患者在日常生活(进食、个人卫生、穿衣、入厕及排泄和移动)中存在不同程度的依赖.单因素分析显示年龄、透析血流量、非计划下机和关注事件(骨折、心血管事件、门急诊住院)在不同ADL能力组间的差异有统计学意义(P＜0.05);衰弱发生率高达85％,衰弱与ADL自理能力中度相关(r=0.503,P＜0.01).多因素Logistic回归分析,ADL可自理者发生ADL轻度、中度依赖的风险因素包括衰弱(OR=0.22、0.124,P＜0.01)和年龄(OR=1.104、1.117,P＜0.01);透析龄是ADL完全不能自理的风险因素(OR=1.151,P＜0.01).结论:老年MHD患者ADL自理能力与衰弱关系密切,衰弱进展增加了自理能力下降的风险.发生临床事件、设置较低的血流量、透析龄增加和非计划下机行为均与ADL自理能力下降有关,临床护理中应给予关注,尽早识别患者ADL能力下降并进行早期护理干预.

Abstract

Objective:To evaluate the self-care ability of activity of daily living(ADL)and weakness of elder-ly patients with maintenance hemodialysis(MHD),and to explore dialysis-related risk factors.Methods:A total of 228 elderly MHD patients from the Blood Purification Center of China-Japan Friendship Hospital were in-cluded.Cross-sectional survey was conducted using the assessment scale of self-care ability and frailty screen-ing scale of the elderly,and correlation analysis,univariate and multivariate regression analyses were carried out.Results:The mean age of the patients was 70.9±7.2 years,among them 51％were males,and 23.70％had various degrees of dependence on daily life(eating,personal hygiene,dressing,toileting and excretion and movement).Univariate analysis showed that age,dialysis blood flow,unplanned dismounting and events of con-cern(fracture,cardiovascular events,outpatient emergency hospitalization)were statistically significant between different ADL ability groups(P＜0.05).The incidence of frailty was as high as 85％,and the correlation coeffi-cient with ADL capacity was 0.503(P＜0.01).The multi-classification logistic regression equation showed that frailty(OR=0.22,0.124,P＜0.01)and age(OR=1.104,OR=1.117,P＜0.01)were risk factors for mild and moderate dependence of ADL in ADL self-care patients.Dialysis age(OR=1.151,P=0.014)was an independent risk fac-tor for ADL who could take care of themselves.Conclusion:Self-care of daily living in elderly MHD patients was strongly associated with prevalent frailty,and that progression of frailty exponentially increased the risk of declining self-care.The occurrence of clinical events,setting a lower blood flow,increasing dialysis age and having unplanned off-board behavior were associated with a decline in self-care in daily life.Attention should be given in clinical care to early recognition of declining ADL in elderly hemodialysis patients and early nursing intervention.

关键词

维持性血液透析/老年患者/日常生活活动/衰弱

Key words

maintenance hemodialysis/elderly patients/activity of daily living/frailty

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基金项目

中日友好医院护理部项目(ZRHL-LCFC-22-03)

出版年

2024
中日友好医院学报
中日友好医院

中日友好医院学报

CSTPCD
影响因子：0.92
ISSN：1001-0025
参考文献量5
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