Psychological Problems Influencing Factors Survey And Effects Of Comprehensive Psychological Intervention Of The Peritoneal Dialysis Patients

Objective To explore the influence factors of anxiety and depression and the effects of specific psychological intervention of the peritoneal dialysis patientsMethods 172 subjects with peritoneal dialysis from 2 Third-level grade-A hospitals were investigated by BAI, BDI, PSSS, KDQOL in the first part. In the second part of this study 82 subjects with peritoneal dialysis were randomly assigned into two groups, every one of 41. Subjects of the test group received specific psychological intervention except for the routine nursing, while the control group received routine nursing only. BAI, BDI, PSSS, KDQOL were assessed respectively before and after 12,24weeks’ intervention. The participation of the test group was also recorded.Results ① Univariate and multivariate logistic regression analyses revealed that dry skin, poor appetite, dry mouth, nausea or upset stomach are the independent risk factors that result in patients’anxiety. Whether in work status, medical burden, poor appetite, itchy skin, cultural degree are the the independent risk factors result in patients’depression. The risk of depression is lower in the patients with high cultural level and higher in patients with the level below the junior middle school. Patients not employed, at one’s own expense, with poor appetite and itchy skin in higher risk of depression.② There was significant difference between the test group and the control group on Anxiety (P<0.05),and significant time effect(P<0.001) and obvious interaction effect between time factor and group factor (P>0.05).Compared with the basic level, the change on Anxiety of test group was significant (P<0.05), while the change of Anxiety of control group was subtle.③) There was significant difference between test group and control group on depression (P<0.05) and had significant time effect(P<0.001) and interaction effect between time factor and group factor (P<0.001).Compared with the basic level, the improvement on depression in test group was significant (P<0.01, P<0.01), while the change in control group was subtle (P>0.05).④ There was no significant difference between test group and control group on perceived social support scale (P>0.05) but had significant time effect(P<0.01) and interaction effect between time factor and group factor (P<0.001).Compared with the basic level, the improvement on perceived social support scale in test group was significant after 12 weeks (P<0.05) but not significant after 24 weeks (P>0.05), while the change in control group was subtle (P>0.05).⑤ There was no significant difference between test group and control group on all scales of KDQOL (P>0.05) but had significant time effect on emotional well-being(P<0.001), role-emotional(P<0.05), burden of kidney disease(P<0.05), quality of social interaction(P<0.01) and sleep (P<0.01) and interaction effect between time factor and group factor (P<0.001) except on burden of kidney disease(P>0.05).Compared with the basic level, the improvement on all scales of KDQOL were not significant after 12,24 weeks both in test group and control group (P>0.05).Conclusion Many factors such as financial constraints, illness effects, culture, social stresses and so on. The comprehensive psychological intervention is more specific and effective than the routine nursing in peritoneal dialysis patients. It not only can decrease the level of anxiety and depression but can improve the mood of the patients and maintain the mental status.