| Objective: To evaluate the applicability of chronic illness resource survey (CIRS) in maintenance hemodialysis patients,to describe the current situation of chronic illness resource utilization in maintenance hemodialysis patients.Analysis of influencing factors in the utilization of chronic disease resources in maintenance hemodialysis patients.Based on this to provide relevant basis for improving the utilization of hemodialysis patients’ resources in the futureMethods: Questionnaire sampling method: Convenient Sampling collection January 2018-June 2018 at three Hospital’s blood Purification Center for 314 maintenance hemodialysis outpatient patients.Using five questionnaires which assessed the use of chronic resources,hope,self-efficacy,anxiety and depression,and general information (general information questionare、CIRS、HHI、HADS,and cronic disease self-efficacy scale).Statistical analysis: Application SPSS19.0 and AMOS21.0 software to evaluate questionnaire’s internal consistency,structural validity,aggregation validity and distinguishing validity.By using SPSS19.0 software to describe the current situation of resource utilization,using t test,variance analysis,multi-variate linear regression to explore the influencing factors of patients resources utilization.Results:(1)The Cronbach’s α coefficient of full scale was 0.928.Construct Validity-Exploratory Factor Analysis: Six common factors with eigenvalue > 1 were extracted and the cumulative variance contribution rate was 80.356%The fit indices of original 7 factor structural equation model were χ2/df=1.992,RMSEA=0.080,NFI=0.889,IFI=0.942,TLI=0.920,CFI=0.941.(2)Current status of resource utilization in maintenance hemodialysis patients: The average score of resource utilization entries is 2.95±0.51.The average score of seven dimensions from high to low are medical staff (3.46±0.60),individual coping (3.32±0.66),family and friends(3.22±0.67),work-related (3.16±0.58),media policy (3.12±0.60),neighborhood community (2.55±0.59),organization (2.23±0.88).(3)Factor Analysis and correlation analysis: Different marital status,primary caregiver,education level,working status,family monthly income (yuan),type of medical insurance,hospital visits,ability to pay fees,blood pathways,number of internal fistula surgeries,weekly dialysis times,other basic diseases,residual urine volume have different resource utilization among patients,The difference is statistically significan,and there was a positive correlation between self-efficacy,level of hope and resource utilization,the difference was statistically significant,and the correlation between anxiety,depression and resource utilization are negative.(4)Multiple factors analysis: Multiple linear regression showed that self-efficacy,hospital visit,hope level,economic condition,educational level and anxiety were the main influencing factors,which explained 65.4% of the variance of hemodialysis patients’ resource utilization.Conclusion:(1)The Chinese version of CIRS questionnaire (7 dimensions) has good validity and high internal consistency.It can be used as a tool to investigate the status of resource utilization in maintenance hemodialysis patients.(2)The utilization of health care team and individual coping in hemodialysis patients are used better,and the utilization of resources in neighborhood communities and organizations of maintenance dialysis patients are less than ideal,which could be improved.(3)Hemodialysis patients who were low level of education,poor economic conditions and poor mental condition need to improve the chronic illness resource utilization.The different resources provided by the hospital would have influence on patient’s resource utilization. |
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