Research On The Status Of Benefit Finding Of Hemodialysis Patients And Promote Program Construction Based On PERMA Flourish Model

Purpose:This study from the perspective of "positive psychology",intends to separate out the status quo of benefit finding(BF)in hemodialysis(HD)patients through crosssectional investigation and analyze influencing factors.On this basis,the BF promotion program for HD patients based on PERMA flourish model is initially developed and revised through export meeting,in order to provide reference in improve the mental health and quality of life of HD patients.Method:Based on quantitative research,Scope review,expert meeting and other methods,this study initially constructed a BF promotion program for HD patients based on PERMA flourish model,which mainly includes the following:1.The Level of BF and Influence Factors in HD Patients: A Cross-Sectional StudyA cross-sectional survey of the status quo and influencing factors of the BF in HD patients was conducted in four hospitals in Shanghai with the convenience sampling method.The sample size was calculated to be at least 168 based on the requirements of the multi-factor analysis method.The research tools included BFS,PERMA Flourish Scale,SCSQ,PSSS.Epi Date 3.1 was used to input and verify the data and IBM SPSS 26.0 software was used to conduct statistical analysis of the data,after confirming the correctness.The descriptive,single factor,correlation and stepwise regression analysis methods were used to conduct statistical analysis of the data.2.The Preliminary Construction of BF Promotion Program for HD Patients Based on PERMA ModelThe Scope review was used to search the Pub Med,Web of Science,EMBASE,CINAHL databases,China Biomedical Literature Abstracted database,China National Knowledge Network,Wanfang database and Weipu Chinese science and technology periodical database.Relevant literatures on psychological intervention and BF promotion programs based on PERMA flourishing model were respectively searched,and the status quo and specific contents of intervention programs were summarized.Based on the literature summary results of the Scope review,supported by the PERMA cardiogram model,and the influence factor model constructed by a crosssectional survey,the BF promotion program for HD patients based on the PERMA model was preliminarily constructed,and was conducted through the Expert meeting.Results:1.The Level of BF and Influence Factors in HD Patients: A Cross-Sectional Study(1)A total of 396 HD patients were investigated in this study with an average age of 57.91±13.54 years old,including 235 males(59.3%)and 161 females(40.7%).The average duration of HD was 6.89±6.73 years.(2)The K-S test showed that none of the continuous variables in this study satisfied normality,so median and quartile were used to describe them.Median BF was 77(64,87),median PERMA flourish was 6.31(5.13,7.69),Positive coping was 23(17,28),Negative coping was 11(8,15),Perceived social support was 60(55,67),Among them,the scores of Family support,Friend support and Other support were 24(21,27),19(15,22),18(14,22).(3)Univariate analysis showed that the BF of HD patients was related to gender,age,occupation,marital status,economic burden,primary caregiver,number of chronic diseases,disease knowledge,disease severity,life impact,and individual coping tendency(P < 0.05).It was not related to ethnic group,education level,duration of HD,kidney transplantation experience,mood in the last month(P>0.05).Spearman correlation analysis showed that the benefit of hemodialysis patients was positively correlated with age,PERMA flourish and its two dimensions,Social support and its three dimensions,Positive and Negative coping(P<0.05).There was no correlation with duration of HD(P>0.05).(4)Stepwise regression analysis was used in multi-factor analysis,and a total of 6 variables were included in the equation.Among them,age,PERMA,Positive coping,Family support and self-perceived HD influence degree on life were positively correlated with the BF,while self-perceived HD knowledge level was negatively.The above common explanation BF 45.6% of the total variation,F=56.079,P< 0.001,DW value of the regression equation is 2.077,VIF value is all < 5,proving that the variables are independent of each other and there is no multicollinearity.2.The Preliminary Construction of BF Promotion Program for HD Patients Based on PERMA Model(1)Through the method of scope review,the relevant domestic and foreign studies on psychological intervention based on benefit discovery promotion program and PERMA model were summarized,and a total of 65 literatures were included.The results showed that the intervention goal was to bring long-term effects,the intervention measures guided the patients to reveal their true thoughts,the intervention content improved the ability to cope with negative events,the intervention form was mainly offline and supplemented by online,the intervention theme was simple and easy,the content was easy to understand,the intervention frequency was common 1-2 times per week,and the outcome indicators focused on the influencing factors of the benefit discovery.(2)The BF promotion program for hd patients based on the PERMA flourish model was preliminarily constructed.The intervention program included intervention form,implementer,duration,intervention content and outcomes.The intervention content consisted of 8 group counseling sessions,group discussion and simulation exercises on different topics based on the PERMA flourish model.(3)8 senior experts were invited to attend the expert meeting.The specific content of the revised intervention plan is as follows: The intervention was conducted in the form of online and offline joint group counseling,and the intervention was carried out by the members of the research group and the HD nurses who received the intervention training.The intervention lasted for 8 weeks,once a week,60 to 90 minutes each time.The physiological and psychological results were evaluated before the intervention,after the fifth and the eighth intervention,1 month and 3 months after the intervention.The themes of each week are:(1)Getting into positive psychology;(2)Finding positive emotions;(3)Experience immersion;(4)Establish positive relationships;(5)Guide and enhance confidence;(6)Seeking the meaning of life;(7)Experience the feeling of achievement;(8)Improve mental health.Conclusion:1.The BF of HD patients need to be improved.The influencing factors include age,PERMA flourish,Positive coping,Family support,Self-perception of HD related knowledge and impact on life.2.Based on evidence-based research,quantitative investigation,expert meetings and other research methods,this study initially constructed a BF promotion program for HD patients based on the PERMA flourish model,which is scientific.