| It was found that the maintained hemodialysis (MHD) patients had lower quality of life (QOL) than others. According to literature review, the QOL of MHD patients has been influenced by many factors which could be generalized into three sorts: social-demographyic factors, illness-related factors and social-psychological factors. As those factors have been studied in some separated researches, the relationship between those factors and QOL, and the relationship within those factors have not been clarified. Thererore, it is necessary to systematically study those factors influencing their QOL. So that the study could provide the theoretic foundation for psychological intervention of MHD patients'QOL and evaluation criteria for psychological therapy.In view of the situation of MHD patients'low QOL, various therapies especially psychological therapies have aroused rising attention. Specific methods of psychological intervention focus on exercise, relaxtion and health education in individual form. The goal of psychological intervention therapy focus on improving a unique symptom. Though those psychological intervention therapy have made some achievements, there still exist some limitations. For example, the form of individual counseling is time-consuming and the methods of psychological intervention lack variation. According to the present studies, the mental health is one of the most important factors influencing MHD patients'QOL. High-level stress results in mental disorder. But there are few studies aiming at improving MHD patients'mental health and QOL by decreasing their specific stressors, modifying their cognitive evaluation and establishing their reasonabale cognition.Thus, first this study choose MHD patients in five hospital as subjects and adopt questionnaire, correlate analysis, regression analysis and path analysis to clarify the factors of QOL. Then this study revises the questionnaire of the"The Hemodialysis Stressor Scale"(HSS). We adopt quantitative methods, such as EFA, CFA, correlate analysis, regression analysis, ANOVA analysis and T test etc. to explore the structure, components and traits of MHD patients'stressors. The study has got HSS in Chinese and surveyed the traits of MHD patients. Then this study give group cognitive psychological intervention on 32 MHD patients according to the influencing factors and traits of stressors in 12-week.Several contributions can be drawn from:1. The QOL of MHD patients are significantly lower than that of ordinary individuals and it become worse in the aged. The direct factors of MHD patients'QOL includ mental health and combination illness, among which, mental health is most important one.What's more, depression has significant correlation with QOL.2. It is suggested that the structure of MHD patients'stressors is composed of three factors: psychological stressors, physical stressors and social stressors. The Hemodialysis Stressor Scale (HSS) has fine validity and reliability which can be used as a valid tool to measure MHD patients'stressors.3. MHD patients have high level of stress. The entire MHD patients'stressors manifest as follows: psychological stressors>biological stressors>social stressors. The patients'stress exists significant differences in age, education status, working status and economic status.4. The most severe stressors include the length of dialysis, cost factors, uncertainty concerning the future, changes in family responsibility and decrease in sexual drive. The most slight stressors include decreasing ability to procreate, being limited to styles of clothing, arterial and venous stick, reversal in family role with the children and changes in bodily appearance.5. This study has provided support for group cognitive therapy to decrease stress and to improve MHD patients'mental health and quality of life. After 12-week group cognitive therap, the experimental group obtained significantly lower score in SCL-90, SDS and SAS than the control group. The Experimental group also obtained significantly lower score in HSS than the control group. The study confirms that group cognitive therapy is benefical for the improvement of MHD patients'QOL.
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