| Objectives To provide the reference for the aiming intervention of nursing MH D patients by investigating the influencing factors of nutritional risk in maintenanc e hemodialysis(MHD) patients.Methods 216 MHD patients with nutritional risk were selected as the case group, another 639 MHD patients without nutritional risk were selected as the control group. All the MHD patients of length of stay in the hospital were from October 2014 to October 2015. A lot of studies were conducted in the course of hemodialysis. The survey contains general information, clinical data and influencing factors of nutritional risk. General information includes Gender, age, marital status, educational level, personal income, professional status. Clinical data includes the ages of MHD patients, dialysis models, dialysis frequency, duration of dialysis, vascular access, original diseases, types of accompanieddiseases and the frequency of Erythropoietin(EPO). Influencing factors of nutritional risk includes many factors. The first one is evaluating self efficacy for Managing Chronic Disease.The second one is evaluating medical coping style for the Medical Coping Modes Questionnaire. The third one is evaluating the state of anxiety for Self-Rating Anxiety Scale. The fourth one is evaluating the state of depression for Selfrating Depression Scale. The fifth one is evaluating family function of patients for Family Assessment Device. The sixth one is evaluating social support status for Social Support Rating Scale. All the data were analyzed by SPSS 19.0. The influencing factors of nutritional risk were researched with single factor analysis and logistic regression method.Results 1 Single factor analysis showed:(1) Compared with the control group, t he ones of the nutritional risk in case group, who are age?60 years old, female,hi gh school education level and more, is higher than the ones, who are age<60 yea rsold, male, middle school cultural level or less. There was a significant difference f orthese factors. c2 are 5.259, 10.850, 5.473 respctively, the average p<0.05. Odds ratioes are 0.689, 0.594, 0.690 respctively, 95% confidence indexes are 0.500~0.948,0.436~0.811, 0.506~0.942 respctively. There was no a significant difference for the sefactors, which are single, personal monthly income?2000, more physical work, co mpareing withother factors which are married, personal monthly income>2000, mor e brain work. c2 are 1.488?3.474?0.642 respctively, the average p>0.05. OR are 0.789, 1.372, 0.875 respctively, 95%CI are 0.539~1.155, 0.983~1.915,0.632~1.213 r espctively.(2) Compared with the control group, the ones of the nutritional risk in case group, who areduration of dialysis ?10 years, single hemodialysis model, dialysis frequency of a week?2, duration of dialysis?4h, the frequency of EPO?2 in a week,vascular accesswith central venous catheter, the types of complication?2, is h igher than the ones,who are duration of dialysis<10 years, combined hemodialysis model, dialysis frequency of a week >2, duration of dialysis=4h, the frequency of EPO>2 in a week, vascular access with internal arteriovenous fistula, the types of complication<2. There was a significant differencefor these factors. c2 are 18.912?4.923?22.510?13.428?20.721?7.511?8.045 respctively, the average p<0.05. OR are 0.463?1.490?3.077?1.784?2.053?0.592?0.639 respctively, 95% CI are 0.325~0.658?1.046~2.121?1.899~4.986?1.307~2.436?1.502~2.805?0.406~0.864?0.469~0.872 respctively. Compared with patients with secondary rennal damage, ther e was noa significant difference for the patients with original rennal damage of the nutritional risk in case group. c2=0.789(p>0.05), OR is 0.857, 95% CI is 0.609~1.206.(3)Compared with the control group,the ones of the nutritional risk in case group, who are the lower self efficacy of chronic diseases, anxiety, depression and passive medical coping style is higher than the ones, who are hingher self efficac y of chronic diseases, no anxiety, no passive and active medical coping style. Ther e was a significant difference for these factors. c2 are 4.868?8.676?5.015?5.687 r espctively, the average P<0.05, OR are 0.706?0.584?1.468?1.456 respctively, 95% CI are0.518~0.963, 0.407~0.837, 1.048~2.057, 1.068~1.985 respctively.(4)Com pared with the control group, the ones of the nutritional risk in case group,who ar e less family assessment, low and medium social Support, is higher than the ones,w ho are higher family assessment, higher and medium social Support. There was a sig nificant difference for these factors. c2 are 10.607, 9.145 respctively, theaverage p<0.05.OR are 0.479, 0.481 respctively, 95% CI are 0.305~0.751, 0.296~0.779 respct ively.2 Multivariate analysis showed that the nutritional risk are mainly related to the dialysisages, genders, social support, family function, the types of complication,treatment modes, education level, dialysis frequency, duration of dialysis, EPO utili zation rate and so on.Conclusions Dialysis ages, genders, social support, family function, the types of complication, treatment modes, education level, dialysis frequency, duration of dialysis and EPO utilization rate are the mainly factors for the nutritional risk patients. |
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