The Status Of Volume Management Behavior In Patients With Maintenance Hemodialysis And Its Influencing Factors

ObjectiveTo investigate the status of volume management behavior in patients with Maintenance Hemodialysis(MHD),analyze the relationship between volume management behavior level and volume load,and analyze the influencing factors of volume management behavior level.MethodsThis study was a cross-sectional investigational study.Total 212 MHD patients were recruited from the North of Jiangsu people's hospital based on informed consents by convenient sampling.General situation questionnaire was applied for collecting demographic information and clinical data,MHD Volume Management Behavior(VMB)Questionnaire for collecting status of volume management level.The percentage of interdialysis weight gain(IDWG%)was used to assesse the volume overload.We analyzed the status of volume management behavior in MHD patients,the relationship between volume management behavior level and volume overload,and the influence factors of volume management behavior level.Results(1)The score of VMBQ in patients with MHD was(67.06 ± 16.54);the score of dietary dimension was lower(61.58 ± 21.53),however the score of the dimension including the blood dialysis related indicators and monitoring management of complications was a little higher(69.80 ± 19.19).(2)The levels of VMB in MHD patients with different demographic and clinical characteristics showed different levels.Education: the patients with junior high school got the lowest score(62.49 ± 13.86),however with college degree or above got the highest score(75.93 ± 17.58);Dialysis years: the patients with less than 1 year got the lowest score(64.07 ± 16.17),1-3 years got the highest score(75.64 ± 15.58);There was a statistically significant difference in the level of volume management behavior among patients with different degrees of education(F=5.841,P=0.001)and different dialysis years(F=3.582,P=0.008).(3)Volume management behavior level was related to volume overload.The diet management dimension was negatively correlated with the percentage of interdialysis weight gain(IDWG%)(R=-0.235,P=0.001).Total volume management behavior was negatively correlated with IDWG %(R=-0.206,P=0.003).(4)The results of multiple linear regression analysis showed: the degree of education [B=3.821,P=0.038,95%CI(0.208-7.434)] and self-efficacy [B=0.292,P=0.032,95%CI(0.026-0.558)] were the factors that influenced the score of dietary management;the annual total medical expenses [B=8.827,P=0.001,95%CI(3.848-13.805)] was the factor that affected the score of hemodialysis related indicators and complications monitoring dimension.ConclusionThe level of volume management behavior in MHD patients was not sufficient,especial in diet management.Medical staff should pay more attention to the patients with junior high school and short dialysis age.At the same time,the level of self-efficacy and medical expenses in MHD patients should be cultured by taking some suitable intervention.