| Objectives1.To understand the status of treatment compliance,negative emotions and self-efficacy in patients with maintenance hemodialysis(MHD);2.To explore the influencing factors of treatment compliance,negative emotions and self-efficacy of MHD patients;3.To analyze the correlation between negative emotions,self-efficacy and treatment compliance in MHD patients.MethodsThis study is a descriptive study.From April to August 2018,the researchers randomly selected blood purification centers of 3 hospitals from tertiary hospitals in changsha,and conducted on-site questionnaire survey on patients meeting the inclusion and exclusion criteria of this study by using cluster sampling.The questionnaires included self-designed general information questionnaire,MHD treatment compliance scale for patients with end-stage renal disease,self-rating anxiety scale(SAS),self-rating depression scale(SDS),and chronic disease self-efficacy scale(SECD6).A total of 240 questionnaires were sent out and 235 were recovered.After eliminating five invalid questionnaires,230 valid samples were obtained,with an effective recovery rate of 95.8%.SPSS18.0 software was used for data processing and analysis.Descriptive statistics were used to analyze the general data of patients.The data were normally distributed,and t-test,one-way anova and multiple linear regression were used to analyze the influencing factors of patients' treatment compliance.Chi-square test and Logisticregression were used to analyze the influencing factors of patients' negative emotions and self-efficacy.Pearson correlation was used to analyze the correlation between patients' negative emotion,self-efficacy and treatment compliance.In this study,the significance level of hypothesis test was all P<0.05,indicating statistical significance.Observations1.The scores of treatment compliance of MHD patients were(79.26±12.89).The average scores of each dimension items ranged from high to low in order: compliance with dialysis program(4.44±0.59),medication compliance(4.06±0.74),dietary compliance(3.09±0.73),fluid intake compliance(2.75±0.93).Univariate analysis of variance showed that MHD patients with different educational background,fertility status,economic burden,primary diseases and dialysis years had different treatment compliance,and the difference was statistically significant(P<0.05).Multivariate linear regression analysis showed that education level,economic burden and dialysis years entered the regression model.2.The scores of anxiety and depression in MHD patients were(47.27±7.65)and(54.88±13.20),which were higher than those of the Chinese norm,and the difference was statistically significant(P<0.05).The incidence of anxiety and depression in MHD patients was 35.2% and59.6% respectively.The chi-square test results showed that the anxiety of MHD patients with different age,education level,employment status,previous or current occupation,family monthly income per capita,economic burden and years of dialysis was different,and the difference was statistically significant(P<0.05).The incidence of depression was different in MHD patients with different education levels,employmentstatus,monthly family income per capita,economic burden and years of dialysis,and the difference was statistically significant(P<0.05).Logistic regression analysis showed that age,financial burden and dialysis duration were the main influencing factors of anxiety in MHD patients.Education level,employment status,economic burden and years of dialysis were important predictors of depression in MHD patients.3.The self-efficacy score of MHD patients was(5.28±2.37).The high self-efficacy level accounted for 30.9% and the low self-efficacy level accounted for 69.1%.The chi-square test results showed that the self-efficacy levels of MHD patients with different ages,education levels,fertility status,employment status,occupation,financial burden,number of acute complications and long-term complications were different,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that age,occupation(freelancing),financial burden,number of acute complications and long-term complications were important influencing factors for self-efficacy of MHD patients.4.The scores of anxiety in MHD patients were negatively correlated with the total scores of treatment compliance and the scores of each dimension(r=-0.315,-0.253,-0.134,-0.327,-0.275);the scores of depression were negatively correlated with the total scores of treatment compliance and the scores of each dimension(r=-0.342,-0.259,-0.220,-0.295,-0.253).The total score of self-efficacy of MHD patients was positively correlated with the total score of treatment compliance,dietary compliance,fluid intake compliance and medication compliance(r=0.242,0.189,0.216,0.158).Anxiety score was negatively correlated with total self-efficacy score and each dimension score(r=-0.436,-0.446,-0.366);depression score was negatively correlated with total self-efficacy score and each dimension score(r=-0.637,-0.650,-0.539).The correlationcoefficients of the above binary variables had statistical significance(P<0.05).Conclusions1.Patients with MHD have poor treatment compliance.The influencing factors of treatment compliance were education level,economic burden and dialysis duration.2.Anxiety and depression are common in MHD patients,and depression is the most common.The influencing factors of anxiety were age,financial burden and dialysis duration.The influencing factors of depression were education level,employment status,financial burden and years of dialysis.3.The level of self-efficacy of MHD patients is low.The influencing factors of self-efficacy were age,occupation(freelancing),financial burden,acute complications and long-term complications.4.The anxiety and depression of MHD patients are negatively correlated with the treatment compliance,that is,the more severe the anxiety and depression are,the worse the treatment compliance will be.Self-efficacy of MHD patients was positively correlated with treatment compliance,that is,patients with higher level of self-efficacy had better treatment compliance.Anxiety and depression are negatively correlated with self-efficacy in MHD patients,that is,the more severe the anxiety and depression are,the lower the self-efficacy level will be. |
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