Study On The Status And Influencing Factors Of Stigma In Patients With Two Different Methods Of Renal Replacement Therapy

?Objective?The purpose of this study was to investigate the status and influencing factors of stigma in maintenance hemodialysis and peritoneal dialysis patients,and to compare the level of stigma in the two types of patients,so as to provide theoretical basis for clinical medical staff to take specific measures.?Methods?(1)using the convenience sampling method,the selection in February 2018-December 2019,respectively,in the eastern zone general hospital blood purification center line maintenance hemodialysis(MHD)patients and 213 cases of peritoneal dialysis center line of 132 patients with peritoneal dialysis(PD),application of general data scale,social impact scale(SIS),social support rating scale(SSRS),general self-efficacy scale(GSES)and family care measure index questionnaire(APGAR),were investigated respectively on two groups of dialysis patients disease shame level status and its influencing factors,Epi Data3.1 was used for data entry and SPSS 24.0 for data analysis.(2)SPSS 24.0 software was used for the tendentiousness distribution of data,and the confounding factors in the two groups of dialysis patients were balanced,so as to compare the level of stigma between the two groups.?Results?1.A total of 213 valid questionnaires were collected from MHD patients,and the score of stigma was(57.11±13.02).The level of medium stigma accounted for 72.8%,while the low level of stigma was only 16.2%.The results of single factor analysis showed that young people,families with low per capita income,other complications,and unemployed MHD patients had higher stigma levels(P<0.05).Correlation analysis showed that subjective support,social support utilization,total social support score,general self-efficacy and family care were negatively correlated with stigma in MHD patients,with statistical significance(P<0.05).The effects of age,family per capita income,comorbidities,general self-efficacy and family care on stigma were statistically significant.2.A total of 132 valid questionnaires were collected from PD patients,and the score of stigma was(56.51±10.76).The level of mediun stigma accounted for 75.0%,while the level of low stigma was only 16.7%.Single-factor analysis showed that PD patients in rural areas,junior high schools and below,unemployment,less residual renal function,more than 3 daily dialysis frequency,and PD patients with PD related complications had higher stigma levels(P<0.05).Correlation analysis showed that subjective support,social support utilization,total social support score,general self-efficacy and family care were negatively correlated with stigma in PD patients(P<0.05).The effects of multiple regression on stigma were statistically significant in terms of education level,abdominal transparency related complications,subjective support and general self-efficacy.3.108 cases of MHD patients and 132 cases of PD patients were finally matched by the propensity matching method,and there was no significant difference in baseline data of the two groups of dialysis patients.There was no statistical difference in the level of total stigma between the two groups(P>0.05),but only in the dimension of economic discrimination(P<0.05),that is,the level of economic discrimination in MHD patients was much higher than that in PD patients.?Conclusion?1.The overwhelming majority of MHD and PD patients had a medium level of stigma,and 72.8% of MHD patients and 75.0% of PD patients had a medium level of stigma.2.The level of stigma in patients with MHD and PD is affected by many factors.Patients with MHD with higher age,higher economic income,no complications,higher general self-efficacy and higher family care index had lower levels of stigma.PD patients with higher education level,no PD complications,better subjective support and higher general self-efficacy had lower levels of stigma.3.There was no significant difference in the level of total stigma between the two groups.Only in the dimension of economic discrimination,MHD patients were significantly higher than PD patients,indicating that the pressure of MHD patients in economy and job stability was higher than that of PD patients,and the pressure of MHD patients in the youth group was more obvious.4.This study analyzed the current situation and influencing factors of stigma in the two groups of dialysis patients.Clinical medical staff can provide targeted measures to reduce the level of stigma in patients and improve the dialysis effect.