Study On The Changes Of Family Dynamics In Maintenance Hemodialysis Patients

Objective:The purpose of this study is:(1)to describe the current situation and changes of family dynamics of maintenance hemodialysis patients,and to analyze the effects of general demographic data and diseases on family dynamics,so as to enrich the deficiency of family dynamics research in our country.to provide theoretical basis for family nursing as a specialist nursing field in the future.(2)taking the family as a whole,to further explore the specific changes and causes of family dynamics of patients and family caregivers,so as to provide a reference basis for medical staff to formulate targeted family nursing intervention strategies and improve the quality of life of patients.Lighten the burden of family members and society.Methods:This study is divided into two parts.The first part is the cross-sectional study in quantitative research.The main results are as follows:(1)A total of 304 patients who received maintenance hemodialysis in 3hospitals in Chengdu from August 2021 to September 2021 were selected by convenient sampling method.general data questionnaire,disease-related questionnaire and family dynamics scale were used to analyze the current situation of family dynamics and related factors of maintenance hemodialysis patients.(2)according to the basic data of maintenance hemodialysis patients,299 normal people were selected as control group.Family dynamics scale was used to analyze and discuss the changes of family dynamics in maintenance hemodialysis patients.The second part is the phenomenological study in qualitative research.From October to December in 2021,the data of 10 groups of hemodialysis families(maintenance hemodialysis patients and their family caregivers)in a Grade 3A hospital in Chengdu were collected by semi-structured interview.The use of Colaizzi data analysis data to determine the theme,in order to identify patients and family caregivers perceived by the disease caused by family dynamics,quality of life and other specific changes and related reasons.Results:Quantitative study:(1)the total score of family dynamics in maintenance hemodialysis patients was 284.85 ±24.20,which was significantly lower than that in normal subjects(286.44 ±37.24).(2)compared with the normal population,the scores of maintenance hemodialysis patients decreased in the dimensions of flexibility to rigidity,stability to disintegration,and clear communication to fuzzy communication,but the score of role complementarity was higher than that of role conflict.The difference was statistically significant(P < 0.05).(3)the effects of different demographic variables on family dynamics of maintenance hemodialysis patients,such as age,place of residence,education level,working status,family per capita monthly income,career frustration and complications,the difference was statistically significant(P < 0.05).(4)multiple linear regression analysis showed that the influencing factors of family dynamics in maintenance hemodialysis patients were education(β = 0.078),on-the-job status(β= 0.161),per capita monthly income(β= 0.104)and complications(β=-0.108).Qualitative research: analyze and classify the contents of the interview,and extract four themes about the specific changes and causes of family dynamics in maintenance hemodialysis patients and family caregivers,namely: family relationship:interdependence;coping ability: decreased flexibility;imprisoned by disease;social support.Conclusions:The main results are as follows:(1)the overall level of family dynamics of maintenance hemodialysis patients is lower than that of normal people,and there is a significant decrease in family flexibility,stability and communication ability,but strong role complementary ability.and affected by low education,not on the job,low monthly income of families,complications.Nursing workers should actively improve family support and understanding and provide guidance for family nursing measures for maintenance hemodialysis patients.(2)maintenance hemodialysis patients and family caregivers show that changes have taken place in family life and work affected by the disease,including high intimacy of family relations,interdependence but decreased independence,decreased coping ability;the life and work of patients and family members are limited by the disease;the current situation and problems of the family,such as low strength of social support but eager to get enough help.Therefore,nurses should not only improve the family support of patients,but also pay more attention to family caregivers so as to further improve the ability of family support.