摘要目的 研究抗逆性、社会支持与血液透析患者日常活动能力及抑郁情绪的相关性以及对不适症状导致抑郁情绪的缓解作用.方法 在这项描述性相关性研究中,选取入住四川省遂宁市中心医院血液透析科196例血液透析老年患者,记录每例患者的人口变量,使用身体不适症状评分表、日常生活活动指数(ADL)、器械辅助活动指数(IADL)、抗逆性量表、社会支持行为量表和Beck抑郁情绪评分Ⅱ(BDI-Ⅱ)评估每例住院患者.将人口变量分层,组内比较抑郁情绪评分.一元线性相关模型评估上述变量两两线性相关性.将和抑郁情绪评分有统计学相关性的变量加入分层回归分析.结果 男性、与家人同居、独立性强、退休后收入高的患者抑郁评分较低(t=2.72、2.28,F=3.29、4.25,P＜0.05).一元线性相关模型显示,身体不适症状评分与透析时间呈正相关(r=0.186,P＜0.05),与ADL、抗逆性、社会支持、抑郁评分呈负相关(r=-0.421～-0.164,P＜0.05).ADL与IADL、抗逆性、社会支持呈正相关(r=0.654、0.549、0.186,P＜0.05),与身体不适症状、抑郁评分呈负相关(r=-0.164、-0.491,P＜0.05).IADL与ADL、抗逆性、社会支持呈正相关(r=0.654、0.577、0.176,P＜0.05),与抑郁评分呈负相关(r=-0.742,P＜0.05).抗逆性与ADL、IADL、社会支持呈正相关(r=0.549、0.557、0.416,P＜0.01或0.05),与身体不适症状、抑郁评分呈负相关(r=-0.261、0.742, P＜0.05).社会支持与ADL、IADL、抗逆性呈正相关(r=0.186、0.176、0.416,P＜0.05),与抑郁评分、身体不适症状评分呈负相关(r=-0.507、-0.178,P＜0.05).分层回归分析提示抗逆性可缓解身体不适症状(b=-0.432,P＜0.05)对抑郁情绪的影响,而社会支持未发挥该缓解作用.结论 身体不适和日常生活活动能力的严重程度是抑郁情绪的决定因素,高抗逆性可缓解老年血液透析患者的抑郁情绪.

abstractsObjective To study the relationship between stress resistance, social support and daily activities and depression in hemodialysis patients, and the relief of discomfort. Methords In this descriptive correlation study, 196 elderly patients with hemodialysis were enrolled in the Department of Hemodialysis, Suining Central Hospital, Sichuan Province. The population variables of each patient were recorded, and the discomfort symptom scores were used. The Activities of Daily Living Index (ADL) and the Instrumental Assisted Activity Index (IADL), the Stress Resistance Scale, the Social Support Behavior Scale, and the Beck Depression Inventory II (BDI-II) were evaluated for each hospitalized patient. The population variables were stratified, and there was a statistical difference in the comparison of the depression scale scores within the group. The one-dimensional linear correlation model evaluates the two-dimensional linear correlation of the above variables. Variables with statistically significant correlations with depression scores were added to the stratified regression analysis. Results Males, who lived with their families, had strong independence, and those with high post-retirement income had lower depression scores (t=2.17, 2.28, F=3.29, 4.25, P<0.05). The linear correlation model showed that the physical discomfort score was positively correlated with dialysis time (r=0.186, P<0.05), and negatively correlated with ADL, stress resistance, social support, and depression score (r=-0.421--0.164, P<0.05). The ADL index was positively correlated with IADL index, stress resistance, and social support (r=0.654, 0.549, 0.186, P<0.05), and negatively correlated with physical discomfort and depression score (r=-0.164,-0.491, P<0.05). The IADL index was positively correlated with ADL, stress resistance, and social support (r=0.654, 0.577, 0.176, P<0.05), and negatively correlated with depression score (r=-0.742, P<0.05). Stress resistance was positively correlated with ADL, IADL, and social support (r=0.549, 0.557, 0.416, P<0.01or 0.05), and negatively correlated with physical discomfort and depression score (r=-0.261, 0.742, P<0.05). Social support was positively correlated with ADL, IADL, and stress resistance (r=0.186, 0.176, 0.416, P<0.05), and negatively correlated with depression score and physical discomfort score (r=-0.507,-0.178, P<0.05). Hierarchical regression analysis suggested that stress resistance can alleviate the effects of physical discomfort (b=-0.432, P<0.05) on depression, and social support did not play this mitigation. Conclusion The severity of physical discomfort and activities of daily living is a determinant of depression, and high stress resistance can alleviate depression in elderly hemodialysis patients.