| 其他摘要 | Chronic kidney disease has gradually become a global public health problem and as the final stage of the development of chronic kidney disease, the end-stage kidney disease has also been rising sharply in recent decades. Maintenance hemodialysis is the most common renal replacement therapy for patients with end-stage renal disease. Although it can effectively improve the patient's symptoms, the emergence of complications, and the high cost of drugs and treatments not only aggravate the patient's financial burden, but also affect their mental health, thus negatively affecting the effectiveness of treatment. Therefore, it is crucial to pay attention to the mental health of maintenance hemodialysis patients. Although patients' mental health has a significant impact on treatment effects of maintenance hemodialysis patients, few studies focused on their mental health. To explore the factors that affect the mental health of maintenance hemodialysis patients and the relationship between these factors and mental health, this paper conducted three studies by using both qualitative and quantitative methods to provide a theoretical basis and intervention pathways to improve the mental health of maintenance hemodialysis patients.
Study 1 was a qualitative study, which explored the mental health of maintenance hemodialysis patients and its influencing factors; Study 2 and 3 were quantitative studies, which explored the relationship between the acceptance of illness and the mental health of maintenance hemodialysis patients.
Based on the Grounded Theory, Study 1 conducted a qualitative study through semi-structured interviews on 35 patients with end-stage renal disease, who were currently receiving the maintenance hemodialysis treatment. The results showed that the acceptance of illness played an important role in the mental health of maintenance hemodialysis patients, while complications, stress and coping styles as well as social support were also related to patients' mental health. Patients with higher acceptance of illness, more healthy coping styles, and higher levels of social support showed higher mental health levels. While patients with lower acceptance of illness, multiple comorbidities, higher stress levels, and unhealthy coping styles showed lower levels of mental health.
Based on the findings of Study 1, Study 2 and 3 aimed to explore the relationship between the acceptance of illness and the mental health according to the Coping Theory, using quantitative research methods. Study 2 conducted a questionnaire survey on 423 maintenance hemodialysis patients, with a total of 410 valid questionnaires collected, and explored the relationship between the acceptance of illness and life satisfaction, depression and anxiety symptoms through a cross-sectional study. The results showed that the acceptance of illness was significantly negatively correlated with depression and anxiety symptoms, and significantly positively correlated with life satisfaction. Study 3 conducted a daily diary study on 100 maintenance hemodialysis patients for 21 consecutive days to explore the relationship between baseline and daily acceptance of illness and daily subjective well-being through a longitudinal study. The results showed that baseline and daily acceptance of illness of maintenance hemodialysis patients were significantly positively correlated with their daily subjective well-being.
In summary, for maintenance hemodialysis patients, the acceptance of illness is closely related to their mental health. By exploring the relationship between the patients' acceptance of illness and their mental health, this study not only provided relevant theoretical basis for subsequent research, but also found that appropriate intervention methods could be used to improve the acceptance of illness for maintenance hemodialysis patients, which could further improve their mental health and therapeutic effect. |
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