血液透析患者心理干預(yù)的研究

[摘要] 目的 利用漢密爾頓焦慮量表分析和解決維持性血液透析患者的心理問題，以提高其生活質(zhì)量。 方法 應(yīng)用漢密爾頓焦慮量表對透析中心56例穩(wěn)定期進行血液規(guī)律透析患者進行心理測量，根據(jù)得分結(jié)果，針對個體問題加以指導(dǎo)。 結(jié)果 56例患者中均存在著不同程度的心理障礙，良好的心理護理使患者處于接受透析治療的最佳生理和心理狀態(tài)，積極主動配合護理工作，獲得了較好的透析效果。 結(jié)論 良好的心理護理可幫助患者學(xué)會自我心理疏導(dǎo)，克服消極心理， 增強戰(zhàn)勝疾病的信心，延長患者生命，提高生活質(zhì)量。

[關(guān)鍵詞]尿毒癥；血液透析；心理護理

[中圖分類號] R473 [文獻標(biāo)識碼] B [文章編號] 2095-0616（2012）21-137-03

Study on the mental intervention for hemodialysis patients

HE Yanfang1 LIU Lixin2 HU Liping1 CHEN Ting1

1.Department of Urology，Nanfang Hospital of Southern Medical University，Guangzhou 510515，China；2.Department of General Surgery，the Third Affiliated Hospital of Southern Medical University，Guangzhou 510630，China

[Abstract] Objective Using HAMA to analyse and solve the psychological care measures for patients with maintenance hemodialysis to improve their quality of life. Methods 56 cases with regular received hemodialysis in the author's hospital were tested by HAMA in the stable stage. Nursing strategies were design according to the HAMA score. Results 56 patients all have different degree mental obstacle，good psychological care made patients receive dialysis treatment in the best physical and mental state，actively coordinate with the nursing work so as to obtain good results dialysis. Conclusion Good psychological nursing helps patients learn self-psychological counseling to overcome the negative psychology，enhance the confidence to overcome the disease，prolong life and improve the quality of life.

[Key words] Uremia；Hemodialysis；Psychological nursing

血液透析（HD）是終末期腎衰竭患者重要的腎臟替代療法之一，是一種有創(chuàng)性的維持性治療[1]。從終末期腎病的保守治療到規(guī)律HD治療的過渡透析時期稱為HD的誘導(dǎo)期。由于HD患者長期面臨著疾病的折磨，加上經(jīng)濟壓力巨大，家庭角色的轉(zhuǎn)變，社會價值的降低，治療方式的改變，這段時期的患者在心理和生理方面都是一個重大的轉(zhuǎn)折期，使患者出現(xiàn)一系列身體及心理障礙。有研究表明，69%的誘導(dǎo)期HD患者需要透析前做心理指導(dǎo)。因為相當(dāng)多患者都存在焦慮、抑郁等緊張情緒，以致血壓升高、心率增快，嚴(yán)重影響了透析的順利進行。為進一步研究心理干預(yù)對焦慮、抑郁等緊張的情緒對HD的作用，抽取2011年筆者所在醫(yī)院56例誘導(dǎo)期HD患者采取心理疏導(dǎo)，觀察對情緒、血壓、心率改變的變化。……