| 摘要: |
| ［摘要］ 目的 分析糖尿病肾病血液透析患者生命意义感的影响因素及变化规律。方法 选择2021年4月至2024年10月南京医科大学第一附属医院收治的94例糖尿病肾病血液透析患者作为研究对象。在患者血液透析治疗0～12周期间，每隔2周填写生命意义感量表。采用多元线性回归分析糖尿病肾病血液透析患者血液透析治疗第0周生命意义感的影响因素。采用MATLAB R2021a软件绘制糖尿病肾病血液透析患者生命意义感的变异曲线。结果 血液透析治疗第0周的生命意义感得分为（35.41±3.61）分。多元线性回归分析结果显示，独居、家庭月收入<3 000元、缺乏体力活动、焦虑、文化程度初中及以下是糖尿病肾病血液透析患者血液透析治疗第0周生命意义感水平下降的影响因素（P<0.05）。血液透析治疗第2、4、6、8、10、12周的生命意义感得分分别为（38.73±2.85）分、（44.12±3.18）分、（51.24±4.32）分、（42.83±3.78）分、（39.48±2.46）分、（37.82±3.26）分，呈先升后降的趋势。糖尿病肾病血液透析患者生命意义感变异曲线可分为3部分，第0～6周（积极区）为生命意义感水平上升期，第6～8周（停滞徘徊区）为生命意义感水平停滞徘徊期、第8～12周（消极区）为生命意义感水平下降期。结论 独居、家庭月收入低、缺乏体力活动、焦虑及文化程度低是糖尿病肾病血液透析患者血液透析治疗第0周生命意义感水平下降的影响因素。糖尿病肾病血液透析患者生命意义感水平随血液透析时长呈先升后降的趋势，第6周是干预的最佳时间节点。 |
| 关键词: 糖尿病肾病 血液透析 生命意义感 影响因素 变异曲线 |
| DOI：10.3969/j.issn.1674-3806.2026.09.20 |
| 分类号:R 587.2 |
| 基金项目:中国社会福利基金会护爱基金资助项目（编号：HLCXKT-20231246） |
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| A study on the variation curves of sense of meaning in life in hemodialysis patients with diabetic nephropathy |
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Miao Jie, Xu Xianrong, Yang Jianping
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Blood Purification Center, Department of Nephrology, the First Affiliated Hospital with Nanjing Medical University(Jiangsu Province Hospital), Nanjing 210001, China
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| Abstract: |
| ［Abstract］ Objective To analyze the risk factors and changing patterns of the sense of meaning in life in hemodialysis patients with diabetic nephropathy. Methods A total of 94 hemodialysis patients with diabetic nephropathy who were admitted to the First Affiliated Hospital with Nanjing Medical University from April 2021 to October 2024 were selected as study participants. During the 0 to 12 weeks of hemodialysis treatment, the sense of meaning in life was measured every two weeks for the patients. Multivariate linear regression was used to analyze the factors influencing the sense of meaning in life of the hemodialysis patients with diabetic nephropathy at week 0 of hemodialysis treatment. MATLAB R2021a software was used to plot the variation curves of sense of meaning in life in the hemodialysis patients with diabetic nephropathy. Results The scores of sense of meaning in life at week 0 of hemodialysis treatment were (35.41±3.61)points. The results of multivariate linear regression analysis showed that living alone, monthly household income less than 3,000 CNY, lack of physical activity, anxiety, and an educational level at junior high school or below were the influencing factors for the decline in the level of sense of meaning in life in the hemodialysis patients with diabetic nephropathy at week 0 of hemodialysis treatment(P<0.05). The scores of sense of meaning in life at weeks 2, 4, 6, 8, 10, and 12 of hemodialysis treatment were (38.73±2.85), (44.12±3.18), (51.24±4.32), (42.83±3.78), (39.48±2.46) and (37.82±3.26)points, respectively, showing a trend of first increasing and then decreasing. The variation curves of sense of meaning in life in the hemodialysis patients with diabetic nephropathy consisted of 3 parts: weeks 0-6(positive zone), weeks 6-8(stagnant and lingering zone) and weeks 8-12(negative zone). The positive zone represented the rising level of sense of meaning in life; the stagnant and lingering zone represented the stagnant and lingering period of sense of meaning in life, and the negative zone represented the continuously declining level of sense of meaning in life. Conclusion Living alone, low monthly household income, lack of physical activity, anxiety, and low educational level are influencing factors for the declining level of sense of meaning in life in the hemodialysis patients with diabetic nephropathy at week 0 of hemodialysis treatment. The levels of sense of meaning in life in the hemodialysis patients with diabetic nephropathy show a trend of first increasing and then decreasing with the duration of hemodialysis. The sixth week is the optimal time point for intervention. |
| Key words: diabetic nephropathy hemodialysis sense of meaning in life risk factors variation curves |
