知觉压力在维持性血液透析患者正念水平与失志综合征间的中介效应

doi:10.6040/j.issn.1671-7554.0.2025.0819

摘要/Abstract

摘要： 目的探讨维持性血液透析(maintenance hemodialysis, MHD)患者失志综合征现状及其影响因素,分析知觉压力在正念水平与失志综合征间的中介效应。方法对2024年8月至9月在烟台两家三级医院就诊的350例MHD患者进行横断面调查,调查问卷包括一般资料调查表、失志综合征量表Ⅱ、知觉压力量表、正念注意觉知量表等,统计分析方法包括单因素分析、Pearson/Spearman相关分析、多元线性回归分析及Bootstrap中介效应分析等。结果 MHD患者失志综合征中位得分为9分,中重度失志综合征占比47.0%(中度41.8%,重度5.2%),正念水平得分为(60.12±12.60)分,知觉压力得分为(26.71±7.15)分;知觉压力与失志综合征呈高度正相关(r_s=0.783,P<0.001),正念水平与失志综合征呈中度负相关(r_s=-0.699,P<0.001);正念水平(β=-0.249,P<0.001)负向预测失志综合征,知觉压力(β=0.550,P<0.001)和无业(β=0.105,P=0.012)正向预测失志综合征;正念水平对失志综合征的总效应为-0.29(P<0.001),其中直接效应为-0.12(41.38%),知觉压力在正念水平与失志综合征间的中介效应为-0.17(58.62%)。结论维持性血液透析患者的中重度失志综合征的发生比例较高,知觉压力在患者的正念水平与失志综合征之间起部分中介作用。

关键词: 维持性血液透析, 失志综合征, 知觉压力, 正念

Abstract: Objective To investigate the current status and influencing factors of demoralization syndrome in maintenance hemodialysis(MHD)patients, and analyze the mediating effect of perceived stress between mindfulness and demoralization syndrome. Methods A cross-sectional survey was conducted among 350 MHD patients from two tertiary hospitals in Yantai, China, from August to September 2024. Data were collected via structured questionnaires including general information, the Demoralization Syndrome Scale-II(DSS-II), the Perceived Stress Scale(PSS), and the Mindful Attention Awareness Scale(MAAS). Statistical analyses were performed using univariate analysis, Pearson or Spearman correlation analysis, multiple linear regression analysis, and the Bootstrap mediation analysis. Results The median score of demoralization syndrome in MHD patients was 9 points, and the proportion of patients with moderate to severe demoralization syndrome was 47.0%(41.8% for moderate and 5.2% for severe). The score of mindfulness level was(60.12±12.60), and the score of perceived stress was(26.71±7.15). Perceived stress was positively correlated with demoralization syndrome(r_s=0.783, P<0.001), while mindfulness level was negatively correlated with demoralization syndrome(r_s=-0.699, P<0.001). Mindfulness level(β=-0.249, P<0.001)negatively predicted demoralization syndrome, while perceived stress(β=0.550, P<0.001)and unemployment(β=0.105, P=0.012)positively predicted demoralization syndrome. The total effect of mindfulness level on demoralization syndrome was -0.29(P<0.001), including a direct effect of -0.12(41.38%)and a mediating effect of perceived stress between mindfulness level and demoralization syndrome of -0.17(58.62%). Conclusion Among MHD patients, the incidence proportion of moderate to severe demoralization syndrome is relatively high. Perceived stress plays a partial mediating role between patients mindfulness level and demoralization syndrome.

Key words: Maintenance hemodialysis, Demoralization syndrome, Perceived stress, Mindfulness

中图分类号:

R473.5

郑金爱,王艳梅,曲艳,李力维,刘勇,张媛. 知觉压力在维持性血液透析患者正念水平与失志综合征间的中介效应[J]. 山东大学学报 (医学版), 2026, 64(4): 109-116.

ZHENG Jinai, WANG Yanmei, QU Yan, LI Liwei, LIU Yong, ZHANG Yuan. Mediating effect of perceived stress between mindfulness and demoralization syndrome in maintenance hemodialysis patients[J]. Journal of Shandong University (Health Sciences), 2026, 64(4): 109-116.

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