Analysis of potential categories of mental health literacy in maintenance hemodialysis patients
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摘要:
目的 探索维持性血液透析患者心理健康素养的潜在类别，并分析不同潜在类别的影响因素。 方法 选取2022年7月—2023年6月就诊于海安市人民医院的255例维持性血液透析患者为研究对象，采用不记名方式进行问卷调查。对透析患者的心理健康素养特征进行潜在类别分析，并通过单因素分析探讨心理健康素养潜在类别的影响因素。 结果 214例透析患者心理健康素养得分为(10.23±2.36)分，知识、信念、资源各维度得分分别为(4.34±1.07)分、(3.98±0.84)分、(1.91±0.58)分。维持性透析患者的心理健康素养存在3个潜在类别：高素养低资源组、低素养组及高素养组。每个类别的维持性血液透析患者归属于各个潜在类别的平均概率分别为0.942、0.906、0.942。不同心理健康素养分组维持性透析患者年龄、文化程度、家庭人均收入、合并基础疾病及透析时间差异均有统计学意义(P＜0.05)。 结论 维持性血液透析患者心理健康素养呈现3个潜在类别，且受年龄、文化程度、家庭人均收入、合并基础疾病及透析时间等因素的影响。临床工作人员应辨别不同类别患者的特征，针对低素养的高危人群积极采用应对措施，鼓励其积极面对及治疗疾病，促进患者心理健康素养的提升。 Abstract:Objective This paper aims to explore the potential categories of mental health literacy in maintenance hemodialysis patients and discuss the influencing factors of different potential profile categories. Methods A total of 255 patients undergoing maintenance hemodialysis, admitted to Hai' an Municipal People' s Hospital from July 2022 to June 2023, were selected as the research objects. A general data questionnaire and a multiple mental health literacy scale were used to conduct a survey. The potential categories of mental health literacy in maintenance hemodialysis patients were analyzed, and the influencing factors on these potential categories were discussed by single factor analysis. Results A total of 214 patients undergoing maintenance hemodialysis had scores of mental health literacy (10.23±2.36), knowledge dimension (4.34±1.07), belief dimension (3.98±0.84) and resource dimension (1.91±0.58). The mental health literacy of maintenance hemodialysis patients was divided into three potential categories: high literacy low resource group, low literacy group, and high literacy group. The mean probability of maintenance hemodialysis patients belonging to each potential category was 0.942, 0.906, and 0.942, respectively. The mental health literacy of maintenance dialysis patients were significantly different in age, education level, per capita family income, combined underlying diseases and dialysis time distribution (P < 0.05). Conclusion There are three potential categories of mental health literacy in maintenance hemodialysis patients, which are influenced factors such as age, educational level, per capita family income, underlying diseases, and dialysis time. Clinical staff should identify the characteristics of different categories of patients, actively implement strategies for high-risk groups with low literacy, encourage them to proactively address and treat their illnesses, and promote the improvement of patients' mental health literacy. -
图 1 维持性血液透析患者心理健康素养潜在类别条件概率
Figure 1. Conditional probability diagram of potential categories of mental health literacy in patients undergoing maintenance hemodialysis
表 1 维持性血液透析患者心理健康素养拟合指标比较
Table 1. Comparison of analysis indicators for potential categories of mental health literacy in patients undergoing maintenance hemodialysis
模型 参量数量 Log(L) AIC BIC aBIC LMR BLRT Entropy 类别概率 1 5 -998.226 6 123.712 6 166.682 6 123.573 2 8 -935.562 5 825.316 5 725.256 5 711.743 0.059 ＜0.001 0.782 0.22/0.78 3 11 -902.193 5 672.518 5 542.435 5 521.423 0.005 ＜0.001 0.844 0.28/0.51/0.21 4 14 -883.679 5 486.874 5 346.784 5 384.257 0.177 ＜0.001 0.872 0.33/0.35/0.09/0.23 5 17 -856.752 5 267.126 5 268.278 5 241.248 0.584 0.142 0.897 0.28/0.11/0.06/0.32/0.23 
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表 2 维持性血液透析患者心理健康素养3个类型的平均归属率(n=214)
Table 2. The average attribution rates of three types of mental health literacy in maintenance hemodialysis patients (n=214)
模型 C1 C2 C3 C1 0.942 0.021 0.037 C2 0.066 0.906 0.028 C3 0.022 0.036 0.942
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表 3 不同心理健康素养分组维持性血液透析患者一般资料比较(例)
Table 3. Comparison of general data for maintenance hemodialysis patients in different mental health literacy groups (cases)
项目 高素养低资源组(n=59) 低素养组(n=110) 高素养组(n=45) χ2值 P值 年龄(岁) 31.783 ＜0.001 ＜45 6 3 15 45~59 33 56 18 ≥60 20 51 12 性别 2.242 0.326 男性 33 61 28 女性 26 49 17 婚姻状况 1.581 0.454 单身 3 8 1 已婚 56 102 44 文化程度 32.226 ＜0.001 初中及以下 11 30 2 高中/高职/中专 13 50 13 大专 23 21 14 本科及以上 12 9 16 家庭人均月收入(元) 22.689 ＜0.001 ＜3 000 9 19 3 3 000~7 000 38 82 24 ＞7 000 12 9 18 居住地 9.367 0.053 城市 17 28 21 乡镇 20 35 15 农村 22 47 9 合并基础疾病 8.765 0.012 是 36 86 26 否 23 24 19 透析时间(年) 23.941 ＜0.001 ＜1 18 35 3 1~5 11 28 7 ＞5~10 19 29 14 ＞10 11 18 21 注：基础疾病指高血压、糖尿病、冠心病等心脑血管慢性病。
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