终末期肾衰竭患者生命意义感与不良情绪、社会支持的相关性分析-现代医学

终末期肾衰竭患者生命意义感与不良情绪、社会支持的相关性分析

单位：南京医科大学第一附属医院老年肾科, 江苏南京 210000

分类号：R692.5;R473.5

出版年·卷·期（页码）：2025·53·第十期（1600-1606）

摘要：

目的：分析终末期肾衰竭(ESRF)患者抑郁现状及影响因素，探讨生命意义感在社会支持和抑郁间的中介效应。方法：选取2021年6月至2024年6月期间于本院就诊的ESRF患者为研究对象，采用一般资料问卷、匹兹堡睡眠质量指数(PSQI)、家庭关怀度指数测评表(APGAR)、日常生活能力(ADL)量表、流调中心抑郁量表(CES-D)、生命意义感量表(MLQ)以及感知社会支持量表(MSPSS)进行评估。结果：共回收有效问卷319份，有效回收率为91.93%。ESRF患者CES-D评分为(22.27±4.31)分，处于较高水平。单因素分析结果显示，居住状态、家庭人均月收入、慢性病共病数量、病程、睡眠障碍、ADL以及家庭功能是影响CES-D评分的重要因素(P＜0.05)。Pearson相关性分析表明，ESRF患者CES-D评分与MLQ和MSPSS各维度评分均呈负相关(P＜0.05)，MLQ各维度评分与MSPSS各维度评分呈正相关(P＜0.05)。中介效应模型显示，社会支持对ESRF患者的抑郁程度存在负向预测作用，总效应值为-1.275(95%CI -1.386～-1.164，P＜0.001)，其中生命意义感间接效应值为-0.498(95%CI-0.617～-0.379)，该中介效应模型间接效应显著(P＜0.001)，占社会支持对抑郁总效应的39.06%。结论：社会支持可通过提高ESRF患者生命意义感有效缓解抑郁情绪，为临床心理干预提供理论依据和实践指导。

Objective: To analyze the current status of depression and its influencing factors in patients with end-stage renal failure(ESRF), and to explore the mediating effect of the sense of meaning in life between social support and depression. Methods: Patients with ESRF who visited our hospital from June 2021 to June 2024 were selected as the study subjects. Data were collected with the General Information Questionnaire, Pittsburgh Sleep Quality Index(PSQI), Family APGAR Index, Activity of Daily Living(ADL) Scale, Center for Epidemiological Studies Depression Scale(CES-D), Meaning in Life Questionnaire(MLQ), and Multidimensional Scale of Perceived Social Support(MSPSS). Results: A total of 319 valid questionnaires were collected, with an effective response rate of 91.93%. The CES-D score was 22.27±4.31, indicating a high level of depressive symptoms. Univariate analysis revealed that living status, monthly household income per capita, number of chronic comorbidities, disease duration, sleep disturbances, ADL, and family function were significant factors influencing CES-D scores(P<0.05). Pearson correlation analysis showed that CES-D scores were negatively correlated with all dimensions of the MLQ and MSPSS(P<0.05), while MLQ scores were positively correlated with all dimensions of MSPSS(P<0.05). The mediation effect model demonstrated that social support had a negative predictive effect on the severity of depression in ESRF patients, with a total effect value of -1.275(95% CI-1.386--1.164), P<0.001). The indirect effect of the sense of meaning in life was -0.498(95% CI-0.617--0.379), and this mediation effect was significant(P<0.001), accounting for 39.06% of the total effect of social support on depression. Conclusion: Social support can effectively alleviate depressive symptoms in ESRF patients by enhancing their sense of meaning in life, providing a theoretical basis and practical guidance for clinical psychological interventions.

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