上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（公共卫生） • 上一篇    下一篇

江苏省终末期肾病患者血液透析和腹膜透析服务满意度对比分析

张文杰，张晓   

  1. 东南大学公共卫生学院， 南京 210009
  • 出版日期:2015-03-28 发布日期:2015-03-26
  • 作者简介:张文杰（1990—）， 男， 硕士生; 电子信箱: jason.wenjie@foxmail.com。
  • 基金资助:

    国家自然科学基金（71373042）

Comparative analysis of service satisfaction of ESRD patients undergoing hemodialysis and peritoneal dialysis in Jiangsu province

ZHANG Wen-jie, ZHANG Xiao   

  1. College of Public Health, Southeast University, Nanjing 210009, China
  • Online:2015-03-28 Published:2015-03-26
  • Supported by:

    National Natural Science Foundation of China, 71373042

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摘要：

目的 比较血液透析和腹膜透析的患者服务满意度，探讨透析患者服务满意度的影响因素。方法 采用自行编制的血液透析患者满意度调查问卷，于2013年3—5月期间选取苏南、苏中和苏北10个代表城市800名透析患者进行问卷调查，回收有效问卷773份，有效回收率96.6%。结果 ①血透组和腹透组两组患者的性别、原发疾病、受教育程度、医疗保险形式构成方面的差异无统计学意义(P>0.05)，在透析持续时间方面的差异有统计学意义(P<0.05)。②血透组和腹透组对透析前宣传教育的评价，腹透组高于血透组，差异有统计学意义(P<0.05)；对随访期宣传教育的评价，腹透组高于血透组，差异有统计学意义(P<0.05)。③通过对血透组和腹透组的χ2检验，影响患者满意度的6个因素对两组影响的差异均无统计学意义(P>0.05)。④根据影响满意度的6个因素，腹透组追加“电话联系医护人员的方便程度”“随访的频率”“透析中意外事件的处理程度”3个因素；对血透组和腹透组分别做多元线性回归，进一步筛选影响血透组和腹透组总体满意度的影响因素。结果显示，血透组中“医生对提出问题的讲解程度”“护士进行技术操作的专业程度”2个因素有统计学意义(P<0.05)；腹透组中“护士进行技术操作的专业程度”“透析中意外事件的处理程度”“医生对提出问题的讲解程度”3个因素有统计学意义(P<0.05)。结论 ①腹膜透析的总体满意度高于血液透析。②加强对腹膜透析知识的宣传教育。③提高护理人员的技术水平。④提升腹膜透析服务水平，利于腹膜透析的推广。

关键词: 透析, 患者满意度, 影响因素

Abstract:

Objective To compare the service satisfaction of patients with end-stage renal disease (ESRD) who undergo hemodialysis (HD) and peritoneal dialysis (PD) and explore the factors that influence the service satisfaction. Methods A total of 800 patients from 10 cities of Jiangsu province were selected from March to May, 2013. A self-designed questionnaire of satisfaction was used. And 773 valid questionnaires were returned and the valid return rate was 96.6%. Results ①The differences of gender, primary disease, education level, and health insurance of the HD group and PD group were not statistically significant (P>0.05), while the difference of dialysis duration was statistically significant (P<0.05). ②The evaluation of propaganda and education before dialysis of the PD group was better than that of the HD group and the difference was statistically significant (P<0.05). The evaluation of propaganda and education during follow-up period of the PD group was better than that of the HD group and the difference was statistically significant (P<0.05). ③The differences of effects of 6 influencing factors on the service satisfaction of patients were not statistically significant (P>0.05) according to the results of chi-square test. ④According to 6 influencing factors of service satisfaction, 3 factors were added for the PD group, i.e. the convenience of contacting medical workers by telephone, frequency of the follow-up, and handling of accidents during dialysis. The multivariate linear regression analysis was conducted for both groups and factors that influenced the overall service satisfaction were screened. The results showed that 2 factors of the HD group, i.e. interpretation of questions by doctors and professional competence of nurses, were statistically significant (P<0.05), while 3 factors of the PD group, i.e. interpretation of questions by doctors, professional competence of nurses, and handling of accidents during dialysis were statistically significant (P<0.05). Conclusion ①The overall satisfaction of patients who undergo the PD is higher than that of patients who undergo the HD. ②The propaganda and education of peritoneal dialysis should be enhanced. ③The competence of nursing staff should be improved. ④The services for peritoneal dialysis should be enhanced and this will benefit the promotion of peritoneal dialysis.

Key words: dialysis, patients satisfaction, influencing factors