血液透析患者重返工作准备度研究进展
Research Progress on the Readiness of Hemodialysis Patients to Return to Work
摘要: 血液透析患者普遍面临低就业率的困境，而重返工作准备度(Readiness for Return-to-Work, RRTW)作为预测患者成功返岗的关键前置指标，日益受到关注。本文综述了RRTW的概念演变、血液透析患者的RRTW现状、多维度影响因素、现有评估工具及其局限性，并系统回顾了旨在提升RRTW的干预研究。旨在为临床医护人员识别患者所处阶段、理解影响因素间的复杂交互作用，并制定个性化干预措施提供理论依据，以最终提高患者的返岗成功率与生活质量。
Abstract: Patients undergoing hemodialysis universally face the challenge of low employment rates. Readiness for Return-to-Work (RRTW), as a key predictor of successful return to work, has gained increasing attention. This paper reviews the conceptual evolution of RRTW, the current status of RRTW among hemodialysis patients, multi-dimensional influencing factors, existing assessment tools and their limitations, and systematically evaluates intervention studies aimed at improving RRTW. The aim is to provide a theoretical basis for clinical staff to identify patients’ stages, understand the complex interactions of influencing factors, and develop personalized interventions, ultimately enhancing patients’ return-to-work success rate and quality of life.
文章引用：许争琪, 汪凤兰, 李晓庆, 刘海艳. 血液透析患者重返工作准备度研究进展[J]. 护理学, 2026, 15(4): 10-17. https://doi.org/10.12677/ns.2026.154099

参考文献

[1] Kovesdy, C.P. (2022) Epidemiology of Chronic Kidney Disease: An Update 2022. Kidney International Supplements, 12, 7-11. [Google Scholar] [CrossRef] [PubMed]
[2] Duff, R., Awofala, O., Arshad, M.T., Lambourg, E., Gallacher, P., Dhaun, N., et al. (2024) Global Health Inequalities of Chronic Kidney Disease: A Meta-Analysis. Nephrology Dialysis Transplantation, 39, 1692-1709. [Google Scholar] [CrossRef] [PubMed]
[3] 付平. 提升中国慢性肾脏病患者自我管理的综合策略[J]. 肾脏病与透析肾移植杂志, 2023, 32(6): 551-553.
[4] 卞帅博, 张亮, 杨璇. 1990-2021年中国慢性肾脏病疾病负担变化趋势及发病预测分析[J]. 实用临床医药杂志, 2025, 29(6): 89-93.
[5] Wang, Y., Sun, J., Guo, F. and Wan, D. (2024) Effect of Periodic Nursing Interventions on Improving Compliance Behavior and Health Status in Long-Term Hemodialysis Patients. Pakistan Journal of Medical Sciences, 40, 2041-2045. [Google Scholar] [CrossRef] [PubMed]
[6] Yang, C., Yang, Z., Wang, J., Wang, H., Su, Z., Chen, R., et al. (2021) Estimation of Prevalence of Kidney Disease Treated with Dialysis in China: A Study of Insurance Claims Data. American Journal of Kidney Diseases, 77, 889-897.e1. [Google Scholar] [CrossRef] [PubMed]
[7] Elsherbiny, M., Almuhanna, S., Alathel, R., Alzahrani, Y., Alshathri, F., Hussamuldin, A., et al. (2024) Quality of Life and Complications among Hemodialysis Patients. Cureus, 16, e71086. [Google Scholar] [CrossRef] [PubMed]
[8] Lam, C.S., Chan, F. and McMahon, B.T. (1991) Factorial Structure of the Change Assessment Questionnaire for Individuals with Traumatic Head Injuries. Rehabilitation Psychology, 36, 189-199. [Google Scholar] [CrossRef] 
[9] Lam, C. (1997) A Conceptual Model for Service Delivery to People Who Are Unemployed. Unpublished Manuscript, Illinois Institute of Technology.
[10] Franche, R. and Krause, N. (2002) Readiness for Return to Work Following Injury or Illness: Conceptualizing the Interpersonal Impact of Health Care, Workplace, and Insurance Factors. Journal of Occupational Rehabilitation, 12, 233-256. [Google Scholar] [CrossRef] [PubMed]
[11] Franche, R., Corbière, M., Lee, H., Breslin, F.C. and Hepburn, C.G. (2007) The Readiness for Return-to-Work (RRTW) Scale: Development and Validation of a Self-Report Staging Scale in Lost-Time Claimants with Musculoskeletal Disorders. Journal of Occupational Rehabilitation, 17, 450-472. [Google Scholar] [CrossRef] [PubMed]
[12] Braathen, T.N., Brage, S., Tellnes, G. and Eftedal, M. (2012) Psychometric Properties of the Readiness for Return to Work Scale in Inpatient Occupational Rehabilitation in Norway. Journal of Occupational Rehabilitation, 23, 371-380. [Google Scholar] [CrossRef] [PubMed]
[13] 曹慧丽. 重返工作准备度量表的汉化及在乳腺癌患者中的初步应用[D]: [硕士学位论文]. 郑州: 郑州大学, 2018.
[14] Helanterä, I., Haapio, M., Koskinen, P., Grönhagen-Riska, C. and Finne, P. (2012) Employment of Patients Receiving Maintenance Dialysis and after Kidney Transplant: A Cross-Sectional Study from Finland. American Journal of Kidney Diseases, 59, 700-706. [Google Scholar] [CrossRef] [PubMed]
[15] Carlsen, R.K., Kirkeskov, L., Riis, M.S., Jacobsen, R.K., Gronemann, F.H., Osler, M., et al. (2025) Employment before and after Initiation of Dialysis or Kidney Transplantation—A Danish Nationwide Registry-Based Cohort Study. BMC Nephrology, 26, Article No. 48. [Google Scholar] [CrossRef] [PubMed]
[16] Erickson, K.F., Zhao, B., Ho, V. and Winkelmayer, W.C. (2018) Employment among Patients Starting Dialysis in the United States. Clinical Journal of the American Society of Nephrology, 13, 265-273. [Google Scholar] [CrossRef] [PubMed]
[17] Msilanga, D., Nkwera, U., Punatar, P., Mngumi, J., Msangi, E., Valentine, G., et al. (2025) Work and Dialysis: Navigating Employment Challenges among Young Adults on Maintenance Hemodialysis in Tanzania. International Journal of Nephrology, 2025, Article 9980961. [Google Scholar] [CrossRef] 
[18] Alquwez, N. and Ormandy, P. (2022) Examining the Influence of Health on Employment and Work Ability of Saudi Haemodialysis Patients: A Mixed-Methods Study. International Journal of Nursing Practice, 28, e12993. [Google Scholar] [CrossRef] [PubMed]
[19] Motiei, M., Attarchi, M. and Ramezanzadeh, E. (2024) The Effect of Workability-Related Factors in Patients with End-Stage Kidney Disease Undergoing Hemodialysis. BMC Nephrology, 25, Article No. 460. [Google Scholar] [CrossRef] [PubMed]
[20] Brown, E.A., Zhao, J., McCullough, K., Fuller, D.S., Figueiredo, A.E., Bieber, B., et al. (2021) Burden of Kidney Disease, Health-Related Quality of Life, and Employment among Patients Receiving Peritoneal Dialysis and In-Center Hemodialysis: Findings from the DOPPS Program. American Journal of Kidney Diseases, 78, 489-500.e1. [Google Scholar] [CrossRef] [PubMed]
[21] Lee, J.Y. and Jin, D. (2020) Patient Characteristics According to Rehabilitation and Employment Status in Korean Hemodialysis Patients. Kidney Research and Clinical Practice, 39, 356-364. [Google Scholar] [CrossRef] [PubMed]
[22] Huang, B., Lai, B., Xu, L., Wang, Y., Cao, Y., Yan, P., et al. (2017) Low Employment and Low Willingness of Being Reemployed in Chinese Working-Age Maintained Hemodialysis Patients. Renal Failure, 39, 607-612. [Google Scholar] [CrossRef] [PubMed]
[23] 龚爱萍, 徐骏, 吉小静, 等. 中青年血液透析患者重返工作准备度现状及影响因素分析[J]. 中华现代护理杂志, 2023, 29(36): 4939-4944.
[24] 王海霞. 中青年维持性血液透析患者重返工作准备度影响因素的研究[D]: [硕士学位论文]. 大连: 大连医科大学, 2023.
[25] 彭源, 朱林芳, 袁怀红, 等. 维持性血液透析患者重返工作准备度及其影响因素分析[J]. 武警医学, 2024, 35(3): 197-200.
[26] Alma, M.A., van der Mei, S.F., Brouwer, S., Hilbrands, L.B., van der Boog, P.J.M., Uiterwijk, H., et al. (2023) Sustained Employment, Work Disability and Work Functioning in CKD Patients: A Cross-Sectional Survey Study. Journal of Nephrology, 36, 731-743. [Google Scholar] [CrossRef] [PubMed]
[27] de Jong, R.W., Boezeman, E.J., Chesnaye, N.C., Bemelman, F.J., Massy, Z.A., Jager, K.J., et al. (2022) Work Status and Work Ability of Patients Receiving Kidney Replacement Therapy: Results from a European Survey. Nephrology Dialysis Transplantation, 37, 2022-2033. [Google Scholar] [CrossRef] [PubMed]
[28] 陈国伟, 黄燕林, 王涵, 等. 腹膜透析病人重返工作准备度及影响因素分析[J]. 护理研究, 2022, 36(4): 594-599.
[29] Ghani, Z., Rydell, H. and Jarl, J. (2019) The Effect of Peritoneal Dialysis on Labor Market Outcomes Compared with Institutional Hemodialysis. Peritoneal Dialysis International, 39, 59-65. [Google Scholar] [CrossRef] [PubMed]
[30] Wilk, A.S., Tang, Z., Hoge, C., Plantinga, L.C. and Lea, J.P. (2019) Association between Patient Psychosocial Characteristics and Receipt of In-Center Nocturnal Hemodialysis among Prevalent Dialysis Patients. Hemodialysis International, 23, 479-485. [Google Scholar] [CrossRef] [PubMed]
[31] Fadem, S.Z. (2022) Dialysis, Transplantation, and Work: Honoring Original Intent. Clinical Journal of the American Society of Nephrology, 17, 1431-1432. [Google Scholar] [CrossRef] [PubMed]
[32] 黄夏赟, 陶惠琴, 陈剑敏, 等. 中青年维持性血液透析患者工作体验与适应策略的质性研究[J]. 护理学报, 2025, 32(14): 69-73.
[33] 彭源, 朱林芳, 杨玉洁, 等. 不同透析方式间患者重返工作准备度与家庭弹性的相关性分析[J]. 重庆医学, 2023, 52(21): 3294-3297.
[34] Muehrer, R.J., Schatell, D., Witten, B., Gangnon, R., Becker, B.N. and Hofmann, R.M. (2011) Factors Affecting Employment at Initiation of Dialysis. Clinical Journal of the American Society of Nephrology, 6, 489-496. [Google Scholar] [CrossRef] [PubMed]
[35] 曹慧丽, 何琨, 齐倩倩. 中文版重返工作准备度量表在乳腺癌患者中的信效度检验[J]. 中国康复医学杂志, 2019, 34(7): 801-807.
[36] Wen, L., Gao, Z., Zhong, X., Wen, L., Zang, S. and Bai, X. (2024) Readiness for Return to Work and Its Influencing Factors among Head and Neck Cancer Patients: A Cross-Sectional Study. Supportive Care in Cancer, 32, Article No. 420. [Google Scholar] [CrossRef] [PubMed]
[37] Ghasempour, M., Shabanloei, R., Rahmani, A., Jafarabadi, M.A., Abri, F. and Khajehgoodari, M. (2019) The Relation of Readiness for Return to Work and Return to Work among Iranian Cancer Survivors. Journal of Cancer Education, 35, 1237-1242. [Google Scholar] [CrossRef] [PubMed]
[38] Lam, C.S., Wiley, A.H., Siu, A. and Emmett, J. (2010) Assessing Readiness to Work from a Stages of Change Perspective: Implications for Return to Work. Work, 37, 321-329. [Google Scholar] [CrossRef] [PubMed]
[39] Chan, H., Li-Tsang, C.W.P., Chan, C., Lam, C.S., Hui, K.L. and Bard, C. (2006) Validation of Lam Assessment of Employment Readiness (C-LASER) for Chinese Injured Workers. Journal of Occupational Rehabilitation, 16, 697-705. [Google Scholar] [CrossRef] [PubMed]
[40] 徐艳文, 罗筱媛, 卢讯文, 等. 林氏就业准备量表在工伤职业康复中信度和效度的研究[J]. 中国康复理论与实践, 2014, 20(6): 592-596.
[41] 韩瑶. 基于认知行为疗法的血液肿瘤患者重返工作准备度干预方案的构建及应用[D]: [硕士学位论文]. 青岛: 青岛大学, 2024.
[42] Feder, J., Nadel, M.V. and Krishnan, M. (2016) A Matter of Choice: Opportunities and Obstacles Facing People with ESRD. Clinical Journal of the American Society of Nephrology, 11, 536-538.
[43] Li, J.W., Wong, J.H.S., Chak, W.L. and Chau, K.F. (2018) Effect of Incident Nocturnal Home Hemodialysis versus Incident Continuous Ambulatory Peritoneal Dialysis on Employment Rate, Clinical, and Laboratory Outcomes: A 1‐Year Retrospective Observation Study. Hemodialysis International, 22, 308-317. [Google Scholar] [CrossRef] [PubMed]

为你推荐