肾衰竭患者CRRT治疗期间心理痛苦现状及 心理护理干预效果分析

Analysis of Psychological Distress Status and the Effectiveness of Psychological Nursing Interventions in Patients with Renal Failure during CRRT Treatment

摘要: 目的：探讨肾衰竭患者连续性肾脏替代治疗(CRRT)期间心理痛苦的现状，并分析针对性心理护理干预的临床效果，为临床缓解患者心理痛苦、改善治疗结局提供参考依据。方法：选取本院2022年1月至2023年12月收治的86例接受CRRT治疗的肾衰竭患者作为研究对象，采用便利抽样法分为对照组(43例)和观察组(43例)。对照组实施CRRT常规护理，观察组在常规护理基础上实施针对性心理护理干预，干预周期为患者CRRT治疗全程(平均14.52 ± 3.76天)。采用心理痛苦温度计(DT)、焦虑自评量表(SAS)、抑郁自评量表(SDS)评估患者干预前后心理痛苦、焦虑及抑郁现状；比较两组患者治疗依从性、并发症发生率及护理满意度。结果：干预前，86例患者中，无心理痛苦12例(13.95%)，轻度心理痛苦28例(32.56%)，中度心理痛苦30例(34.88%)，重度心理痛苦16例(18.60%)；SAS评分为(56.78 ± 7.25)分，SDS评分为(58.34 ± 7.56)分，均处于中度焦虑、抑郁水平。干预后，观察组DT评分、SAS评分、SDS评分分别为(2.15 ± 1.02)分、(42.36 ± 5.89)分、(43.18 ± 6.05)分，显著低于对照组的(4.87 ± 1.35)分、(52.17 ± 6.98)分、(53.69 ± 7.12)分，差异有统计学意义(P < 0.05)；观察组治疗依从性(95.35%)、护理满意度(97.67%)显著高于对照组的(79.07%)、(83.72%)，并发症发生率(6.98%)显著低于对照组的(23.26%)，差异有统计学意义(P < 0.05)。结论：肾衰竭患者CRRT治疗期间普遍存在不同程度的心理痛苦，以中度心理痛苦为主，且伴随明显的焦虑、抑郁情绪；实施针对性心理护理干预，可有效缓解患者心理痛苦及负面情绪，提高治疗依从性，降低并发症发生率，提升护理满意度，改善患者治疗体验及临床结局，值得临床推广应用。

Abstract: Objective: To explore the status of psychological distress in patients with renal failure during continuous renal replacement therapy (CRRT), and to analyze the clinical effects of targeted psychological nursing interventions, so as to provide a reference for clinical practice in alleviating patients’ psychological distress and improving treatment outcomes. Methods: Eighty-six patients with renal failure who received CRRT treatment in our hospital from January 2022 to December 2023 were selected as study subjects and divided into a control group (43 cases) and an observation group (43 cases) using convenience sampling. The control group received routine CRRT care, while the observation group received targeted psychological nursing interventions in addition to routine care. The intervention period lasted throughout the patients’ CRRT treatment (average 14.52 ± 3.76 days). The Distress Thermometer (DT), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS) were used to assess the patients’ psychological distress, anxiety, and depression before and after the intervention. Treatment compliance, complication rates, and nursing satisfaction were compared between the two groups. Results: Before the intervention, among the 86 patients, 12 (13.95%) had no psychological distress, 28 (32.56%) had mild psychological distress, 30 (34.88%) had moderate psychological distress, and 16 (18.60%) had severe psychological distress. The SAS score was (56.78 ± 7.25) points, and the SDS score was (58.34 ± 7.56) points, indicating moderate levels of anxiety and depression. After the intervention, the observation group had significantly lower DT, SAS, and SDS scores [(2.15 ± 1.02), (42.36 ± 5.89), and (43.18 ± 6.05) points, respectively] compared to the control group [(4.87 ± 1.35), (52.17 ± 6.98), and (53.69 ± 7.12) points, respectively], with statistically significant differences (P < 0.05). The observation group also showed significantly higher treatment compliance (95.35%) and nursing satisfaction (97.67%) compared to the control group (79.07% and 83.72%, respectively), and a significantly lower complication rate (6.98%) compared to the control group (23.26%), with statistically significant differences (P < 0.05). Conclusion: Patients with renal failure undergoing CRRT commonly experience varying degrees of psychological distress, predominantly moderate distress, accompanied by significant anxiety and depression. Implementing targeted psychological nursing interventions can effectively alleviate psychological distress and negative emotions, improve treatment compliance, reduce complication rates, enhance nursing satisfaction, and improve patients’ treatment experience and clinical outcomes, making it worthy of clinical promotion and application.