终末期肾病患者心理筛查干预及 相关危险因素研究

A Study on Psychological Screening and Intervention and Related Risk Factors for Patients with End-Stage Renal Disease

摘要: 终末期肾病(End-Stage Renal Disease, ESRD)是慢性肾脏病进展至不可逆阶段的最终表现，大多数患者依靠血液透析延长生命，在疾病与治疗双重压力下，焦虑、抑郁、疲乏、睡眠障碍等心理问题高发，心理痛苦已成为影响预后与生活质量的重要因素。规范、快速、准确的心理筛查，是实现“生物–心理–社会”一体化管理的关键环节。心理痛苦温度计(Distress Thermometer, DT)是一种心理筛查工具，被推荐用于临床，可快速识别患者的心理痛苦程度。本文就终末期肾病患者心理痛苦的流行特点、常用筛查工具、独立危险因素及干预策略进行系统综述，重点对比传统情绪量表与心理痛苦温度计的应用价值，总结经济状况、躯体症状、营养炎症指标、钙磷代谢及社会支持等关键影响因素，为临床开展早期识别、分层评估与精准干预提供依据。

Abstract: End-Stage Renal Disease (ESRD) represents the final stage of chronic kidney disease progression, during which most patients rely on hemodialysis to prolong life. Under the dual pressures of the disease and its treatment, psychological issues such as anxiety, depression, fatigue, and sleep disorders are highly prevalent. Psychological distress has become a significant factor affecting prognosis and quality of life. Standardized, rapid, and accurate psychological screening is a critical component of implementing the “biological-psychological-social” integrated management model. The Distress Thermometer (DT), a psychological screening tool, is recommended for clinical use to quickly identify the extent of psychological distress in patients. This article provides a systematic review of the epidemiological characteristics of psychological distress in patients with ESRD, commonly used screening tools, independent risk factors, and intervention strategies. It focuses on comparing the application value of traditional mood scales with the Distress Thermometer, and summarizes key influencing factors such as economic status, somatic symptoms, nutritional and inflammatory markers, calcium-phosphate metabolism, and social support. The aim is to provide evidence for early identification, stratified assessment, and precise intervention in clinical practice.