Latent class growth model-based study of demoralization syndrome among maintenance hemodialysis patients in young and middle-aged adults / 中国实用护理杂志

ABSTRACT

Objective:To investigate distinct trahectories of demoralization of maintenance hemodialysis patients in young and middle-aged adults, and analyze the factors that affect the trajectory category, so as to provides reference for formulating individualized intervention strategies.Methods:This study was a cross-sectional survey. From April 2020 to April 2021, young and middle-aged maintenance hemodialysis patients fromShangyu People′s Hospital were collected by convenience sampling method and conducted 4-time follow-up investigation. The survey tools included general information questionnaire, Demoralization Scale Mandarin Version (DS-MV) and Experiences in Close Relationship Scale-Short Form (ECR-S). Latent class growth model was used to identify trajectory patterns of demoralization, Logistic regression was used to identify predictors of demoralization trajectories.Results:Totally, 105 patients were enrolled in the present study. Three distinct trajectories were identified and named as "table high level group" 24 cases, "slow reduction group" 39 cases and "continuous reduction group" 42 cases. Univariate analysis showed that age, occupational status, average income per person in family, number of comorbidities, attachment anxiety scores were related to the category of demoralization trajectories ( F = 15.92, χ2 values were 9.16-15.95, all P<0.05). Multivariate Logistic regression analysis showed that age, occupational status, average income per person in family, number of comorbidities, and attachment anxiety scores were important predictors of patterns of demoralization trajectories in young and middle-aged maintenance hemodialysis patients. Conclusions:This study identified three distinct demoralization trajectories in young and middle-aged maintenance hemodialysis patients, clinical nursing should formulate individualized intervention strategies according to the types of patients′ delirium trajectories.