Analysis of influencing factors and pathways of social alienation in young and middle-aged maintenance haemodialysis patients
10.3760/cma.j.cn211501-20240708-01786
- VernacularTitle:中青年维持性血液透析患者社会疏离的影响因素及路径分析
- Author:
Xiaojie YANG
1
;
Chunyan LI
;
Wanli DONG
;
Shanshan LI
Author Information
1. 南阳市中心医院血液净化科，南阳 473009
- Publication Type:Journal Article
- Keywords:
Renal dialysis;
Maintenance hemodialysis;
Social alienation;
Stigma;
Influencing factors;
Structural equation mode
- From:
Chinese Journal of Practical Nursing
2025;41(21):1637-1645
- CountryChina
- Language:Chinese
-
Abstract:
Objective:Based on the stress process theory, the influencing factors and pathways of social alienation among young and middle-aged patients undergoing maintenance hemodialysis (MHD) were explored, so as to provide evidence for healthcare professionals to develop targeted interventions.Methods:Convenience sampling method was used to select young and middle-aged MHD patients from Nanyang Central Hospital between October 2023 and April 2024. A cross-sectional survey was conducted using a General Information Questionnaire, the General Alienation Scale, the Perceived Social Support Scale, and the Medical Coping Modes Questionnaire, the Social Impact Scale.Results:A total of 307 questionnaires were distributed, and 296 valid questionnaires were returned, with an effective response rate of 96.4%. Among the 296 participants, 190 were male and 106 were female; 124 were aged 18-45 years, and 172 were aged 46-59 years. The score of social alienation in young and middle-aged MHD patients was (40.79 ± 7.67). Stepwise multiple linear regression analysis revealed that education level, monthly household income per capita, duration of dialysis, number of chronic comorbidities, fatigue level, stigma, perceived social support, yielding coping style, avoidance coping style were significant influencing factors of social alienation in young and middle-aged MHD patients ( t values were -3.43-6.05, all P<0.05). The pathways analysis indicated that stigma, yielding coping style, and avoidance coping style had direct positive effects on social alienation in young and middle-aged MHD patients, with the effect values of 0.441, 0.286, 0.166, respectively (all P<0.05); perceived social support had a direct negative effect, with the effect value of -0.210 ( P<0.05); stigma and perceived social support exerted indirect effects on social alienation, with the effect values of 0.216, -0.108, respectively (both P<0.05). Conclusions:A relatively high level of social alienation was observed among young and middle-aged MHD patients, indicating an urgent need for improvement. Healthcare professionals should prioritize interventions targeting patient stigma. Enhancing perceived social support, offering psychological counseling, and teaching stress-coping strategies may help reduce maladaptive coping behaviors, thereby alleviating social alienation and promoting social reintegration.
