Application Research Of Distress Thermometer In Maintenance Hemodialysis Patients

Objective:Verify the reliability and validity of the Chinese version of the Distress Thermometer in maintenance hemodialysis patients,determine the best critical value,and explore the psychological pain level and problem list distribution of maintenance hemodialysis patients,and further analyze the influencing factors of significant psychological pain.Methods:1.The Chinese version of Distress Thermometer was adjusted and revised.In April 2020,a total of 150 hemodialysis patients in the blood purification center of the second people’s Hospital of Yibin City were investigated by random sampling method.Using the Hospital Anxiety and Depression Scale,Beck Depression Scale and Beck Anxiety Scale as calibration criteria,we tested the reliability and validity of the psychological distress thermometer,including content validity,structure validity,calibration correlation validity,Cronbach’s alpha and Kappa value,and determined the optimal critical value by ROC curve.2.This study adopted a cross-sectional survey.From May 2020 to June 2020,we randomly selected 1486 dialysis patients from 10 hospitals in southern Sichuan Province to conduct questionnaire survey and passed the psychological pain thermometer after verification to evaluate the status of psychological pain of patients.We assessed the status of patients’psychological distress,and collected their sociodemographic characteristics and laboratory examination data to analyze the sources of psychological distress and influencing factors.In this study,Spss20.0 statistical software was used for chi square test,independent sample t test,Pearson correlation analysis and binary logistic regression.Results:1.The I-CVI of each item in the problem list is 0.833-1.000,the factor load value is 0.50-0.93,the R value is 0.451-711(p<0.05),the Cronbach’s α is 0.775-0.918,and the Kappa value is 0.416-0.718,indicating that it has good reliability and validity.The maximum Youden index is 0.744 and when the DT value is 5,the AUC is 0.868,the sensitivity is 80.00%,and the specificity is 94.38%.2.Logistic regression analysis results show that demographic characteristics include monthly income,number of fistulas,combined with hypertension/diabetes,laboratory tests include HGB,ALB,P,iPTH,CRP,RDW,List of problems:lack of time and energy to do housework,getting along with a partner,depression,sadness,worry,restriction of drinking or eating,fatigue,dry skin/pruritus,and restricted physical activity are factors that affect patients’psychological distress.Conclusion:1.The Distress Thermometer is a scale with good reliability and validity.5 points is the best critical value for significant psychological distress.This scale is suitable for rapid and effective screening of dialysis patients.2.Significant psychological distress of dialysis patients is widespread.We recommend that medical staff increase their psychological attention to dialysis patients,conduct psychological screening of patients in a timely manner,and provide psychological counseling or intervention for patients with psychological distress to improve their quality of life.