看護師のサポートが透析患者の抑うつに与える影響

Influence of nursing support on depression in hemodialysis patients

【目的】透析患者の抑うつを軽減させるための効果的な看護師のサポートについて示唆を得るため，看護師のサポートが透析患者の抑うつに与える影響について明らかにすることを目的とした．

【研究方法】透析患者を対象に調査票を配布し，基本属性，家族の状況，健康状態，抑うつ，看護師のサポートについて尋ねた．分析では抑うつを目的変数とし，説明変数には3つの看護師のサポート；情動的サポート（情緒的なサポート），保健情報サポート（説明や情報提供的なサポート），専門的技術的能力サポート（医療専門職としての適切な判断力や対処能力などを用いたサポート）とともに，年齢，性別などの基本属性のほか，抑うつリスク因子や抑うつ軽減因子となる10項目の交絡因子を選択しロジスティック回帰分析を行った．

【結果/考察】分析の結果，看護師の3つのサポートのなかで保健情報サポートのみが透析患者の抑うつと有意な関連を示し，看護師からの保健情報サポートが透析患者の抑うつを軽減できるサポートであることが示された．一方で，透析患者の抑うつの最大の要因は身体症状であることも示された．透析患者の抑うつを軽減させるための効果的な看護師のサポートとは，透析患者の身体症状の安定・改善を目的とした保健情報の提供であることが示唆された．

【Purpose】We clarified the influence of nursing support on depression in hemodialysis patients to gain suggestions on effective nursing support to alleviate depression in hemodialysis patients.

【Methods】We distributed questionnaires to hemodialysis patients, that included questions about basic attributes, family situation, health condition, cognitive situation of depression, and nursing support. Depression was the objective variable, and explanatory variables included nursing/emotional (emotional support), health information (explanation and informative support), and professional technical ability (such as appropriate judgment as a medical professional and ability to cope with problems) supports. Logistic regression analysis was conducted by selecting confounding factors of 10 items that comprise basic attributes, including age and sex, and depression risk and depression mitigating factors.

【Result/Consideration】As per the analysis, nursing support related to depression in hemodialysis patients was the only health information support, and that was found to be support to alleviate depression in hemodialysis patients. On the other hand, the physical symptoms perceived by hemodialysis patients had a stronger influence on their depression than nursing support. It was suggested that effective nursing support to alleviate depression in dialysis patients is provision of health information for the purpose of stabilizing and improving the physical symptoms of hemodialysis patients.