关键词: 血液透析；疾病接受度；自我管理；潜在剖面分析

Abstract: Objective: To explore the latent categories of illness acceptance in Maintenance Hemodialysis patients, and to analyze the relationship between each category and the level of self-management, in order to provide patients with more effective personalized disease management and self-management support. Methods: A total of 290 patients undergoing maintenance hemodialysis who were treated in a tertiary grade A hospital in Shanxi Province from April to July 2023 were conveniently selected as the study subjects. Eight items of the Disease Acceptance Scale were used as explicit indicators for potential profile analysis, and the influencing factors of different categories of patients were identified by univariate analysis and multivariate logistic regression, and the regression mixed model was used to explore the differences in the self-management level of different categories of patients. Results: The illness acceptance of Maintenance Hemodialysis patients was divided into three potential categories, namely "low acceptance-social dependence" (41.0%), "medium acceptance-lack of self-confidence" (26.6%), and "high acceptance-action constraint" (32.4%). Per capita monthly household income, number of comorbidities and age on dialysis as factors influencing illness acceptance in different categories of maintenance hemodialysis patients (P<0.05). The total score of the patient self-management scale in the "high acceptance-action constraint group" was the highest. The scores of patients in the "medium acceptance-lack of self-confidence" group were lower than those in the "low acceptance-social dependence group" in the dimension of emotional processing. Conclusion: There is significant heterogeneity in illness acceptance among Maintenance Hemodialysis patients, and there are differences in the level of self-management among different types of patients. Caregivers should provide individualized interventions to improve self-management according to the category characteristics of patients' illness acceptance.

Key words: hemodialysis; illness acceptance; self-management; latent profile analysis