慢性肾脏病透析治疗患者“跳蚤效应”的护理研究

Nursing study of the "flea effect" in patients treated for dialysis in chronic kidney disease

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DOI 10.12208/j.ijnr.20250514
刊名
International Journal of Nursing Research
年,卷(期) 2025, 7(10)
作者
作者单位

湖北医药学院附属十堰市太和医院 湖北十堰

摘要
随着维持性血液透析(MHD)成为终末期肾病患者的主要治疗手段,长期医疗过程中的心理与行为障碍对患者的生活质量和疾病管理产生深远影响。跳蚤效应作为一种自我设限行为,体现了患者因长期的病理压力及社会环境限制,主动降低目标和管理期望,从而阻碍其潜能的发挥和健康行为的持续改善。本文系统梳理了跳蚤效应的理论内涵及其在血液透析患者中的心理、社会功能和自我管理表现,详细探讨了个人心理因素、社会支持网络及健康认知等在跳蚤效应形成中的多重机制。综合分析表明,心理弹性、自我效能及社会支持是缓解跳蚤效应、促进积极健康行为的关键环节。针对这一现象,心理护理干预、社会支持增强及基于行为理论的综合自我管理方案被证实能有效改善患者的负性情绪、治疗依从性与生活质量,但现有研究在样本异质性、干预持续性及机制解析方面仍存不足。未来研究应聚焦多层次机制的精细探究,推动个性化与智能化护理干预技术的融合应用,强化长期随访与多维度干预体系构建,以促进慢性肾脏病透析患者心理行为的深度重塑和整体健康水平的提升。
Abstract
As maintenance hemodialysis (MHD) becomes the primary treatment for end-stage renal disease patients, psychological and behavioral barriers during long-term medical care profoundly impact patients' quality of life and disease management. The flea effect, as a form of self-limiting behavior, reflects patients' proactive reduction of goals and management expectations due to prolonged pathological stress and social constraints, thereby hindering the realization of their potential and sustained improvement in health behaviors. This paper systematically reviews the theoretical underpinnings of the flea effect and its manifestations in psychological, social functioning, and self-management among hemodialysis patients. It thoroughly examines the multifaceted mechanisms involved in the development of the flea effect, including individual psychological factors, social support networks, and health cognition. Comprehensive analysis indicates that psychological resilience, self-efficacy, and social support are critical components for mitigating the flea effect and promoting positive health behaviors. Psychological nursing interventions, social support enhancement, and comprehensive self-management programs grounded in behavioral theory have been demonstrated to effectively improve patients' negative emotions, treatment adherence, and quality of life. However, existing research remains limited in terms of sample heterogeneity, intervention sustainability, and mechanism clarification. Future research should focus on refining the exploration of multi-level mechanisms, promoting the integrated application of personalized and intelligent nursing intervention technologies, and strengthening long-term follow-up and multidimensional intervention systems. This will facilitate the profound psychological and behavioral transformation of chronic kidney disease dialysis patients and enhance their overall health outcomes.
关键词
慢性肾脏病;跳蚤效应;血液透析;心理护理;社会支持;自我管理
KeyWord
Chronic kidney disease; Flea effect; Hemodialysis; Psychological care; Social support; Self-management
基金项目
页码 25-31
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周贝柠. 慢性肾脏病透析治疗患者“跳蚤效应”的护理研究 [J]. 国际护理学研究. 2025; 7; (10). 25 - 31.

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