Influencing factors of resource utilisation in haemodialysis patients-Based on socioecological pyramid model

To describe the current situation and analyse influencing factors of resource utilisation in maintenance haemodialysis patients.

The self-management level of patients undergoing maintenance haemodialysis in China is low. The applicability of the Chronic Illness Resources Survey in Chinese maintenance haemodialysis patients has been validated, and this survey can be used to assess the utilisation of self-management support resources among haemodialysis patients. Determining the influencing factors of resource utilisation can help improve the self-management behaviour of haemodialysis patients and control the progression of the disease.

A descriptive study design was chosen.

A convenience sample of 314 patients undergoing haemodialysis was recruited from dialysis centres in three hospitals in western Xinjiang from June 2018-April 2019. SPSS19.0 software was used to describe the current situation of resource utilisation. Moreover, t test, analysis of variance and multivariate linear regression were applied to explore the influencing factors of patients' resource utilisation. Standards for observational studies STROBE Statement checklist-v4 were chosen on reporting the study process.

The average score of the total resource utilisation was 2.95 ± 0.51. The average item score of seven dimensions from high to low was 3.46 for medical staff, 3.32 for personal, 3.22 for family and friends, 3.16 for work-related, 3.12 for media policy, 2.55 for neighbourhood/community and 2.23 for organisation. Multiple linear regression showed that there have six main factors, which explained 65.4% of the variance of haemodialysis patients' resource utilisation.

The personal, family and friends, work and media and policy subscales were rated the highest, with support from neighbourhood/community and organisation rated the lowest. In general, participants perceived moderate levels of support. Government and healthcare team should pay more attention on haemodialysis patients who had low level of education, poor economic conditions and poor mental condition.

ESRD has caused a burden on healthcare expenditure and has become a critical public health problem worldwide. Self-management is particularly important for dialysis patients which have attracted extensive interest. In the future research, we can use this questionnaire to evaluate the related resources of disease management of dialysis patients, encourage patients to make full use of the resources around them and focus on those patients with low education and monthly income level and bad mental state.