关键词: 慢性病, 慢性肾脏病, 患者积极度, 心理健康, 社会支持, 相关性研究

Abstract: Background　Disease spectrum changes as time goes on.Chronic kidney disease（CKD） has become a global public health problem threatening people's health，causing a substantially great burden.The traditional disease-centered model is no longer applicable，the new appropriate chronic disease management model highlights the central role of the patient in disease prevention and treatment.Hence，how to increase patient self-management initiative，namely，patient activation，has become a research hotspot of CKD follow-up management.Objective　To explore the correlation of activation with psychological distress and social support in CKD patients with outpatient follow-up management，providing evidence for improving patient activation.Methods　A single-center，cross-sectional design with convenience sampling was adopted in the research carried out between August 2017 and October 2018.Participants were totally 301 non-dialysis patients with CKD stages 1-5 who received regular outpatient follow-up from the Clinic of Kidney Disease Center，Nanfang Hospital.They were investigated with Patient Activation Measure（PAM），Kessler Psychological Distress Scale（KPDS） and Social Support Scale.Results　The rates with activation levels of 1-4 were 12.3%（37/301），18.3%（55/301），36.5%（110/301），and 32.9%（99/301），respectively，with corresponding mean evaluation score of 45.1（43.2，46.1），51.1（51.1，52.6），61.1（59.4，64.1），and 73.1（68.1，77.0），respectively.The PAM score was negatively correlated with KPDS score（rs=-0.301，P<0.01），but was positively correlated with the total score of social support，scores of objective support，subjective support and utilization of support（rs=0.195-0.359，P<0.01）.Conclusion　The activation for most CKD patients is not high，indicating that they have no sufficient self-management knowledge and confidence，and skills for health maintenance and promotion.In addition，CKD patients' activation increases with the growth of social support，but decreases with the aggravation of psychological distress.So the activation of such patients during the outpatient follow-up management may be enhanced by psychological rehabilitation interventions and increased social support.

Key words: Chronic disease, Chronic kidney disease, Patient activation, Mental health, Social support, Correlation study