首页 期刊 论文 学科刊群 资讯 加盟 关于
EN
image
Article(id=1322931577168212816, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322931549481599694, articleNumber=null, orderNo=null, doi=10.12102/j.issn.1009-6493.2026.12.002, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1757606400000, receivedDateStr=2025-09-12, revisedDate=1780416000000, revisedDateStr=2026-06-03, acceptedDate=null, acceptedDateStr=null, onlineDate=1793341066876, onlineDateStr=2026-10-30, pubDate=1782316800000, pubDateStr=2026-06-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793341066876, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793341066876, creator=13701087609, updateTime=1793341066876, updator=13701087609, issue=Issue{id=1322931549481599694, tenantId=1146029695717560320, journalId=1220038315760373764, year='2026', volume='40', issue='12', pageStart='2001', pageEnd='2192', issueExtLink='null', onlineDate='null', pubDate='1782316800000', pubDateStr='2026-06-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793341060276, creator='13701087609', updateTime=1793343118019, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322940180335829530, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322931549481599694, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322940180335829531, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322931549481599694, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=2013, endPage=2021, ext={EN=ArticleExt(id=1322931577377928017, articleId=1322931577168212816, tenantId=1146029695717560320, journalId=1220038315760373764, language=EN, title=Construction and validation of a prediction model for social frailty in elderly patients undergoing maintenance hemodialysis, columnId=1220689484526572183, journalTitle=Chinese Nursing Research, columnName=Original Articles, runingTitle=null, highlight=null, articleAbstract=
Objective

To construct a prediction model for social frailty in elderly patients undergoing maintenance hemodialysis.To explore the predictive value of modifiable factors such as dialysis symptom burden,family function,depression,and physical activity for the model.

Methods

By using the convenience sampling method,451 elderly patients undergoing maintenance hemodialysis in the hemodialysis room of a tertiary grade A hospital in Chengde City from November 2024 to April 2025 were selected as the research subjects for the construction group.Another 181 elderly patients undergoing maintenance hemodialysis in the hemodialysis rooms of two tertiary grade A hospitals from May to July 2025 were selected as the external validation group for the research.A cross-sectional survey was conducted using general information questionnaires,5-Item Geriatric Depression Scale(GDS-5),Dialysis Symptom Index(DSI),Brief Aging Perceptions Questionnaire(B-APQ),Family APGAR Index(APGAR),and the Score of the Chinese Version of the International Physical Activity Questionnaire-Short Form.Logistic regression analysis was used to screen the influencing factors of social frailty.The ROC curve was drawn using R language and internal and external validations were conducted.The distinguishability,calibration,and clinical practicability of the model were evaluated.Based on the predictive factors,the basic model and the full model were constructed.The predictive value of the modifiable factors was quantified.

Results

The incidence rates of social frailty among elderly maintenance hemodialysis patients in the construction group and the validation group were 33.7% and 35.9% respectively.Logistic results showed that dialysis duration,burden of dialysis symptoms,family function,physical activity,and depression were the influencing factors of social frailty in elderly maintenance hemodialysis patients.Based on the above five factors,the area under the receiver operating characteristic curve of the Nomogram for internal and external validation was 0.888 and 0.876 respectively.The Hosmer-Lemeshow test results showed that both P>0.05.The calibration curves and decision curves of internal and external validation both showed that the model had good calibration and high clinical practicability.The modifiable factors significantly contributed to the predictive value of the model.

Conclusions

The constructed prediction model for social frailty in elderly patients undergoing maintenance hemodialysis has good predictive efficacy and clinical applicability.It could provide a tool for the early identification of social frailty in elderly maintenance hemodialysis patients.Medical staff could formulate corresponding intervention measures based on factors that can be intervened,such as the burden of dialysis symptoms,family function,depression,and physical activity,so as to delay the occurrence and development of social frailty in elderly patients undergoing maintenance hemodialysis.

, authors=Chenrui FAN1, Junying LIU2, authorsList=Chenrui FAN, Junying LIU, authorCompany=null, correspAuthors=Junying LIU, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322931578401338202, articleId=1322931577168212816, tenantId=1146029695717560320, journalId=1220038315760373764, language=CN, title=老年维持性血液透析病人社会衰弱预测模型的构建与验证, columnId=1220689484681761433, journalTitle=护理研究, columnName=科研论著, runingTitle=null, highlight=null, articleAbstract=
目的

构建老年维持性血液透析病人社会衰弱风险预测模型，探讨透析症状负担、家庭功能、抑郁、体力活动等可干预因素对模型的预测价值。

方法

采用便利抽样法，选取2024年11月—2025年4月在承德市某三级甲等医院血液透析室进行透析的451例老年维持性血液透析病人作为构建组研究对象，选取2025年5月—7月另外2所三级甲等医院血液透析室进行透析的181例老年维持性血液透析病人作为外部验证组研究对象。采用一般资料调查表、简版老年抑郁量表、透析症状评估量表、自我感知老化量表、家庭关怀度量表、中文版国际体力活动问卷评分、社会衰弱量表进行横断面调查。采用Logistic回归分析筛选社会衰弱的影响因素，R语言绘制列线图并进行内外部验证，评价模型的区分度、校准度和临床实用性。基于预测因子的可干预性构建基础模型与全模型，量化可干预因素的预测价值。

结果

构建组与验证组老年维持性血液透析病人社会衰弱发生率分别为33.7%、35.9%。Logistic回归分析结果显示，透析龄、透析症状负担、家庭功能、体力活动和抑郁是老年维持性血液透析病人社会衰弱的影响因素。根据上述5个因素绘制的列线图内外部验证受试者工作特征曲线下面积分别为0.888，0.876；Hosmer-Lemeshow拟合优度检验结果显示P>0.05；内外部验证的校准曲线与决策曲线均显示模型的校准度较好、临床实用性较高，可干预因素对模型预测价值贡献显著。

结论

构建的老年维持性血液透析病人社会衰弱预测模型具有良好的预测效能和临床适用性，可为老年维持性血液透析病人社会衰弱的早期识别提供依据。医护人员可针对透析症状负担、家庭功能、抑郁及体力活动等可干预因素制定相应干预措施，延缓老年维持性血液透析病人社会衰弱的发生发展。

, authors=范辰瑞1, 刘俊英2, *, *, authorsList=范辰瑞, 刘俊英, authorCompany=null, correspAuthors=刘俊英, authorNote=

范辰瑞，硕士研究生在读

, correspAuthorsNote=
刘俊英，E-mail：
LIU Junying， E-mail：
, copyrightStatement=除非特别声明，本刊刊出的所有文章不代表本刊编委会的观点。, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=zP5872AQtl2nUQJ/vRaaMA==, magXml=OZGIL8HWJeXgaB+WW6wM0w==, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=m0j+cEP1Lyyg8uKWSnXkvA==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=3M2o+PPi37C1xyFrSnO5Og==, mapNumber=null, fund=null)}, authors=[Author(id=1322931578984346466, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, orderNo=0, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1322931580674650981, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, authorId=1322931578984346466, language=EN, stringName=Chenrui FAN, firstName=Chenrui, middleName=null, lastName=FAN, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=1, address=1School of Nursing, Chengde Medical University, Hebei 067000 China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1322931580745954150, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, authorId=1322931578984346466, language=CN, stringName=范辰瑞, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=1, address=1承德医学院护理学院，河北 067000, bio={"content":"

范辰瑞，硕士研究生在读

"}, bioImg=null, bioContent=

范辰瑞，硕士研究生在读

, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1322931578762048347, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, xref=1, ext=[AuthorCompanyExt(id=1322931578791408476, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, companyId=1322931578762048347, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1School of Nursing, Chengde Medical University, Hebei 067000 China), AuthorCompanyExt(id=1322931578799797085, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, companyId=1322931578762048347, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1承德医学院护理学院，河北 067000)])]), Author(id=1322931580834034536, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, orderNo=1, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=15633142986@163.com, emailSecond=null, emailThird=null, correspondingAuthor=1, authorType=1, ext={EN=AuthorExt(id=1322931580947280746, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, authorId=1322931580834034536, language=EN, stringName=Junying LIU, firstName=Junying, middleName=null, lastName=LIU, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=2, address=2the Affiliated Hospital of Chengde Medical University, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1322931581043749739, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, authorId=1322931580834034536, language=CN, stringName=刘俊英, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=2, *, *, address=2承德医学院附属医院, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1322931578883683166, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, xref=2, ext=[AuthorCompanyExt(id=1322931578892071775, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, companyId=1322931578883683166, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2the Affiliated Hospital of Chengde Medical University), AuthorCompanyExt(id=1322931578900460384, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, companyId=1322931578883683166, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2承德医学院附属医院)])])], keywords=[Keyword(id=1322931581169578860, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, language=EN, orderNo=1, keyword=elderly people), Keyword(id=1322931581249270637, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, language=EN, orderNo=2, keyword=maintenance hemodialysis), Keyword(id=1322931581337351022, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, language=EN, orderNo=3, keyword=social frailty), Keyword(id=1322931581404459887, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, language=EN, orderNo=4, keyword=prediction model), Keyword(id=1322931581467374448, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, language=EN, orderNo=5, keyword=risk factors), Keyword(id=1322931581538677617, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, language=CN, orderNo=1, keyword=老年人), Keyword(id=1322931581635146610, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, language=CN, orderNo=2, keyword=维持性血液透析), Keyword(id=1322931581710644083, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, language=CN, orderNo=3, keyword=社会衰弱), Keyword(id=1322931581786141556, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, language=CN, orderNo=4, keyword=预测模型), Keyword(id=1322931581874221941, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, language=CN, orderNo=5, keyword=危险因素)], refs=[Reference(id=1322931583476446086, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, doi=null, pmid=null, pmcid=null, year=2023, volume=183, issue=4, pageStart=298, pageEnd=310, url=null, language=null, rfNumber=1, rfOrder=0, authorNames=Wang L M, Xu X, Zhang M, journalName=JAMA Internal Medicine, refType=null, unstructuredReference=Wang L M,Xu X,Zhang M,et al.Prevalence of chronic kidney disease in China:results from the sixth China chronic disease and risk factor surveillance[J].JAMA Internal Medicine,2023,183(4):298-310., articleTitle=Prevalence of chronic kidney disease in China:results from the sixth China chronic disease and risk factor surveillance, refAbstract=null), Reference(id=1322931585149973384, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, doi=null, pmid=null, pmcid=null, year=2025, volume=25, issue=2, pageStart=111, pageEnd=115, url=null, language=null, rfNumber=2, rfOrder=1, authorNames=王静, 尼春萍, 盖海云, journalName=护理管理杂志, refType=null, unstructuredReference=王静,尼春萍,盖海云,等.心理控制感在血液透析患者恐惧疾病进展与心理社会适应间的中介效应[J].护理管理杂志,2025,25(2):111-115., articleTitle=心理控制感在血液透析患者恐惧疾病进展与心理社会适应间的中介效应, refAbstract=null), Reference(id=1322931585271608201, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, doi=null, pmid=null, pmcid=null, year=2023, volume=20, issue=6, pageStart=752, pageEnd=756, url=null, language=null, rfNumber=3, rfOrder=2, authorNames=黄铮, 邵庭芳, 梁冉, journalName=中华护理教育, refType=null, unstructuredReference=黄铮,邵庭芳,梁冉,等.老年人社会衰弱的概念分析[J].中华护理教育,2023,20(6):752-756., articleTitle=老年人社会衰弱的概念分析, refAbstract=null), Reference(id=1322931585347105674, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, doi=null, pmid=null, pmcid=null, year=2021, volume=21, issue=8, pageStart=664, pageEnd=669, url=null, language=null, rfNumber=4, rfOrder=3, authorNames=Usui N, Yokoyama M, Nakata J, journalName=Geriatrics & Gerontology International, refType=null, unstructuredReference=Usui N,Yokoyama M,Nakata J,et al.Association between social frailty as well as early physical dysfunction and exercise intolerance among older patients receiving hemodialysis[J].Geriatrics & Gerontology International,2021,21(8):664-669., articleTitle=Association between social frailty as well as early physical dysfunction and exercise intolerance among older patients receiving hemodialysis, refAbstract=null), Reference(id=1322931585443574667, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, doi=null, pmid=null, pmcid=null, year=2025, volume=52, issue=11, pageStart=1957, pageEnd=1962, url=null, language=null, rfNumber=5, rfOrder=4, authorNames=王鑫, 王晓虹, 齐加芹, journalName=现代预防医学, refType=null, unstructuredReference=王鑫,王晓虹,齐加芹,等.老年维持性血液透析患者社会衰弱影响因素分析及风险预测模型的构建[J].现代预防医学,2025,52(11):1957-1962., articleTitle=老年维持性血液透析患者社会衰弱影响因素分析及风险预测模型的构建, refAbstract=null), Reference(id=1322931585544237964, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, doi=null, pmid=null, pmcid=null, year=2023, volume=114, issue=null, pageStart=105082, pageEnd=null, url=null, language=null, rfNumber=6, rfOrder=5, authorNames=Imamura K, Yamamoto S, Suzuki Y, journalName=Archives of Gerontology and Geriatrics, refType=null, unstructuredReference=Imamura K,Yamamoto S,Suzuki Y,et al.Prevalence,overlap,and prognostic impact of multiple frailty domains in older patients on hemodialysis[J].Archives of Gerontology and Geriatrics,2023,114:105082., articleTitle=Prevalence,overlap,and prognostic impact of multiple frailty domains in older patients on hemodialysis, refAbstract=null), Reference(id=1322931585615541133, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, doi=null, pmid=null, pmcid=null, year=2023, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=7, rfOrder=6, authorNames=鲜圆圆, journalName=null, refType=null, unstructuredReference=鲜圆圆.养老机构老年人社会衰弱风险预测模型的构建与验证[D].成都:成都中医药大学,2023., articleTitle=养老机构老年人社会衰弱风险预测模型的构建与验证, refAbstract=null), Reference(id=1322931585678455694, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, doi=10.19538/j.nk2017010108, pmid=null, pmcid=null, year=2017, volume=37, issue=1, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=8, rfOrder=7, authorNames=上海慢性肾脏病早发现及规范化诊治与示范项目专家组, journalName=中国实用内科杂志, refType=null, unstructuredReference=上海慢性肾脏病早发现及规范化诊治与示范项目专家组.慢性肾脏病筛查诊断及防治指南[J].中国实用内科杂志,2017,37(1)., articleTitle=慢性肾脏病筛查诊断及防治指南, refAbstract=null), Reference(id=1322931585745564559, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, doi=null, pmid=null, pmcid=null, year=1948, volume=null, issue=null, pageStart=108, pageEnd=null, url=null, language=null, rfNumber=9, rfOrder=8, authorNames=Kendall M G, journalName=Rank correlation methods, refType=null, unstructuredReference=Kendall M G.Rank correlation methods[M].London:C.Griffin,1948:108., articleTitle=null, refAbstract=null), Reference(id=1322931585829450640, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, doi=null, pmid=null, pmcid=null, year=2024, volume=19, issue=5, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=10, rfOrder=9, authorNames=Namanja A, Nyondo D, Banda T, journalName=PLoS One, refType=null, unstructuredReference=Namanja A,Nyondo D,Banda T,et al.Delivering effective,comprehensive,multi-exercise component cardiac rehabilitation(CR) for chronic heart failure patients in low resource settings in sub-Saharan Africa:Queen Elizabeth Central Hospital(QECH-CR) randomised CR study,Malawi[J].PLoS One,2024,19(5):e0297564., articleTitle=Delivering effective,comprehensive,multi-exercise component cardiac rehabilitation(CR) for chronic heart failure patients in low resource settings in sub-Saharan Africa:Queen Elizabeth Central Hospital(QECH-CR) randomised CR study,Malawi, refAbstract=null), Reference(id=1322931585917531025, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, doi=null, pmid=null, pmcid=null, year=2024, volume=39, issue=24, pageStart=52, pageEnd=56, url=null, language=null, rfNumber=11, rfOrder=10, authorNames=周新艺, 孙建华, 王晓杰, journalName=护理学杂志, refType=null, unstructuredReference=周新艺,孙建华,王晓杰,等.临床风险预测模型外部验证指南(2024版)的解读与启示[J].护理学杂志,2024,39(24):52-56., articleTitle=临床风险预测模型外部验证指南(2024版)的解读与启示, refAbstract=null), Reference(id=1322931585988834194, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, doi=null, pmid=null, pmcid=null, year=2018, volume=22, issue=8, pageStart=989, pageEnd=995, url=null, language=null, rfNumber=12, rfOrder=11, authorNames=Ma L, Sun F, Tang Z, journalName=The Journal of Nutrition,Health and Aging, refType=null, unstructuredReference=Ma L,Sun F,Tang Z.Social frailty is associated with physical functioning,cognition,and depression,and predicts mortality[J].The Journal of Nutrition,Health and Aging,2018,22(8):989-995., articleTitle=Social frailty is associated with physical functioning,cognition,and depression,and predicts mortality, refAbstract=null), Reference(id=1322931586072720275, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, doi=null, pmid=null, pmcid=null, year=1999, volume=47, issue=7, pageStart=873, pageEnd=878, url=null, language=null, rfNumber=13, rfOrder=12, authorNames=Hoyl M T, Alessi C A, Harker J O, journalName=Journal of the American Geriatrics Society, refType=null, unstructuredReference=Hoyl M T,Alessi C A,Harker J O,et al.Development and testing of a five-item version of the Geriatric Depression Scale[J].Journal of the American Geriatrics Society,1999,47(7):873-878., articleTitle=Development and testing of a five-item version of the Geriatric Depression Scale, refAbstract=null), Reference(id=1322931586353738644, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, doi=null, pmid=null, pmcid=null, year=2017, volume=37, issue=5, pageStart=1249, pageEnd=1250, url=null, language=null, rfNumber=14, rfOrder=13, authorNames=朱彩云, 王国栋, 刘鑫, journalName=中国老年学杂志, refType=null, unstructuredReference=朱彩云,王国栋,刘鑫,等.老年住院患者抑郁发病率[J].中国老年学杂志,2017,37(5):1249-1250., articleTitle=老年住院患者抑郁发病率, refAbstract=null), Reference(id=1322931586743808917, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, doi=null, pmid=null, pmcid=null, year=2004, volume=27, issue=3, pageStart=226, pageEnd=240, url=null, language=null, rfNumber=15, rfOrder=14, authorNames=Weisbord S D, Fried L F, Arnold R M, journalName=Journal of Pain and Symptom Management, refType=null, unstructuredReference=Weisbord S D,Fried L F,Arnold R M,et al.Development of a symptom assessment instrument for chronic hemodialysis patients:the dialysis symptom index[J].Journal of Pain and Symptom Management,2004,27(3):226-240., articleTitle=Development of a symptom assessment instrument for chronic hemodialysis patients:the dialysis symptom index, refAbstract=null), Reference(id=1322931587112907670, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, doi=null, pmid=null, pmcid=null, year=2016, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=16, rfOrder=15, authorNames=郝艳华, journalName=null, refType=null, unstructuredReference=郝艳华.血液透析患者症状的相关研究[D].北京:北京协和医学院,2016., articleTitle=血液透析患者症状的相关研究, refAbstract=null), Reference(id=1322931587175822231, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, doi=null, pmid=null, pmcid=null, year=2018, volume=45, issue=4, pageStart=655, pageEnd=658, url=null, language=null, rfNumber=17, rfOrder=16, authorNames=扈娜, 孟令弟, 刘堃, journalName=现代预防医学, refType=null, unstructuredReference=扈娜,孟令弟,刘堃.简版自我感知老化量表在社区老年人中应用的信效度研究[J].现代预防医学,2018,45(4):655-658., articleTitle=简版自我感知老化量表在社区老年人中应用的信效度研究, refAbstract=null), Reference(id=1322931587247125400, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, doi=null, pmid=null, pmcid=null, year=1978, volume=6, issue=6, pageStart=1231, pageEnd=1239, url=null, language=null, rfNumber=18, rfOrder=17, authorNames=Smilkstein G, journalName=The Journal of Family Practice, refType=null, unstructuredReference=Smilkstein G.The Family APGAR:a proposal for family function test and its use by physicians[J].The Journal of Family Practice,1978,6(6):1231-1239., articleTitle=The Family APGAR:a proposal for family function test and its use by physicians, refAbstract=null), Reference(id=1322931587331011481, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, doi=null, pmid=null, pmcid=null, year=1999, volume=null, issue=11, pageStart=27, pageEnd=28, url=null, language=null, rfNumber=19, rfOrder=18, authorNames=吕繁, 曾光, 刘松暖, journalName=中国公共卫生, refType=null, unstructuredReference=吕繁,曾光,刘松暖,等.家庭关怀度指数问卷测量脑血管病病人家庭功能的信度和效度研究[J].中国公共卫生,1999(11):27-28., articleTitle=家庭关怀度指数问卷测量脑血管病病人家庭功能的信度和效度研究, refAbstract=null), Reference(id=1322931587586864026, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, doi=null, pmid=null, pmcid=null, year=2004, volume=25, issue=3, pageStart=265, pageEnd=268, url=null, language=null, rfNumber=20, rfOrder=19, authorNames=屈宁宁, 李可基, journalName=中华流行病学杂志, refType=null, unstructuredReference=屈宁宁,李可基.国际体力活动问卷中文版的信度和效度研究[J].中华流行病学杂志,2004,25(3):265-268., articleTitle=国际体力活动问卷中文版的信度和效度研究, refAbstract=null), Reference(id=1322931587666555803, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, doi=null, pmid=null, pmcid=null, year=2025, volume=28, issue=2, pageStart=220, pageEnd=227, url=null, language=null, rfNumber=21, rfOrder=20, authorNames=卢静, 孙国珍, 王洁, journalName=中国全科医学, refType=null, unstructuredReference=卢静,孙国珍,王洁,等.慢性心力衰竭患者社会衰弱现状及其影响因素可解释性分析研究[J].中国全科医学,2025,28(2):220-227., articleTitle=慢性心力衰竭患者社会衰弱现状及其影响因素可解释性分析研究, refAbstract=null), Reference(id=1322931587733664668, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, doi=null, pmid=null, pmcid=null, year=2022, volume=34, issue=3, pageStart=535, pageEnd=543, url=null, language=null, rfNumber=22, rfOrder=21, authorNames=Inoue T, Maeda K, Satake S, journalName=Aging Clinical and Experimental Research, refType=null, unstructuredReference=Inoue T,Maeda K,Satake S,et al.Osteosarcopenia,the co-existence of osteoporosis and sarcopenia,is associated with social frailty in older adults[J].Aging Clinical and Experimental Research,2022,34(3):535-543., articleTitle=Osteosarcopenia,the co-existence of osteoporosis and sarcopenia,is associated with social frailty in older adults, refAbstract=null), Reference(id=1322931587804967837, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, doi=null, pmid=null, pmcid=null, year=2025, volume=51, issue=3, pageStart=229, pageEnd=232, url=null, language=null, rfNumber=23, rfOrder=22, authorNames=周燕菲, 方一茜, 蒋倩, journalName=现代临床医学, refType=null, unstructuredReference=周燕菲,方一茜,蒋倩,等.维持性血液透析患者病耻感的研究进展[J].现代临床医学,2025,51(3):229-232., articleTitle=维持性血液透析患者病耻感的研究进展, refAbstract=null), Reference(id=1322931587964351390, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, doi=null, pmid=null, pmcid=null, year=2025, volume=27, issue=3, pageStart=373, pageEnd=376, url=null, language=null, rfNumber=24, rfOrder=23, authorNames=刘红群, 陈灿灿, 徐霞, journalName=中华保健医学杂志, refType=null, unstructuredReference=刘红群,陈灿灿,徐霞.维持性血液透析患者衰弱发生风险因素研究[J].中华保健医学杂志,2025,27(3):373-376., articleTitle=维持性血液透析患者衰弱发生风险因素研究, refAbstract=null), Reference(id=1322931589671433119, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, doi=null, pmid=null, pmcid=null, year=2024, volume=23, issue=4, pageStart=307, pageEnd=312, url=null, language=null, rfNumber=25, rfOrder=24, authorNames=钟志聪, 吴一帆, 魏琳, journalName=中国血液净化, refType=null, unstructuredReference=钟志聪,吴一帆,魏琳.维持性血液透析患者肌少症影响因素及预后研究[J].中国血液净化,2024,23(4):307-312., articleTitle=维持性血液透析患者肌少症影响因素及预后研究, refAbstract=null), Reference(id=1322931589780485024, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, doi=null, pmid=null, pmcid=null, year=2024, volume=38, issue=24, pageStart=4325, pageEnd=4332, url=null, language=null, rfNumber=26, rfOrder=25, authorNames=郑雨鹃, 何璐晨, 骆芬霞, journalName=护理研究, refType=null, unstructuredReference=郑雨鹃,何璐晨,骆芬霞,等.维持性血液透析病人症状潜在类别分析及其与生活质量的关系[J].护理研究,2024,38(24):4325-4332., articleTitle=维持性血液透析病人症状潜在类别分析及其与生活质量的关系, refAbstract=null), Reference(id=1322931589864371105, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, doi=null, pmid=null, pmcid=null, year=2023, volume=42, issue=2, pageStart=206, pageEnd=210, url=null, language=null, rfNumber=27, rfOrder=26, authorNames=周翠, 江文, 姚梦, journalName=中华老年医学杂志, refType=null, unstructuredReference=周翠,江文,姚梦,等.抑郁焦虑与老年人睡眠质量的关联分析[J].中华老年医学杂志,2023,42(2):206-210., articleTitle=抑郁焦虑与老年人睡眠质量的关联分析, refAbstract=null), Reference(id=1322931589952451490, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, doi=null, pmid=null, pmcid=null, year=2024, volume=38, issue=9, pageStart=1578, pageEnd=1584, url=null, language=null, rfNumber=28, rfOrder=27, authorNames=朱贝莎, 吕思雨, 吴杭, journalName=护理研究, refType=null, unstructuredReference=朱贝莎,吕思雨,吴杭,等.维持性血液透析病人社会疏离体验的质性研究[J].护理研究,2024,38(9):1578-1584., articleTitle=维持性血液透析病人社会疏离体验的质性研究, refAbstract=null), Reference(id=1322931590069892003, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, doi=null, pmid=null, pmcid=null, year=1979, volume=18, issue=1, pageStart=3, pageEnd=28, url=null, language=null, rfNumber=29, rfOrder=28, authorNames=Olson D H, Sprenkle D H, Russell C S, journalName=Family Process, refType=null, unstructuredReference=Olson D H,Sprenkle D H,Russell C S.Circumplex model of marital and family system:I.cohesion and adaptability dimensions,family types,and clinical applications[J].Family Process,1979,18(1):3-28., articleTitle=Circumplex model of marital and family system:I.cohesion and adaptability dimensions,family types,and clinical applications, refAbstract=null), Reference(id=1322931590166360996, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, doi=null, pmid=null, pmcid=null, year=2023, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=30, rfOrder=29, authorNames=尹艳茹, journalName=null, refType=null, unstructuredReference=尹艳茹.血液透析与腹膜透析患者社会衰弱现状及影响因素研究[D].湖州:湖州师范学院,2023., articleTitle=血液透析与腹膜透析患者社会衰弱现状及影响因素研究, refAbstract=null), Reference(id=1322931590246052773, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, doi=null, pmid=null, pmcid=null, year=2023, volume=40, issue=3, pageStart=10, pageEnd=14, url=null, language=null, rfNumber=31, rfOrder=30, authorNames=王九瑞, 刘健, 延泽萍, journalName=军事护理, refType=null, unstructuredReference=王九瑞,刘健,延泽萍,等.老年人社会衰弱发生率及影响因素的系统评价和Meta分析[J].军事护理,2023,40(3):10-14., articleTitle=老年人社会衰弱发生率及影响因素的系统评价和Meta分析, refAbstract=null), Reference(id=1322931590321550246, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, doi=null, pmid=null, pmcid=null, year=2003, volume=36, issue=6, pageStart=698, pageEnd=703, url=null, language=null, rfNumber=32, rfOrder=31, authorNames=Goodwin R D, journalName=Preventive Medicine, refType=null, unstructuredReference=Goodwin R D.Association between physical activity and mental disorders among adults in the United States[J].Preventive Medicine,2003,36(6):698-703., articleTitle=Association between physical activity and mental disorders among adults in the United States, refAbstract=null), Reference(id=1322931590405436327, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, doi=null, pmid=null, pmcid=null, year=2021, volume=13, issue=8, pageStart=67, pageEnd=70, url=null, language=null, rfNumber=33, rfOrder=32, authorNames=伍梦寒, 王艳, 艾霜兰, journalName=中国医学前沿杂志, refType=null, unstructuredReference=伍梦寒,王艳,艾霜兰,等.运动锻炼对维持性血液透析患者心肺功能和心理状态的改善作用[J].中国医学前沿杂志(电子版),2021,13(8):67-70., articleTitle=运动锻炼对维持性血液透析患者心肺功能和心理状态的改善作用, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1322931578762048347, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, xref=1, ext=[AuthorCompanyExt(id=1322931578791408476, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, companyId=1322931578762048347, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1School of Nursing, Chengde Medical University, Hebei 067000 China), AuthorCompanyExt(id=1322931578799797085, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, companyId=1322931578762048347, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1承德医学院护理学院，河北 067000)]), AuthorCompany(id=1322931578883683166, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, xref=2, ext=[AuthorCompanyExt(id=1322931578892071775, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, companyId=1322931578883683166, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2the Affiliated Hospital of Chengde Medical University), AuthorCompanyExt(id=1322931578900460384, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, companyId=1322931578883683166, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2承德医学院附属医院)])], figs=[ArticleFig(id=1322931582008439670, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, language=EN, label=Figure 1, caption=Nomogram for predicting social frailty in elderly patients undergoing maintenance hemodialysis, figureFileSmall=/rvJeg4DN20KbYQBIBGO9g==, figureFileBig=m0j+cEP1Lyyg8uKWSnXkvA==, tableContent=null), ArticleFig(id=1322931582083937143, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, language=CN, label=图1, caption=老年维持性血液透析病人社会衰弱预测模型列线图, figureFileSmall=/rvJeg4DN20KbYQBIBGO9g==, figureFileBig=m0j+cEP1Lyyg8uKWSnXkvA==, tableContent=null), ArticleFig(id=1322931582310429560, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, language=EN, label=Figure 2, caption=ROC curves of the development and validation cohorts, figureFileSmall=Cwx+VB//dF9uzxwlU9C6Jg==, figureFileBig=molVhPTsw0tun5UhCLfHQg==, tableContent=null), ArticleFig(id=1322931582377538425, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, language=CN, label=图2, caption=构建组和验证组的ROC曲线, figureFileSmall=Cwx+VB//dF9uzxwlU9C6Jg==, figureFileBig=molVhPTsw0tun5UhCLfHQg==, tableContent=null), ArticleFig(id=1322931582461424506, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, language=EN, label=Figure 3, caption=Calibration curves of the development and validation cohorts, figureFileSmall=49kMeL4Li+pz5XjtxlZv3A==, figureFileBig=0dj+ZMbgPN1S8jilRmJX7Q==, tableContent=null), ArticleFig(id=1322931582557893499, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, language=CN, label=图3, caption=构建组和验证组的校准曲线, figureFileSmall=49kMeL4Li+pz5XjtxlZv3A==, figureFileBig=0dj+ZMbgPN1S8jilRmJX7Q==, tableContent=null), ArticleFig(id=1322931582654362492, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, language=EN, label=Figure 4, caption=Decision curvefor the development and validation cohorts, figureFileSmall=0w1YZlfV9mpax5iyHrKifQ==, figureFileBig=SkAVWxg/Zh29u5/W+PweRg==, tableContent=null), ArticleFig(id=1322931582729859965, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, language=CN, label=图4, caption=构建组和验证组的临床决策曲线, figureFileSmall=0w1YZlfV9mpax5iyHrKifQ==, figureFileBig=SkAVWxg/Zh29u5/W+PweRg==, tableContent=null), ArticleFig(id=1322931582809551742, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, language=EN, label=Table 1, caption=

Univariate analysis of the influencing factors of social frailty in elderly patients undergoing maintenance hemodialysis

, figureFileSmall=null, figureFileBig=null, tableContent=
项目分类非社会衰弱组（n=299）社会衰弱组（n=152）统计值P
性别[例（%）]男168（56.2）80（52.6）χ²=0.5150.473
女131（43.8）72（47.4）
文化程度[例（%）]专科及以上43（14.4）17（11.2）χ²=2.6870.442
高中/中专74（24.7）33（21.7）
初中89（29.8）44（28.9）
小学及以下93（31.1）58（38.2）
婚姻状况[例（%）]已婚272（91.0）126（82.9）χ²=6.3360.012
离异/丧偶27（9.0）26（17.1）
居住地[例（%）]城镇131（43.8）82（53.9）χ²=4.1530.042
农村168（56.2）70（46.0）
居住方式[例（%）]独居26（8.7）28（18.4）χ²=9.0430.003
非独居273（91.3）124（81.6）
家庭月收入[例（%）]<3 000元51（17.1）45（29.6）χ²=10.6490.005
3 000~5 000元91（30.4）46（30.3）
>5 000元157（52.5）61（40.1）
医保类型[例（%）]城镇居民医疗保险175（58.5）70（46.0）χ²=7.1380.028
城镇职工医疗保险116（38.8）79（52.0）
自费或其他8（2.7）3（2.0）
透析频率[例（%）]≤3次/周229（76.6）111（73.0）χ²=0.6890.406
≥4次/周70（23.4）41（27.0）
血管通路[例（%）]自体动静脉内瘘200（66.9）116（76.3）χ²=4.2690.039
中心静脉导管99（33.1）36（23.7）
抑郁[例（%）]是36（12.0）67（44.1）χ²=58.699<0.001
否263（88.0）85（55.9）
家庭功能[例（%）]障碍31（10.4）70（46.1）χ²=73.836<0.001
良好268（89.6）82（53.9）
体力活动[例（%）]低84（28.1）82（53.9）χ²=28.959<0.001
中/高215（71.9）70（46.1）
年龄（岁）66.00（62.00,71.00）68.00（62.25,74.00）Z=-1.8610.063
透析龄（月）17.00（4.00,36.00）71.50（42.25,100.25）Z=-10.888<0.001
透析症状负担（分）20.00（12.00,30.00）47.50（33.00,65.00）Z=-10.885<0.001
自我感知老化（分）46.00（42.00,54.00）53.00（47.00,60.00）Z=-5.725<0.001
血红蛋白（g/L）100.00（85.00，113.00）106.50（90.25，120.00）Z=-2.4820.013
白蛋白（g/L）35.90（32.27,39.70）37.15（33.50，40.19）Z=-2.1480.032
钙离子（mmol/L）2.15（2.02，2.29）2.26（2.09，2.43）Z=-4.169<0.001
无机磷酸盐（mmol/L）1.42（1.11，1.98）1.50（1.08，1.90）Z=-0.2500.803
甲状旁腺激素（pg/mL）190.70（98.80，322.00）237.50（135.79，408.75）Z=-2.7500.006
), ArticleFig(id=1322931582893437823, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, language=CN, label=表1, caption=

老年维持性血液透析病人社会衰弱影响因素的单因素分析

, figureFileSmall=null, figureFileBig=null, tableContent=
项目分类非社会衰弱组（n=299）社会衰弱组（n=152）统计值P
性别[例（%）]男168（56.2）80（52.6）χ²=0.5150.473
女131（43.8）72（47.4）
文化程度[例（%）]专科及以上43（14.4）17（11.2）χ²=2.6870.442
高中/中专74（24.7）33（21.7）
初中89（29.8）44（28.9）
小学及以下93（31.1）58（38.2）
婚姻状况[例（%）]已婚272（91.0）126（82.9）χ²=6.3360.012
离异/丧偶27（9.0）26（17.1）
居住地[例（%）]城镇131（43.8）82（53.9）χ²=4.1530.042
农村168（56.2）70（46.0）
居住方式[例（%）]独居26（8.7）28（18.4）χ²=9.0430.003
非独居273（91.3）124（81.6）
家庭月收入[例（%）]<3 000元51（17.1）45（29.6）χ²=10.6490.005
3 000~5 000元91（30.4）46（30.3）
>5 000元157（52.5）61（40.1）
医保类型[例（%）]城镇居民医疗保险175（58.5）70（46.0）χ²=7.1380.028
城镇职工医疗保险116（38.8）79（52.0）
自费或其他8（2.7）3（2.0）
透析频率[例（%）]≤3次/周229（76.6）111（73.0）χ²=0.6890.406
≥4次/周70（23.4）41（27.0）
血管通路[例（%）]自体动静脉内瘘200（66.9）116（76.3）χ²=4.2690.039
中心静脉导管99（33.1）36（23.7）
抑郁[例（%）]是36（12.0）67（44.1）χ²=58.699<0.001
否263（88.0）85（55.9）
家庭功能[例（%）]障碍31（10.4）70（46.1）χ²=73.836<0.001
良好268（89.6）82（53.9）
体力活动[例（%）]低84（28.1）82（53.9）χ²=28.959<0.001
中/高215（71.9）70（46.1）
年龄（岁）66.00（62.00,71.00）68.00（62.25,74.00）Z=-1.8610.063
透析龄（月）17.00（4.00,36.00）71.50（42.25,100.25）Z=-10.888<0.001
透析症状负担（分）20.00（12.00,30.00）47.50（33.00,65.00）Z=-10.885<0.001
自我感知老化（分）46.00（42.00,54.00）53.00（47.00,60.00）Z=-5.725<0.001
血红蛋白（g/L）100.00（85.00，113.00）106.50（90.25，120.00）Z=-2.4820.013
白蛋白（g/L）35.90（32.27,39.70）37.15（33.50，40.19）Z=-2.1480.032
钙离子（mmol/L）2.15（2.02，2.29）2.26（2.09，2.43）Z=-4.169<0.001
无机磷酸盐（mmol/L）1.42（1.11，1.98）1.50（1.08，1.90）Z=-0.2500.803
甲状旁腺激素（pg/mL）190.70（98.80，322.00）237.50（135.79，408.75）Z=-2.7500.006
), ArticleFig(id=1322931583006684032, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, language=EN, label=Table 2, caption=

Collinearity diagnostics among predictors of social frailty

, figureFileSmall=null, figureFileBig=null, tableContent=
变量容差方差膨胀因子
婚姻状况0.6301.588
居住地0.7951.257
居住方式0.6111.637
家庭月收入0.9131.095
医保类型0.7841.276
透析龄0.5691.757
血管通路0.8871.128
血红蛋白0.8371.195
白蛋白0.9271.079
钙离子0.7891.268
甲状旁腺激素0.9291.077
抑郁0.7731.293
透析症状负担0.6251.600
自我感知老化0.8361.196
家庭功能0.7791.283
体力活动0.8451.183
), ArticleFig(id=1322931583090570113, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, language=CN, label=表2, caption=

社会衰弱预测变量的共线性分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量容差方差膨胀因子
婚姻状况0.6301.588
居住地0.7951.257
居住方式0.6111.637
家庭月收入0.9131.095
医保类型0.7841.276
透析龄0.5691.757
血管通路0.8871.128
血红蛋白0.8371.195
白蛋白0.9271.079
钙离子0.7891.268
甲状旁腺激素0.9291.077
抑郁0.7731.293
透析症状负担0.6251.600
自我感知老化0.8361.196
家庭功能0.7791.283
体力活动0.8451.183
), ArticleFig(id=1322931583161873282, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, language=EN, label=Table 3, caption=

Assignment situation of variables

, figureFileSmall=null, figureFileBig=null, tableContent=
变量赋值方式
婚姻状况已婚=0，离异/丧偶=1
居住地城镇=0，农村=1
居住方式独居=0，非独居=1
家庭月收入<3 000元=0，3 000~5 000元=1，>5 000元=2
医保类型城镇居民医疗保险=0，城镇职工医疗保险=1，自费或其他=2
血管通路自体动静脉内瘘=0，中心静脉导管=1
抑郁否=0，是=1
家庭功能障碍=0，良好=1
体力活动低=0，中/高=1
血红蛋白原值输入
白蛋白原值输入
钙离子原值输入
甲状旁腺激素原值输入
透析症状负担原值输入
自我感知老化原值输入
透析龄原值输入
), ArticleFig(id=1322931583233176451, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, language=CN, label=表3, caption=

变量赋值情况

, figureFileSmall=null, figureFileBig=null, tableContent=
变量赋值方式
婚姻状况已婚=0，离异/丧偶=1
居住地城镇=0，农村=1
居住方式独居=0，非独居=1
家庭月收入<3 000元=0，3 000~5 000元=1，>5 000元=2
医保类型城镇居民医疗保险=0，城镇职工医疗保险=1，自费或其他=2
血管通路自体动静脉内瘘=0，中心静脉导管=1
抑郁否=0，是=1
家庭功能障碍=0，良好=1
体力活动低=0，中/高=1
血红蛋白原值输入
白蛋白原值输入
钙离子原值输入
甲状旁腺激素原值输入
透析症状负担原值输入
自我感知老化原值输入
透析龄原值输入
), ArticleFig(id=1322931583300285316, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, language=EN, label=Table 4, caption=

Logistic regression analysis of the influencing factors of social frailty in elderly patients undergoing maintenance hemodialysis

, figureFileSmall=null, figureFileBig=null, tableContent=
变量回归系数标准误Wald χ2值POR值95%CI
常量-1.7550.43116.608<0.0010.173
透析龄0.0160.00417.058<0.0011.016[1.009,1.024]
透析症状负担0.0470.00835.519<0.0011.048[1.032,1.065]
家庭功能-1.3330.31917.5040.0010.264[0.141,0.492]
体力活动-0.7090.2766.6040.0100.492[0.287,0.845]
抑郁0.9310.3218.3880.0042.536[1.351,4.760]
), ArticleFig(id=1322931583371588485, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, language=CN, label=表4, caption=

老年维持性血液透析病人社会衰弱影响因素的Logistic回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量回归系数标准误Wald χ2值POR值95%CI
常量-1.7550.43116.608<0.0010.173
透析龄0.0160.00417.058<0.0011.016[1.009,1.024]
透析症状负担0.0470.00835.519<0.0011.048[1.032,1.065]
家庭功能-1.3330.31917.5040.0010.264[0.141,0.492]
体力活动-0.7090.2766.6040.0100.492[0.287,0.845]
抑郁0.9310.3218.3880.0042.536[1.351,4.760]
)], attaches=null, journal=Journal(id=1220037649855897604, delFlag=0, nameCn=护理研究, nameEn=Chinese Nursing Research, nameHistory1=null, nameHistory2=null, issn=1009-6493, eissn=null, cn=14-1272/R, coden=null, periodic=3, language=CN, oaType=null, ccby=null, superviseOffice=null, ownerOffice=null, pubOffice=null, editorOffice=null, officeType=null, aims=null, clcCode=null, officeProv=null, officeCity=null, officeAddr=null, officeZip=null, officeEmail=null, officePhone=null, editDirector=null, officeDirector=null, officeDirectorPhone=null, officeStaffNum=null, officeEmpNum=null, coverPicUrl=5ND/w5RQYz//x8ucn+e6Vw==, journalPrice=null, startedYear=null, abbrevIsoEn=Chinese Nursing Research, journalRemark=null, publicationField=null, createdTime=1768809242933, updatedTime=1789628561524, createdBy=18614031015, updatedBy=13041195026, firstLetterCn=H, firstLetterEn=H, subjectCode=Medical and Pharmaceutical Sciences, subjectName=null, subjectCodeEn=Medical and Pharmaceutical Sciences, subjectNameEn=null, picCn=5ND/w5RQYz//x8ucn+e6Vw==, picEn=vXneBBf6WfTz/ls4yy3nnA==, jcr=null, cjcr=null, exts=[JournalExt(id=1307360202571928186, language=CN, name=护理研究, nameHistory1=null, nameHistory2=null, managedBy=, sponsoredBy=, publishedBy=, editorOffice=, officeProv=null, officeCity=null, officeAddr=, officeZip=, editDirector=, officeDirector=null, officePhone=null, coverPicUrl=null, journalRemark=, submitArticleUrl=null, websiteUrl=, createdTime=1789628561871, updatedTime=1789628561871, createdBy=13041195026, updatedBy=13041195026, submissionGuidelinesUrl=, submissionAuthorUrl=https://journal.ids.fzyun.cn/auth/realms/journal/protocol/openid-connect/auth?client_id=journal-sxyxqks-author&redirect_uri=https%3A%2F%2Fgj.sxyxqks.com%2Foauth%2Fcallback&response_type=code&scope=phone+openid+email+profile&state=1de4c13f-4807-4ea4-8d8a-5, submissionEditorUrl=https://journal.ids.fzyun.cn/auth/realms/journal/protocol/openid-connect/auth?client_id=journal-sxyxqks-author&redirect_uri=https%3A%2F%2Fgj.sxyxqks.com%2Foauth%2Fcallback&response_type=code&scope=phone+openid+email+profile&state=321a724c-d51d-4f08-a85e-2, submissionReviewUrl=https://journal.ids.fzyun.cn/auth/realms/journal/protocol/openid-connect/auth?client_id=journal-sxyxqks-author&redirect_uri=https%3A%2F%2Fgj.sxyxqks.com%2Foauth%2Fcallback&response_type=code&scope=phone+openid+email+profile&state=dadec7f2-d93c-4f73-8f97-e, submissionCeEditorUrl=, submissionAeEditorUrl=, option={"copyright":""}), JournalExt(id=1307360202618065531, language=EN, name=Chinese Nursing Research, nameHistory1=null, nameHistory2=null, managedBy=, sponsoredBy=, publishedBy=, editorOffice=, officeProv=null, officeCity=null, officeAddr=, officeZip=, editDirector=, officeDirector=null, officePhone=null, coverPicUrl=null, journalRemark=, submitArticleUrl=null, websiteUrl=, createdTime=1789628561882, updatedTime=1789628561882, createdBy=13041195026, updatedBy=13041195026, submissionGuidelinesUrl=, submissionAuthorUrl=https://journal.ids.fzyun.cn/auth/realms/journal/protocol/openid-connect/auth?client_id=journal-sxyxqks-author&redirect_uri=https%3A%2F%2Fgj.sxyxqks.com%2Foauth%2Fcallback&response_type=code&scope=phone+openid+email+profile&state=1de4c13f-4807-4ea4-8d8a-5, submissionEditorUrl=https://journal.ids.fzyun.cn/auth/realms/journal/protocol/openid-connect/auth?client_id=journal-sxyxqks-author&redirect_uri=https%3A%2F%2Fgj.sxyxqks.com%2Foauth%2Fcallback&response_type=code&scope=phone+openid+email+profile&state=321a724c-d51d-4f08-a85e-2, submissionReviewUrl=https://journal.ids.fzyun.cn/auth/realms/journal/protocol/openid-connect/auth?client_id=journal-sxyxqks-author&redirect_uri=https%3A%2F%2Fgj.sxyxqks.com%2Foauth%2Fcallback&response_type=code&scope=phone+openid+email+profile&state=dadec7f2-d93c-4f73-8f97-e, submissionCeEditorUrl=, submissionAeEditorUrl=, option={"copyright":""})], databaseList=null, tenantJournalId=1220038315760373764, websiteList=[Website(id=1220043903038837076, webName=null, webTitle=null, webDomain=null, webCopyrigh=null, webIpcNo=null, seoTitle=null, seoKeywords=null, seoDescription=null, tenantJournalId=null, journalId=1220038315760373764, journalNameCn=null, journalNameEn=null, grayFlag=null, tenantId=1146029695717560320, platformId=null, journalGroupId=null, journalGroupNameCn=null, journalGroupNameEn=null, type=1, domain=https://castjournals.cast.org.cn/joweb/hlyj/CN, language=CN, createTime=1768810733804, createBy=18614031015, updateTime=1768811130580, updateBy=18614031015, name=护理研究-中文, tplId=1146099689490845704, title=护理研究, delFlag=0, indexPage=/home, props=[WebsiteProps(id=1228001613021904925, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1220043903038837076, code=articleTextType, value=kx, createTime=1770707999711, updateTime=1770707999711, creator=18614031015, updator=18614031015), WebsiteProps(id=1228001613005127706, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1220043903038837076, code=banner, value=null, createTime=1770707999707, updateTime=1770707999707, creator=18614031015, updator=18614031015), WebsiteProps(id=1228001613038682144, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1220043903038837076, code=grayFlag, value=0, createTime=1770707999715, updateTime=1770707999715, creator=18614031015, updator=18614031015), WebsiteProps(id=1228001613000933401, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1220043903038837076, code=logo, value=https://castjournals.cast.org.cn/joweb/hlyj/CN/file/pic?fileId=pB29yYO+7WdTp0HLQ4KSzg==, createTime=1770707999706, updateTime=1770707999706, creator=18614031015, updator=18614031015), WebsiteProps(id=1228001613047070754, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1220043903038837076, code=minRunFlag, value=0, createTime=1770707999717, updateTime=1770707999717, creator=18614031015, updator=18614031015), WebsiteProps(id=1228001613017710620, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1220043903038837076, code=picServerUrl, value=https://castjournals.cast.org.cn/joweb/hlyj/CN/file/pic, createTime=1770707999710, updateTime=1770707999710, creator=18614031015, updator=18614031015), WebsiteProps(id=1228001613042876449, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1220043903038837076, code=silenceFlag, value=0, createTime=1770707999716, updateTime=1770707999716, creator=18614031015, updator=18614031015), WebsiteProps(id=1228001613013516315, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1220043903038837076, code=staticResourcePath, value=https://castjournals.cast.org.cn/joweb/cast_kjdb_cn_619/, createTime=1770707999709, updateTime=1770707999709, creator=18614031015, updator=18614031015), WebsiteProps(id=1228001613026099230, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1220043903038837076, code=themeColor, value=null, createTime=1770707999712, updateTime=1770707999712, creator=18614031015, updator=18614031015), WebsiteProps(id=1228001613034487839, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1220043903038837076, code=themeStyle, value=null, createTime=1770707999714, updateTime=1770707999714, creator=18614031015, updator=18614031015)]), Website(id=1220043903097557352, webName=null, webTitle=null, webDomain=null, webCopyrigh=null, webIpcNo=null, seoTitle=null, seoKeywords=null, seoDescription=null, tenantJournalId=null, journalId=1220038315760373764, journalNameCn=null, journalNameEn=null, grayFlag=null, tenantId=1146029695717560320, platformId=null, journalGroupId=null, journalGroupNameCn=null, journalGroupNameEn=null, type=1, domain=https://castjournals.cast.org.cn/joweb/hlyj/EN, language=EN, createTime=1768810733819, createBy=18614031015, updateTime=1768811154181, updateBy=18614031015, name=护理研究-英文, tplId=1146101810881728533, title=Chinese Nursing Research, delFlag=0, indexPage=/home, props=[WebsiteProps(id=1220045841042166147, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1220043903097557352, code=articleTextType, value=kx, createTime=1768811195860, updateTime=1768811195860, creator=18614031015, updator=18614031015), WebsiteProps(id=1220045841017000320, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1220043903097557352, code=banner, value=null, createTime=1768811195854, updateTime=1768811195854, creator=18614031015, updator=18614031015), WebsiteProps(id=1220045841063137670, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1220043903097557352, code=grayFlag, value=0, createTime=1768811195865, updateTime=1768811195865, creator=18614031015, updator=18614031015), WebsiteProps(id=1220045841008611711, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1220043903097557352, code=logo, value=https://castjournals.cast.org.cn/joweb/hlyj/EN/file/pic?fileId=pB29yYO+7WdTp0HLQ4KSzg==, createTime=1768811195852, updateTime=1768811195852, creator=18614031015, updator=18614031015), WebsiteProps(id=1220045841075720584, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1220043903097557352, code=minRunFlag, value=0, createTime=1768811195868, updateTime=1768811195868, creator=18614031015, updator=18614031015), WebsiteProps(id=1220045841033777538, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1220043903097557352, code=picServerUrl, value=https://castjournals.cast.org.cn/joweb/hlyj/EN/file/pic, createTime=1768811195858, updateTime=1768811195858, creator=18614031015, updator=18614031015), WebsiteProps(id=1220045841071526279, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1220043903097557352, code=silenceFlag, value=0, createTime=1768811195867, updateTime=1768811195867, creator=18614031015, updator=18614031015), WebsiteProps(id=1220045841025388929, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1220043903097557352, code=staticResourcePath, value=https://castjournals.cast.org.cn/joweb/cast_kjdb_en_623/, createTime=1768811195857, updateTime=1768811195857, creator=18614031015, updator=18614031015), WebsiteProps(id=1220045841046360452, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1220043903097557352, code=themeColor, value=null, createTime=1768811195861, updateTime=1768811195861, creator=18614031015, updator=18614031015), WebsiteProps(id=1220045841054749061, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1220043903097557352, code=themeStyle, value=null, createTime=1768811195863, updateTime=1768811195863, creator=18614031015, updator=18614031015)])], journalTitle=护理研究, weixinUrl=null, journalUrl=https://www.hlyjzz.com/, iacademicId=null, status=1, seqNo=null, journalTitleEn=Chinese Nursing Research, journalPhotoCn=5ND/w5RQYz//x8ucn+e6Vw==, journalPhotoEn=vXneBBf6WfTz/ls4yy3nnA==, journalFirstLetter=H, journalRecommend=null, journalNew=null, journalCollection=null, jcrJf=null, cjcrJf=null, jcrJfStr=null, cjcrJfStr=null, submissionFirstDecision=null, sciSubjectClassification=null, casSubjectClassification=null, citeScore=null, totalCitationFrequency=null, icpCode=null, psCode=null, advertisingLicenseCode=null, copyrightInformation=null, country=null, option=, provinceCode=null, provinceName=null, collectFlag=false, interPubPlatform=, interPubPlatformUrl=null), detailUrlCn=https://castjournals.cast.org.cn/joweb/hlyj/CN/10.12102/j.issn.1009-6493.2026.12.002, detailUrlEn=https://castjournals.cast.org.cn/joweb/hlyj/EN/10.12102/j.issn.1009-6493.2026.12.002, pdfUrlCn=https://castjournals.cast.org.cn/joweb/hlyj/CN/PDF/10.12102/j.issn.1009-6493.2026.12.002, pdfUrlEn=https://castjournals.cast.org.cn/joweb/hlyj/EN/PDF/10.12102/j.issn.1009-6493.2026.12.002, aliStartDate=0, aliEndDate=0, collectionFlag=false, citedCount=null, citedUrl=null, previewStatus=0, delFlag=0, hasFullText=1, orderTime=1782316800000, fullTextJson=null, articleText=null, reference=null)
收藏切换
老年维持性血液透析病人社会衰弱预测模型的构建与验证
收藏切换
范辰瑞 1 , 刘俊英 2, *, *
护理研究 | 科研论著 2026,40(12): 2013-2021
收起
收藏切换
护理研究 |科研论著 2026 , 40 (12) : 2013 -2021
老年维持性血液透析病人社会衰弱预测模型的构建与验证
全屏
[Author(id=1322931578984346466, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, orderNo=0, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1322931580674650981, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, authorId=1322931578984346466, language=EN, stringName=Chenrui FAN, firstName=Chenrui, middleName=null, lastName=FAN, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=1, address=1School of Nursing, Chengde Medical University, Hebei 067000 China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1322931580745954150, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, authorId=1322931578984346466, language=CN, stringName=范辰瑞, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=1, address=1承德医学院护理学院，河北 067000, bio={"content":"

范辰瑞，硕士研究生在读

"}, bioImg=null, bioContent=

范辰瑞，硕士研究生在读

, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1322931578762048347, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, xref=1, ext=[AuthorCompanyExt(id=1322931578791408476, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, companyId=1322931578762048347, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1School of Nursing, Chengde Medical University, Hebei 067000 China), AuthorCompanyExt(id=1322931578799797085, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, companyId=1322931578762048347, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1承德医学院护理学院，河北 067000)])]), Author(id=1322931580834034536, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, orderNo=1, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=15633142986@163.com, emailSecond=null, emailThird=null, correspondingAuthor=1, authorType=1, ext={EN=AuthorExt(id=1322931580947280746, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, authorId=1322931580834034536, language=EN, stringName=Junying LIU, firstName=Junying, middleName=null, lastName=LIU, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=2, address=2the Affiliated Hospital of Chengde Medical University, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1322931581043749739, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, authorId=1322931580834034536, language=CN, stringName=刘俊英, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=2, *, *, address=2承德医学院附属医院, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1322931578883683166, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, xref=2, ext=[AuthorCompanyExt(id=1322931578892071775, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, companyId=1322931578883683166, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2the Affiliated Hospital of Chengde Medical University), AuthorCompanyExt(id=1322931578900460384, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931577168212816, companyId=1322931578883683166, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2承德医学院附属医院)])])]
范辰瑞1, 刘俊英2, *, *
作者信息
  • 1承德医学院护理学院，河北 067000
  • 2承德医学院附属医院
通讯作者:
刘俊英，E-mail：
LIU Junying， E-mail：
作者简介:

范辰瑞，硕士研究生在读

Construction and validation of a prediction model for social frailty in elderly patients undergoing maintenance hemodialysis
Chenrui FAN1, Junying LIU2
Affiliations
  • 1School of Nursing, Chengde Medical University, Hebei 067000 China
  • 2the Affiliated Hospital of Chengde Medical University
出版时间: 2026-06-25 doi: 10.12102/j.issn.1009-6493.2026.12.002
文章导航
收藏切换
摘要
收起
目的

构建老年维持性血液透析病人社会衰弱风险预测模型，探讨透析症状负担、家庭功能、抑郁、体力活动等可干预因素对模型的预测价值。

方法

采用便利抽样法，选取2024年11月—2025年4月在承德市某三级甲等医院血液透析室进行透析的451例老年维持性血液透析病人作为构建组研究对象，选取2025年5月—7月另外2所三级甲等医院血液透析室进行透析的181例老年维持性血液透析病人作为外部验证组研究对象。采用一般资料调查表、简版老年抑郁量表、透析症状评估量表、自我感知老化量表、家庭关怀度量表、中文版国际体力活动问卷评分、社会衰弱量表进行横断面调查。采用Logistic回归分析筛选社会衰弱的影响因素，R语言绘制列线图并进行内外部验证，评价模型的区分度、校准度和临床实用性。基于预测因子的可干预性构建基础模型与全模型，量化可干预因素的预测价值。

结果

构建组与验证组老年维持性血液透析病人社会衰弱发生率分别为33.7%、35.9%。Logistic回归分析结果显示，透析龄、透析症状负担、家庭功能、体力活动和抑郁是老年维持性血液透析病人社会衰弱的影响因素。根据上述5个因素绘制的列线图内外部验证受试者工作特征曲线下面积分别为0.888，0.876；Hosmer-Lemeshow拟合优度检验结果显示P>0.05；内外部验证的校准曲线与决策曲线均显示模型的校准度较好、临床实用性较高，可干预因素对模型预测价值贡献显著。

结论

构建的老年维持性血液透析病人社会衰弱预测模型具有良好的预测效能和临床适用性，可为老年维持性血液透析病人社会衰弱的早期识别提供依据。医护人员可针对透析症状负担、家庭功能、抑郁及体力活动等可干预因素制定相应干预措施，延缓老年维持性血液透析病人社会衰弱的发生发展。

老年人  /  维持性血液透析  /  社会衰弱  /  预测模型  /  危险因素
Objective

To construct a prediction model for social frailty in elderly patients undergoing maintenance hemodialysis.To explore the predictive value of modifiable factors such as dialysis symptom burden,family function,depression,and physical activity for the model.

Methods

By using the convenience sampling method,451 elderly patients undergoing maintenance hemodialysis in the hemodialysis room of a tertiary grade A hospital in Chengde City from November 2024 to April 2025 were selected as the research subjects for the construction group.Another 181 elderly patients undergoing maintenance hemodialysis in the hemodialysis rooms of two tertiary grade A hospitals from May to July 2025 were selected as the external validation group for the research.A cross-sectional survey was conducted using general information questionnaires,5-Item Geriatric Depression Scale(GDS-5),Dialysis Symptom Index(DSI),Brief Aging Perceptions Questionnaire(B-APQ),Family APGAR Index(APGAR),and the Score of the Chinese Version of the International Physical Activity Questionnaire-Short Form.Logistic regression analysis was used to screen the influencing factors of social frailty.The ROC curve was drawn using R language and internal and external validations were conducted.The distinguishability,calibration,and clinical practicability of the model were evaluated.Based on the predictive factors,the basic model and the full model were constructed.The predictive value of the modifiable factors was quantified.

Results

The incidence rates of social frailty among elderly maintenance hemodialysis patients in the construction group and the validation group were 33.7% and 35.9% respectively.Logistic results showed that dialysis duration,burden of dialysis symptoms,family function,physical activity,and depression were the influencing factors of social frailty in elderly maintenance hemodialysis patients.Based on the above five factors,the area under the receiver operating characteristic curve of the Nomogram for internal and external validation was 0.888 and 0.876 respectively.The Hosmer-Lemeshow test results showed that both P>0.05.The calibration curves and decision curves of internal and external validation both showed that the model had good calibration and high clinical practicability.The modifiable factors significantly contributed to the predictive value of the model.

Conclusions

The constructed prediction model for social frailty in elderly patients undergoing maintenance hemodialysis has good predictive efficacy and clinical applicability.It could provide a tool for the early identification of social frailty in elderly maintenance hemodialysis patients.Medical staff could formulate corresponding intervention measures based on factors that can be intervened,such as the burden of dialysis symptoms,family function,depression,and physical activity,so as to delay the occurrence and development of social frailty in elderly patients undergoing maintenance hemodialysis.

elderly people  /  maintenance hemodialysis  /  social frailty  /  prediction model  /  risk factors
范辰瑞, 刘俊英. 老年维持性血液透析病人社会衰弱预测模型的构建与验证. 护理研究, 2026 , 40 (12) : 2013 -2021 . DOI: 10.12102/j.issn.1009-6493.2026.12.002
Chenrui FAN, Junying LIU. Construction and validation of a prediction model for social frailty in elderly patients undergoing maintenance hemodialysis[J]. Chinese Nursing Research, 2026 , 40 (12) : 2013 -2021 . DOI: 10.12102/j.issn.1009-6493.2026.12.002
正文
收起
维持性血液透析（maintenance hemodialysis,MHD）是终末期肾脏病病人主要的肾脏替代治疗方式。截至2023年底，我国血液透析病人已达96.1万例，是全球维持性血液透析病人最多的国家[1]。透析人数日益增多，医务人员在关注其生理健康之余，应同时重视其社会适应水平。老年维持性血液透析病人由于疾病特点和透析需要，往往存在社会活动较少、心理社会适应偏低等情况[2]。社会衰弱（social frailty,SF）作为影响其生活质量的关键因素，是指个体持续处于失去或正在失去用于满足其基本社会需求的社会资源、活动和能力的风险状态，具体表现在社会资源不足、社会活动和行为减弱以及自我管理能力下降[3]。研究表明，老年维持性血液透析病人社会衰弱的发生率为28.82%~59.50%[4-5]，明显升高了病人的住院与死亡风险，影响其远期预后[6]。然而，目前国内对其研究较为有限，现存的风险评估工具存在样本来源单一、缺乏外部验证等局限性[5]。现有研究表明，社会衰弱受到心理、生理以及社会等多方面的影响[7]。因此，本研究基于多中心数据，从多维度探索社会衰弱的影响因素，构建预测模型并进行内部与外部验证，提升了模型的普适性和临床应用价值，通过研究模型中可干预变量对模型预测性能的价值，从而识别关键干预靶点，为后续制定精准且高效的管理方案提供实证依据，实现对老年维持性血液透析病人社会衰弱的早期预防。
1　对象与方法
收起
1.1　研究对象
选取2024年11月—2025年4月在承德市某三级甲等医院透析的老年维持性血液透析病人为构建组研究对象，选择2025年5月—7月承德市另外2所三级甲等医院透析的老年维持性血液透析病人为外部验证组研究对象。纳入标准：1）年龄≥60岁；2）根据我国慢性肾脏病诊断和防治指南经临床诊断为终末期肾脏病[8]，且规律进行血液透析治疗时间≥3个月；3）知情同意，自愿参加本研究。排除标准：1）合并严重威胁病人生存的疾病，如恶性肿瘤等；2）传染病病人；3）存在意识障碍或精神疾病的病人；4）病历资料不完整的病人。剔除标准：1）问卷作答不完整或明显规律性作答问卷；2）问卷填写时间少于5 min。根据Kendall[9]样本量估算方法，样本量为自变量的15~20倍，通过专家咨询及文献研究共纳入21个自变量，再加上10%的无效问卷，计算得出样本量为350~467例。根据Logistic回归分析样本量的计算方法[10]，样本量=自变量×（5~10）/发生率。社会衰弱的发生率为35%左右，同时考虑10%的无效问卷，得到样本量为334~667例。结合实际本研究纳入451例老年维持性血液透析病人为构建组研究对象。外部验证的样本量是构建模型所纳入样本量的1/4或1/2[11]，考虑10%的无效问卷，计算得出验证组所需样本量为126~251例。因此，最终纳入构建组451例、验证组181例，共632例研究对象。本研究已获得医院伦理委员会伦理审批（批准号：CYFYLL2024053）。
1.2　研究工具
1.2.1　一般资料调查表
一般资料调查表由课题组自行编制而成，包括年龄、性别、文化程度、婚姻状况、居住地、居住方式、家庭月收入、医保类型、透析龄、透析频率、血管通路、血红蛋白、白蛋白、钙离子、无机磷酸盐、甲状旁腺激素。
1.2.2　社会衰弱量表（Help，Participation，Loneliness，Financial，Talk，HALFT）
HALFT由Ma等[12]开发，评估病人的社会衰弱程度。量表共5个条目，≥3分为存在社会衰弱。本研究中该量表的Cronbach's α系数为0.712。
1.2.3　简版老年抑郁量表（5-Item Geriatric Depression Scale,GDS-5）
GDS-5由Hoyl等[13]编制，经朱彩云等[14]汉化，用于评估病人的抑郁情况，量表共5个条目，≥2分表明存在抑郁症状，得分越高抑郁症状越明显。本研究中该量表的Cronbach's α系数为0.838。
1.2.4　透析症状评估量表（Dialysis Symptom Index,DSI）
DSI由Weisbord等[15]于2004年研发，经郝艳华[16]汉化，用于评估透析病人的症状负担。该量表包含2个维度，共30个条目。采用Likert 5级评分法，总分为0~120分，得分越高表明调查对象症状负担越重。本研究中该量表的Cronbach′s α系数为0.815。
1.2.5　自我感知老化量表（Brief Aging Perceptions Questionnaire,B-APQ）
B-APQ由Sexton编制，经扈娜等[17]汉化，包含5个维度，共17个条目，采用Likert 5级评分法，总分17~85分，得分越高表明调查对象自我感知老化越消极。本研究中该量表的Cronbach′s α系数为0.818。
1.2.6　家庭关怀度量表（Family APGAR Index,APGAR）
APGAR由Smilkstein[18]编制，经吕繁等[19]汉化，评估受试者的家庭功能。该量表共5个条目，采用Likert 3级评分法，总分为0~10分，≥7分为家庭功能良好，<7分为家庭功能障碍。本研究中该量表的Cronbach′s α系数是0.801。
1.2.7　中文版国际体力活动问卷（the Score of the Chinese Version of the International Physical Activity Questionnaire-Short Form）
该问卷由国际体力活动工作组制定，经屈宁宁等[20]汉化，用于评价受试者过去7 d内的体力活动水平。每周总体力活动量为代谢当量（MET）赋值、每周活动天数和每日活动时长的乘积。根据计算结果将受试者体力活动划分为低体力活动（<600 MET-min/w）和中高体力活动（≥600 MET-min/w）2个等级。
1.3　资料收集方法
采用问卷调查法，由2名经过系统培训并通过考核的研究者进行调查。在调查前向病人说明本研究的目的、意义及相关流程，获取知情同意。于血液透析期间开展面对面调查，疾病相关资料从电子病历中提取。调查结束后由调查者即刻核查问卷，对遗漏条目及时补充完善，保证资料完整。在质量控制方面，3所医院执行统一的纳入及排除标准、调查程序，确保数据的一致性和可靠性。共发放问卷660份，回收有效问卷632份，有效回收率为95.76%。
1.4　统计学方法
数据由2名研究者分别进行独立核对与双盲录入。采用SPSS 26.0和R4.5.1软件进行统计分析，以P<0.05为差异有统计学意义。
1.4.1　统计描述与单因素分析
连续变量经Shapiro-Wilk正态性检验，本研究中年龄、透析龄、血红蛋白、白蛋白、钙离子、无机磷酸盐、甲状旁腺激素、透析症状负担和自我感知老化等连续性变量经正态性检验均不符合正态分布，非正态分布的定量资料用中位数（四分位数）[M(P25,P75)]进行描述，采用Mann-Whitney U秩和检验。定性资料采用频数、百分比（%）进行描述，采用χ2检验。
1.4.2　预测因子的筛选与模型构建
对单因素分析中有统计学意义的变量进行共线性诊断，容差（TOL）>0.1或方差膨胀因子（VIF）<10则变量间无共线性问题。采用二分类Logistic回归-向后-Wald法和前进-似然比法筛选独立预测因子，利用确定的预测因子构建模型并采用rms程序包绘制列线图。
1.4.3　模型验证
内部验证使用构建组数据集，采用Bootstrap法（1 000次重抽样）进行验证，外部验证使用独立的数据集进行验证。1）区分度：采用pROC程序包绘制内部、外部验证的受试者工作特征(ROC)曲线，计算ROC曲线下面积（AUC）及其95%CI。2）校准度：采用“ResourceSelection”程序包进行Hosmer-Lemeshow(H-L)拟合优度检验，绘制校准曲线并计算Brier评分、校准斜率和校准截距及其95%CI。3）临床实用性：采用rmda程序包绘制临床决策曲线，并报告最佳截断值下的阳性预测值（PPV）与阴性预测值（NPV）及其95%CI。
1.4.4　预测价值的量化
为论证本研究关注的可干预因素对临床风险管理的价值，依据预测因子的可干预性定义并比较两个嵌套模型。基础模型：纳入透析龄变量。全模型：除透析龄变量外，纳入可干预因素如透析症状负担、家庭功能、抑郁、体力活动变量。计算净重新分类指数（NRI）、综合判别改善指数（IDI）及其95%CI，量化全模型相较于基础模型在风险重分类与综合判别能力上的提升幅度；比较两个模型的Akaike信息准则（AIC）与贝叶斯信息准则（BIC），评估其拟合优度与简洁性的平衡。
2　结果
收起
2.1　老年维持性血液透析病人社会衰弱影响因素的单因素分析
构建组451例病人中有152例病人发生社会衰弱，社会衰弱发生率为33.7%。单因素分析结果见表1。
2.2　老年维持性血液透析病人社会衰弱影响因素的多因素分析
在进行Logistic回归分析之前，使用容差与方差膨胀因子对单因素有统计学意义的变量进行多重共线性分析。结果显示各变量的容差为0.569~0.929，均>0.1，方差膨胀因子为1.077~1.757，均<10，可以忽略变量间的共线性问题，详见表2。以单因素有意义的变量作为自变量，是否发生社会衰弱（无=0，有=1）为因变量，采用Logistic-向后-Wald逐步选择法、前进法-逐步似然比法进行多因素回归分析，自变量赋值情况见表3，结果见表4。
2.3　老年维持性血液透析病人社会衰弱风险预测模型的建立
老年维持性血液透析病人社会衰弱的Logistic回归模型：Logit(P)=-1.755+0.016×透析龄+0.047×透析症状负担-1.333×家庭功能-0.709×体力活动+0.931×抑郁。基于Logistic分析结果绘制列线图，见图1。
2.4　预测模型的效能检验
验证组纳入181例老年维持性血液透析病人，社会衰弱的发生率为35.9%。1）模型的区分度较好。内外部验证的AUC分别为0.888[95%CI（0.878，0.892）]、0.876[95%CI（0.816，0.936）]，内外部验证的ROC曲线见图2。2）模型的校准度较好。内部验证H-L检验结果显示，χ²=9.289，P=0.319，Brier评分为0.117[95%CI(0.098，0.138)]。外部验证H-L检验结果显示，χ²=13.831，P=0.086，Brier评分为0.129[95%CI(0.102，0.158)]。内外部验证的校准曲线见图3，内部验证校准曲线的斜率为1.000[95%CI（0.814，1.209）]，截距为0.000[95%CI（-0.326，0.313）]；外部验证校准曲线的斜率为1.289[95%CI（0.926，1.911）]，截距为0.015[95%CI（-0.409，0.517）]。3）模型的临床实用性较高。决策曲线分析（DCA）结果表明，构建组和验证组分别在1%~93%和1%~96%的风险范围内显现出正向净获益，内外部验证的决策曲线见图4。内部验证显示在最佳截断值0.296下，模型的阳性预测率为0.721[95%CI（0.648，0.787）]，阴性预测率为0.900[95%CI（0.858，0.932）]，灵敏度为0.816[95%CI（0.745，0.874）]，特异度为0.839[95%CI（0.793，0.879）]。外部验证显示，在最佳截断值0.351下，模型的阳性预测率为0.753[95%CI（0.639，0.847）]，阴性预测率为0.907[95%CI（0.836，0.955）]，灵敏度为0.846[95%CI（0.735，0.924）]，特异度为0.845[95%CI（0.766，0.905）]。
2.5　量化可干预因素对模型的预测价值
基础模型纳入透析龄变量。全模型除透析龄变量外，纳入可干预因素透析症状负担、家庭功能、抑郁、体力活动变量。基础模型和全模型的AUC为0.813[95%CI(0.765，0.861)]和0.888[95%CI (0.878，0.892)]，Brier评分为0.150[95%CI（0.130，0.171）]和0.117[95%CI（0.098，0.138）]，AIC为449.5和360.6，BIC为457.7和385.3，NRI为0.125[95%CI（0.044，0.198）]，P<0.05；IDI=0.164[95%CI（0.123，0.204）]，P<0.05。
3　讨论
收起
3.1　老年维持性血液透析病人社会衰弱现状
构建组与验证组老年维持性血液透析病人社会衰弱的发生率分别为33.7%和35.9%，均高于王鑫等[5]的研究结果（28.82%），低于Imamura等[6]的研究结果（57.3%）。结果的差异与调查地区与研究工具的不同相关，本研究调查地点为河北省承德市，与王鑫等[5]调查地点山东省济南市相比，承德属于山区城市，经济发展较为落后，医疗及社会支持资源相对匮乏，社会衰弱的发生率较高。本研究采用的HALFT量表为基于我国人群开发的普适性评估工具，其维度设置与条目内容更贴合我国老年群体。而Imamura等[6]采用不同的评估工具，导致社会衰弱的识别标准存在差异，未来可针对血液透析病人开发具有疾病特异性的社会衰弱评估工具以更精准地反映其社会衰弱程度。本研究结果显示，老年维持性血液透析病人社会衰弱的患病率高于老年慢性心力衰竭病人[21]与肌肉减少症病人[22]。相较于其他类型的慢性病病人，维持性血液透析病人不仅受原发病的影响，还需要长期规律前往医院透析，病人的自我管理能力和社会参与程度均受到影响。另外，血液透析的并发症（如皮肤色素沉着、性功能受损等）易导致病人形象紊乱与病耻感[23]，增加其心理压力，诱发社会衰弱。因此，相较于其他慢性病病人，老年维持性血液透析病人更容易发生社会衰弱。提示医务人员应对老年维持性血液透析病人这一特殊群体开展社会衰弱的筛查，及时采取相应的措施，预防或延缓社会衰弱的发展进程。
3.2　构建的老年维持性血液透析病人社会衰弱风险预测模型具有科学性及实用性
本研究综合了社会人口学、疾病相关资料等多种因素对老年维持性血液透析病人社会衰弱进行风险预测，经内外部验证显示模型的区分度、校准度和临床实用性较好，为临床医务人员提供了可靠的风险评估工具。本研究构建的预测模型包含透析龄、透析症状负担、家庭功能、体力活动和抑郁5个预测因子。
3.2.1　透析龄
本研究结果显示，透析龄是社会衰弱的危险因素。随着透析龄的不断增加，病人的身体机能不断下降。研究显示，透析龄≥3年病人发生衰弱的风险是透析龄3年以下的2.852倍[24]。肌肉减少、耐力不足等问题使病人的身体状况不足以支撑其长时间的社会活动，客观上造成病人的社交减少[25]。另外，长时间的透析往往伴随着沉重的经济压力，病人往往将有限的资源集中在医疗支出等方面，迫使其主动减少非必要的社会活动，进而导致社会衰弱。因此，临床医务人员应重点关注高透析龄的老年维持性血液透析病人，加强社会衰弱筛查与早期预防，延缓其发生发展。
3.2.2　透析症状负担
本研究结果显示，透析症状负担是社会衰弱的危险因素。生理上的症状如乏力、瘙痒、口渴等直接对病人的舒适度及生活质量产生影响，直接导致其社会活动受限[26]。另外，长期存在的症状负担如睡眠障碍、慢性疼痛等还能通过内分泌系统间接影响社会活动，如睡眠障碍会导致去甲肾上腺素、多巴胺等神经递质失衡，干扰大脑的情绪调节功能，影响人际交往的能力[27]。心理症状如负性情绪会使病人对疾病关注过多，产生自我封闭、社会疏离等[28]，进而导致社会衰弱的发生。因此，临床工作中医务人员应及时采取措施干预病人的不适症状，降低社会衰弱相关危险因素。
3.2.3　家庭功能
本研究结果显示，家庭功能是社会衰弱的保护因素。根据家庭功能理论，良好的家庭环境能帮助病人更有效地应对疾病挑战，顺利完成家庭及社会角色的过渡，从而更好地适应疾病的发展进程并维持治疗信心[29]。家庭关怀度作为衡量家庭成员对病人的关心和支持程度的指标，其水平高低直接影响了病人的社会适应能力。建议临床医护人员完善病人家庭功能评估工作，并针对家庭功能欠佳的病人建立规范化的随访体系，倡导家属参与到症状管理过程中，通过提高病人的家庭功能进而降低社会衰弱的发生风险。
3.2.4　抑郁
抑郁是社会衰弱的危险因素，与尹艳茹[30]研究结果相符。王九瑞等[31]Meta分析也证明，抑郁是社会衰弱的独立危险因素。抑郁常常伴随着失眠、兴趣缺失及动力下降等问题，导致病人对社交失去兴趣，社会参与减少[32]。另外，抑郁情绪会放大透析后疲劳、疼痛等身体不适感，限制了病人进行社会参与的客观身体条件。因此，提示临床医务人员在关注病人生理健康的同时还应注意其心理健康，对存在负面情绪的病人及时采取心理干预，实现身心层面的双层照护。
3.2.5　体力活动
本研究结果显示，体力活动是社会衰弱的保护因素。首先，集体类活动类似广场舞、太极拳等为个体直接提供了社会接触的机会，增加了社会交往，能直接预防社会衰弱的发生。其次，规律的体力活动可提升维持性血液透析病人的心肺功能，提高透析充分性，缓解焦虑、抑郁等心理问题[33]，通过改善症状负担间接缓解社会衰弱。医务人员可结合病人的身体状况为其制定个性化的体力活动指导方案，鼓励其在安全范围内进行适当的体力活动，从而降低社会衰弱的发生风险。
3.3　可干预因素对老年维持性血液透析病人社会衰弱模型的预测价值显著
本研究结果显示，与仅包含透析龄的基础模型相比，纳入透析症状负担、家庭功能、体力活动和抑郁等可干预因素的全模型，在预测老年维持性血液透析病人社会衰弱风险方面有更显著的性能。在模型区分度方面，全模型的AUC为0.888[95%CI (0.878，0.892)]，高于基础模型的0.813[95%CI(0.765，0.861)]，表明其区分社会衰弱高风险与低风险的能力更强。在模型拟合度方面，全模型的AIC、BIC均低于基础模型，说明在加入了可干预因素后，模型在拟合优度与简洁性方面取得了更好的平衡。在风险重分类与综合判别能力上，NRI值为0.125[95%CI（0.044，0.198）]，IDI值为0.164[95%CI（0.123，0.204）]，表明全模型能更准确地将病人划分到正确的风险层级中，预测能力得到提升。本研究纳入4个可干预因素，透析症状负担、家庭功能、体力活动和抑郁分别属于生理、社会、心理和行为不同维度，进一步验证了社会衰弱的发生是多维度共同作用的结果，为构建系统性的护理干预方案提供了精准的靶点与理论依据。
4　小结
收起
本研究结果显示，老年维持性血液透析病人社会衰弱的发生率处于较高水平。基于透析龄、透析症状负担、家庭功能、体力活动和抑郁5个因素构建的预测模型具有较好的区分度、校准度和临床实用性。透析症状负担、家庭功能、抑郁、体力活动作为老年维持性血液透析病人的可干预因素不仅提升了模型的预测精度，更为临床干预提供了靶点。但本研究存在一定的局限性，首先，采用便利抽样法可能会导致潜在的选择偏倚，从而可能会对社会衰弱发生率的估计产生影响，未来可采用多阶段随机抽样以提高样本的代表性；其次，横断面研究不能对变量间的因果关系进行推断，且本研究仅运用传统Logistic回归构建模型，模型的精准度和泛化能力有待提升。未来可开展前瞻性的队列研究，通过随访判断社会衰弱的发生发展过程并结合机器学习算法（如随机森林、神经网络等）构建预测模型，提高模型的预测效能，构建更精准的风险评估工具。

文献
收起
参考文献 引证文献
排序方式：
1
Wang L M,Xu X,Zhang M,et al.Prevalence of chronic kidney disease in China:results from the sixth China chronic disease and risk factor surveillance[J].JAMA Internal Medicine,2023,183(4):298-310.
2
王静,尼春萍,盖海云,等.心理控制感在血液透析患者恐惧疾病进展与心理社会适应间的中介效应[J].护理管理杂志,2025,25(2):111-115.
3
黄铮,邵庭芳,梁冉,等.老年人社会衰弱的概念分析[J].中华护理教育,2023,20(6):752-756.
4
Usui N,Yokoyama M,Nakata J,et al.Association between social frailty as well as early physical dysfunction and exercise intolerance among older patients receiving hemodialysis[J].Geriatrics & Gerontology International,2021,21(8):664-669.
5
王鑫,王晓虹,齐加芹,等.老年维持性血液透析患者社会衰弱影响因素分析及风险预测模型的构建[J].现代预防医学,2025,52(11):1957-1962.
6
Imamura K,Yamamoto S,Suzuki Y,et al.Prevalence,overlap,and prognostic impact of multiple frailty domains in older patients on hemodialysis[J].Archives of Gerontology and Geriatrics,2023,114:105082.
7
鲜圆圆.养老机构老年人社会衰弱风险预测模型的构建与验证[D].成都:成都中医药大学,2023.
8
上海慢性肾脏病早发现及规范化诊治与示范项目专家组.慢性肾脏病筛查诊断及防治指南[J].中国实用内科杂志,2017,37(1).
9
Kendall M G.Rank correlation methods[M].London:C.Griffin,1948:108.
10
Namanja A,Nyondo D,Banda T,et al.Delivering effective,comprehensive,multi-exercise component cardiac rehabilitation(CR) for chronic heart failure patients in low resource settings in sub-Saharan Africa:Queen Elizabeth Central Hospital(QECH-CR) randomised CR study,Malawi[J].PLoS One,2024,19(5):e0297564.
11
周新艺,孙建华,王晓杰,等.临床风险预测模型外部验证指南(2024版)的解读与启示[J].护理学杂志,2024,39(24):52-56.
12
Ma L,Sun F,Tang Z.Social frailty is associated with physical functioning,cognition,and depression,and predicts mortality[J].The Journal of Nutrition,Health and Aging,2018,22(8):989-995.
13
Hoyl M T,Alessi C A,Harker J O,et al.Development and testing of a five-item version of the Geriatric Depression Scale[J].Journal of the American Geriatrics Society,1999,47(7):873-878.
14
朱彩云,王国栋,刘鑫,等.老年住院患者抑郁发病率[J].中国老年学杂志,2017,37(5):1249-1250.
15
Weisbord S D,Fried L F,Arnold R M,et al.Development of a symptom assessment instrument for chronic hemodialysis patients:the dialysis symptom index[J].Journal of Pain and Symptom Management,2004,27(3):226-240.
16
郝艳华.血液透析患者症状的相关研究[D].北京:北京协和医学院,2016.
17
扈娜,孟令弟,刘堃.简版自我感知老化量表在社区老年人中应用的信效度研究[J].现代预防医学,2018,45(4):655-658.
18
Smilkstein G.The Family APGAR:a proposal for family function test and its use by physicians[J].The Journal of Family Practice,1978,6(6):1231-1239.
19
吕繁,曾光,刘松暖,等.家庭关怀度指数问卷测量脑血管病病人家庭功能的信度和效度研究[J].中国公共卫生,1999(11):27-28.
20
屈宁宁,李可基.国际体力活动问卷中文版的信度和效度研究[J].中华流行病学杂志,2004,25(3):265-268.
21
卢静,孙国珍,王洁,等.慢性心力衰竭患者社会衰弱现状及其影响因素可解释性分析研究[J].中国全科医学,2025,28(2):220-227.
22
Inoue T,Maeda K,Satake S,et al.Osteosarcopenia,the co-existence of osteoporosis and sarcopenia,is associated with social frailty in older adults[J].Aging Clinical and Experimental Research,2022,34(3):535-543.
23
周燕菲,方一茜,蒋倩,等.维持性血液透析患者病耻感的研究进展[J].现代临床医学,2025,51(3):229-232.
24
刘红群,陈灿灿,徐霞.维持性血液透析患者衰弱发生风险因素研究[J].中华保健医学杂志,2025,27(3):373-376.
25
钟志聪,吴一帆,魏琳.维持性血液透析患者肌少症影响因素及预后研究[J].中国血液净化,2024,23(4):307-312.
26
郑雨鹃,何璐晨,骆芬霞,等.维持性血液透析病人症状潜在类别分析及其与生活质量的关系[J].护理研究,2024,38(24):4325-4332.
27
周翠,江文,姚梦,等.抑郁焦虑与老年人睡眠质量的关联分析[J].中华老年医学杂志,2023,42(2):206-210.
28
朱贝莎,吕思雨,吴杭,等.维持性血液透析病人社会疏离体验的质性研究[J].护理研究,2024,38(9):1578-1584.
29
Olson D H,Sprenkle D H,Russell C S.Circumplex model of marital and family system:I.cohesion and adaptability dimensions,family types,and clinical applications[J].Family Process,1979,18(1):3-28.
30
尹艳茹.血液透析与腹膜透析患者社会衰弱现状及影响因素研究[D].湖州:湖州师范学院,2023.
31
王九瑞,刘健,延泽萍,等.老年人社会衰弱发生率及影响因素的系统评价和Meta分析[J].军事护理,2023,40(3):10-14.
32
Goodwin R D.Association between physical activity and mental disorders among adults in the United States[J].Preventive Medicine,2003,36(6):698-703.
33
伍梦寒,王艳,艾霜兰,等.运动锻炼对维持性血液透析患者心肺功能和心理状态的改善作用[J].中国医学前沿杂志(电子版),2021,13(8):67-70.
2026年第40卷第12期
20
9
引用本文
BibTeX
文章信息
doi: 10.12102/j.issn.1009-6493.2026.12.002
  • 接收时间：2025-09-12
  • 首发时间：2026-10-30
  • 出版时间：2026-06-25
补充材料
相关文章
文章信息
作者
出版历史
  • 收稿日期：2025-09-12
  • 修回日期：2026-06-03
基金
作者信息
    1承德医学院护理学院，河北 067000
    2承德医学院附属医院

通讯作者:

刘俊英，E-mail：
LIU Junying， E-mail：
参考文献
分享链接
https://castjournals.cast.org.cn/joweb/hlyj/CN/10.12102/j.issn.1009-6493.2026.12.002
分享至
全文二维码

扫描看全文

引用本文
BibTeX
本文的引用情况
2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
关闭全屏
相关链接
论文
最新文章
热读文章
热点专题
内参
蓝皮书
产业发展报告
传播力报告
期刊分级目录
资讯
学术新闻
行业新闻
学术会议
行业会议
关于
关于我们
联系我们
北京市海淀区学院南路86号
100081
010-62662699（运营及技术支持）
qkjq@cast.org.cn

中国科学技术协会版权所有 京ICP 备10216604号-4 海淀分局备案 1101084647
科技导报社主办 中国科协信息中心技术支持