摘要
目的探讨自我管理能力集束干预在终末期肾病血液透析患者临床依从性和治疗结局中的作用。方法选择2019年6~12月在透析中心进行血液透析的88例患者作为研究对象,按奇偶数字法随机分为干预组(44例)和对照组(40例)。两组患者均行血液透析治疗和基础治疗,干预组实施集束行为干预。比较两组患者干预前后自我管理能力、透析依从性及相关并发症的情况。采用SPSS 26.0对数据进行统计分析,组间比较使用独立样本t检验,组内比较使用配对t检验。结果两组间自我管理能力评分基线值差异无统计学意义(P>0.05)。6个月后,干预组自我管理能力总分[(68.61±10.16)分,(55.12±9.29)分]及情绪处理[(13.42±2.89)分,(11.04±2.46)分]、执行自我护理[(21.67±4.87)分,(16.71±3.59)分]、问题解决[(16.61±3.22)分,(12.03±4.61)分]、伙伴关系[(14.26±3.64)分,(10.88±3.29)分]4个因子得分均高于对照组,均差异有统计学意义(t=7.112,3.764,4.739,5.515,5.834;均P<0.05);干预组自我管理行为总分及4个维度得分均高于对照组,均差异有统计学意义(t=13.413,5.432,8.114,1.910,4.127;均P<0.05);干预组与对照组透析跳跃行为(9.09%、22.50%)、透析缩短行为(11.36%、30.00%)、高钾血症(15.91%、55.00%)、心力衰竭(11.36%、37.50%)、动静脉内瘘闭塞发生率(4.55%、10.00%),均差异有统计学意义(χ^(2)=4.095,5.206,17.571,8.843,5.127;均P<0.05);干预组与对照组的尿素清除指数、贫血改善、血磷、甲状旁腺素水平,均差异有统计学意义(t=3.830,4.558,-3.720,6.481;均P<0.05)。结论自我管理能力集束干预能改善终末期肾病透析患者临床依从性和治疗结局。
Objective To explore the effect of self-management capability cluster intervention on clinical compliance and treatment outcome in patients with end-stage renal disease undergoing hemodialysis.Methods A total of 88 patients undergoing hemodialysis in dialysis center from June to December 2019 were randomly divided into intervention group(44 cases)and control group(40 cases)according to odd-even number method.Patients in both groups were treated with hemodialysis and basic treatment,and patients in intervention group were treated with self-management capability cluster intervention.The self-management ability,dialysis compliance and related complications were compared between the two groups before and after intervention.The data were statistically analyzed by SPSS 26.0 software.Independent sample t-test was used for intergroup comparison,and paired t-test was used for intragroup comparison.Results There was no significant difference in self-management ability at baseline between intervention group and control group(P>0.05).After 6 months,the total score of self-management ability((68.61±10.16),(55.12±9.29))and emotional processing((13.42±2.89),(11.04±2.46)),executive self-care((21.67±4.87),(16.71±3.59)),problem solving((16.61±3.22),(12.03±4.61)),partnership((14.26±3.64),(10.88±3.29))were higher than those in the control group,and the differences were statistically significant(t=7.112,3.764,4.739,5.515,5.834,all P<0.05).The total score of self-management behavior and the scores of four dimensions in the intervention group were significantly higher than those in the control group(t=13.413,5.432,8.114,1.910,4.127,all P<0.05).There were significant differences between the intervention group and the control group in jumping behavior(9.09%,22.50%),shortening behavior(11.36%,30.00%),hyperkalemia(15.91%,55.00%),heart failure(11.36%,37.50%)and arteriovenous fistula occlusion(4.55%,10.00%)(χ^(2)=4.095,5.206,17.571,8.843,5.127,all P<0.05).There were significant differences between the intervention group and the control group in urea clearance index,anemia improvement,blood phosphorus,parathyroid hormone level(t=3.830,4.558,-3.720,6.481,all P<0.05).Conclusion Self-management capability cluster intervention can improve the clinical compliance and treatment outcome in patients with end-stage renal disease undergoing hemodialysis.
作者
孟令强
董伟
陈秀敏
李萍
刘立春
Meng Lingqiang;Dong Wei;Chen Xiumin;Li Ping;Liu Lichun(Department of Renal Medicine,Qingzhou Hospital Affiliated to Shandong First Medical University(Qingzhou People's Hospital),Weifang 262500,China;Department of Pediatrics,Qingzhou Hospital Affiliated to Shandong First Medical University(Qingzhou People's Hospital),Weifang 262500,China)
出处
《中华行为医学与脑科学杂志》
CAS
CSCD
北大核心
2021年第11期1011-1016,共6页
Chinese Journal of Behavioral Medicine and Brain Science
基金
潍坊市卫生健康委科研项目(wfwsjk_2019_217)。
关键词
自我管理能力
集束干预
血液透析
临床依从性
治疗结局
终末期肾病
Self-management capability
Cluster intervention
Hemodialysis
Clinical compliance
Treatment outcome
End-stage renal disease
作者简介
通信作者:刘立春,Email:13793661668@163.com。
