摘要
目的探讨阶段变化护理干预模式提高血液透析(HD)患者液体摄入依从性的中期效果。方法将58例液体摄入不依从的HD患者随机分为干预组(30例)和对照组(28例)。干预组实施以阶段变化理论为指导的为期3个月的护理干预,对照组仅接受常规护理。干预结束随访3个月,评价干预第6个月HD患者的液体摄入依从性。结果干预后干预组患者透析间期体重增长与干体重的比值、液体摄入量及不依从天数显著低于对照组(均P<0·01);依从程度显著高于对照组(P<0·01);患者的液体摄入依从行为所处阶段显著高于对照组(P<0·01)。结论以阶段变化理论为指导,实施有关HD患者液体摄入控制的教育,可提高患者液体摄入依从性,建立合理的液体控制行为,将透析间期体重增长控制在理想范围。
Objective To explore the medium-term effects of transtheoretical nursing intervention on hemodiaysis patients＇ compliance to fluid intake. Methods Fifty-eight hemodialysis patients without compliance to fluid intake were randomly divided into an intervention group of 30 and a control group of 28 respectively. Three months＇ nursing intervention based on the transtheoretical model was carried out in the intervention group, while in the control group the patients were subjected to routine nursing. The patients were followed up for 3 months. Six months after the intervention, the hemodialysis patients＇ compliance to fluid intake was evaluated. Results After the intervention, the ratio of interdialysis weight gain and dry weight and the total quantity of fluid intake were significantly decreased and non-compliance days were lower in the intervention group as compared with those in the control group （all P〈0. 01）. The degree of compliance was obviously stronger than that of the control group （P〈0. 01）. The fluid intake compliance behavior in the intervention group reached a higher stage than in the control group （P〈50. 01）. Conclusion Guided by the transtheoretical model, the education project of hemodialysis patients＇ fluid intake controlling is assuredly effective. It is helpful to improve hemodialysis patients＇ compliance to fluid intake, to develop reasonable fluid-intake-controlling behavior and to control interdialysis weight gain within a rational range.
关键词
肾透析
液体摄入
依从性
阶段变化模式
护理干预
renal dialysis
fluid intake
compliance
transtheoretical model
nursing intervention
