摘要
目的探讨基于营养、心理、运动的全方位护理干预对肾衰竭血液透析患者营养状况、心理状态、生存质量及并发症的影响。方法选取河南大学淮河医院2021-01-01-2022-07-31收治的肾衰竭患者106例作为研究对象,随机数字表法分为传统护理组和全方位护理组,各53例。2组患者均接受血液透析治疗,传统护理组采用传统护理干预,全方位护理组在传统护理干预基础上进行基于营养、心理、运动的全方位护理干预。比较2组患者营养状况〔血清白蛋白(ALB)、血红蛋白(Hb)、前白蛋白(PA)〕、心理状态〔抑郁自评量表(SDS)、焦虑自评量表(SAS)〕、健康行为〔健康促进生活方式量表(HPLP-Ⅱ)〕、自我效能〔自我效能感量表(GSES)〕、生存质量〔肾脏疾病生存质量简表(KDQOL-SFTM)〕、治疗依从性及并发症。结果护理干预3个月后,2组患者ALB、Hb、PA水平均高于干预前,且全方位护理组血清ALB水平为(43.18±3.89)g/L,高于传统护理组的(38.42±3.77)g/L,F=21.417,P<0.001;Hb水平为(115.74±5.62)g/L,高于传统护理组的(101.33±5.44)g/L,F=89.945,P<0.001;PA水平为(310.36±7.38)mg/L,高于传统护理组的(280.43±7.04)mg/L,F=230.371,P<0.001。干预3个月后,2组患者SDS、SAS、KDQOL-SFTM评分均低于干预前,且全方位护理组SDS评分为(48.32±3.48)分,低于传统护理组的(52.45±3.37)分,F=19.090,P<0.001;SAS评分为(49.25±3.27)分,低于传统护理组的(51.85±3.35)分,F=8.914,P<0.001;KDQOL-SFTM评分为(49.72±4.89)分,低于传统护理组的(55.38±4.75)分,F=20.423,P<0.001。HPLP-Ⅱ和GSES评分均高于干预前,且全方位护理组HPLP-Ⅱ评分为(136.47±6.94)分,高于传统护理组的(118.45±7.35)分,F=89.387,P<0.001;GSES评分为(30.51±2.87)分,高于传统护理组的(26.75±2.94)分,F=21.893,P<0.001。全方位护理组治疗依从性(96.23%)高于传统护理组(83.02%),差异有统计学意义,χ^(2)=4.970,P=0.026;并发症发生率(7.55%)低于传统护理组(22.64%),差异有统计学意义,χ^(2)=4.711,P=0.030。结论基于营养、心理、运动的全方位护理干预能改善肾衰竭血液透析患者的营养状况和负性心理状态,提高自我效能及治疗依从性,建立健康行为,降低并发症发生的风险,有利于提高生存质量。
Objective To investigate the effects of comprehensive nursing intervention based on nutrition,psychology and exercise on the nutritional status,psychological status,quality of life and complications in hemodialysis patients with renal failure.Methods Totally 106patients with renal failure admitted to Huaihe Hospital of Henan University from January 1,2021to July 31,2022were selected as research objects and divided into traditional nursing group and comprehensive nursing group by random number table method,with 53cases in each group.Both groups received hemodialysis treatment,the traditional nursing group was treated with traditional nursing intervention,and the comprehensive nursing group was treated with comprehensive nursing intervention based on nutrition,psychology and exercise.The nutritional status[serum albumin(ALB),hemoglobin(Hb)and prealbumin(PA)],psychological status[self-rating depression scale(SDS),self-rating anxiety scale(SAS)],health behavior[(health promoting lifestyle profile-Ⅱ(HPLP-Ⅱ)],selfefficacy[general self-efficacy scale(GSES)],quality of life[kidney disease quality of life short form(KDQOLSFTM)],treatment compliance and complications were compared between the two groups.Results After 3months of intervention,the levels of ALB,Hb,and PA in both groups were higher than those before the intervention,and the serum level of ALB in the comprehensive nursing group was(43.18±3.89)g/L,which was higher than that in traditional nursing group(38.42±3.77)g/L,F=21.417,P<0.001;the serum level Hb was(115.74±5.62)g/L,which was higher than that in traditional nursing group(101.33±5.44)g/L,F=89.945,P<0.001;serum level of PA was(310.36±7.38)mg/L,which was higher than that in traditional nursing group(280.43±7.04)mg/L,F=230.371,P<0.001.SDS,SAS and KDQOL-SFTM scores in 2groups were lower than those before intervention,the score of SDS in the comprehensive nursing group was(48.32±3.48)points,which was lower than that in the traditional nursing group(52.45±3.37)points,F=19.090,P<0.001;the score of SAS was(49.25±3.27)points,which was lower than that in the traditional nursing group(51.85±3.35)points,F=8.914,P<0.001;the score of KDQOL-SFTM was(49.72±4.89)points,which was lower than that in the traditional nursing group(55.38±4.75)points(F=20.423,P<0.001).HPLP-Ⅱand GSES scores in 2groups were higher than those before intervention,the score of HPLP-Ⅱin the comprehensive nursing group was(136.47±6.94)points,which was lower than that in the traditional nursing group(118.45±7.35)points,F=89.387,P<0.001;the score of GSES was(30.51±2.87)points,which was lower than that in the traditional nursing group(26.75±2.94)points,F=21.893,P<0.001.The treatment compliance of the comprehensive nursing group(96.23%)was higher than that of the traditional nursing group(83.02%),the difference was statistically significant,χ^(2)=4.970,P=0.026;the complication rate(7.55%)was lower than that of the traditional nursing group(22.64%),the difference was statistically significant,χ^(2)=4.711,P=0.030.Conclusion Comprehensive nursing intervention based on nutrition,psychology and exercise can improve the nutritional status and negative psychological state of hemodialysis patients with renal failure,improve self-efficacy and treatment compliance,establish healthy behaviors,reduce the risk of complications,and improve the quality of life.
作者
刘燕燕
董永清
张松
石兴元
LIU Yanyan;DONG Yongqing;ZHANG Song;SHI Xingyuan(Department of Hemodialysis,Huaihe Hospital,Henan University,Kaifeng,Henan475000,China)
出处
《社区医学杂志》
CAS
2024年第9期306-311,共6页
Journal Of Community Medicine
