文章摘要

基于动机行为转变的康复护理对血液透析患者的干预效果

作者: 1周丽丽
1 安徽省宿州市皖北煤电集团总医院肾内科,安徽 宿州 234000
通讯: 周丽丽 Email: 1037759921@qq.com
DOI: 10.3978/j.issn.2095-6959.2020.08.040

摘要

目的:探究动机行为转变的康复护理对血液透析患者的干预效果,为临床诊疗及护理提供依据。方法:选择安徽省宿州市皖北煤电集团总医院2018年1月至2019年3月进行血液透析的80例慢性肾衰竭患者进行研究。将所有患者采用随机数表法均分为对照组和研究组(n=40)。对照组患者采用常规护理模式;研究组患者在常规护理模式的基础上采用基于动机行为转变的康复护理干预。比较两组患者的肾脏病饮食依从性量表(Renal Adherence Altitudes Renal Questionnaire,RAAQ)与肾脏病饮食依从行为量表(Renal Adherence Behavior Questionnaire,RABQ)评分结果、每日饮水量、24 h尿量、每日饮食含水量、超滤量、水肿程度与透析充分性。结果:干预前,两组RAAQ和RABQ评分比较差异无统计学意义(均P>0.05);干预后,研究组RAAQ和RABQ评分均明显提高,且明显高于对照组(均P<0.05)。干预前,两组每日饮水量、24 h尿量、每日饮食含水量、超滤量相比差异无统计学意义(均P>0.05);干预后,两组每日饮水量、24 h尿量、每日饮食含水量均明显降低,超滤量明显升高;研究组患者每日饮水量、24 h尿量、每日饮食含水量均明显低于对照组,超滤量明显高于对照组(均P<0.05)。干预前,两组患者水肿情况比较差异无统计学意义(P>0.05);干预后,两组患者的水肿情况均得到明显改善;研究组水肿情况明显轻于对照组(P<0.05)。干预前,两组尿胆素(urobilin,BUN)、血清肌酐(serum creatinine,SCr)、尿素清除分数(Kt/V)比较差异无统计学意义(均P>0.05);干预后,研究组静脉血BUN,SCr降低,Kt/V明显升高,且研究组静脉血BUN,SCr明显低于对照组,Kt/V明显高于对照组,差异有统计学意义(均P<0.05)。结论:基于动机行为转变的康复护理对血液透析患者的干预效果良好,可有效提高患者的透析充分性,改善患者的参与度与依从性。
关键词: 肾功能衰竭;血液透析;动机;康复护理;充分性;依从性

Intervention effect of rehabilitation nursing based on motivation behavior transformation on hemodialysis patients

Authors: 1ZHOU Lili
1 Department of Nephrology, Wanbei Coal Power Group General Hospital, Suzhou Anhui 234000, China

CorrespondingAuthor: ZHOU Lili Email: 1037759921@qq.com

DOI: 10.3978/j.issn.2095-6959.2020.08.040

Abstract

Objective: To study the intervention effect of rehabilitation nursing based on the change of motivation and behavior on hemodialysis patients, so as to provide basis for clinical diagnosis and nursing. Methods: Eighty patients with chronic renal failure who underwent hemodialysis in Wanbei Coal Power Group General Hospital from January 2018 to March 2019 were selected for the study. According to the random number table method, all patients were divided into control group and study group, 40 cases each. Patients in the control group were intervened by routine nursing mode. Patients in the study group adopted rehabilitation nursing intervention based on motivation behavior change on the basis of the routine nursing mode. Renal Adherence Altitudes Renal Questionnaire (RAAQ) and Renal Adherence Behavior Questionnaire (RABQ) scores, daily water consumption, 24 h urine volume, daily dietary water content, ultrafiltration volume, edema degree and dialysis adequacy of the two groups were compared. Results: Before intervention, there were no statistically significant difference between the two groups in the total scores RAAQ and RABQ (P>0.05). After intervention, total scores of RAAQ and RABQ of the two groups were significantly higher than those of the control group (P<0.05). Before intervention, there were no significant differences in daily water intake, 24-hour urine volume, daily dietary water content and ultrafiltration between the two groups (P>0.05). After intervention, the daily drinking water volume, 24-hour urine volume and daily dietary water content of the two groups were significantly reduced, and the ultrafiltration volume were significantly increased; the daily drinking water volume, 24-hour urine volume and daily dietary water content of the study group were significantly lower than those of the control group, and the ultrafiltration volume was significantly higher than that of the control group, with a statistically significant difference (all P<0.05). Before intervention, there was no significant difference in edema between the two groups (all P>0.05). After intervention, edema improved in both groups; edema in the study group was significantly lighter than in the control group (P<0.05). Before intervention, there were no significant differences in venous blood levels of urobilin (BUN) and serum creatinine (SCr) and Kt/V between the two groups (P>0.05). After intervention, venous blood levels of BUN and SCr were decreased, and Kt/V was significantly increased in the study group; venous blood levels of BUN and SCr in the study group were significantly lower, and Kt/V was significantly higher than those in the control group (all P<0.05). Conclusion: Rehabilitation nursing based on the change of motivation and behavior has a good intervention effect on hemodialysis patients, which can effectively improve the dialysis adequacy of patients, and improve patients’ participation and compliance.
Keywords: renal failure; hemodialysis; motivation; rehabilitation nursing; sufficiency; compliance