营养指导对慢性肾脏病腹膜透析患者自我管理行为及生活质量的影响

Effect of nutrition-guided care on self-management behavior and quality of life of peritoneal dialysis patients with chronic kidney disease

目的探讨营养指导对慢性肾脏病腹膜透析患者自我管理行为及生活质量的影响。方法选取2016年1月-2018年4月在驻马店市某医院行腹膜透析的90例慢性肾脏病患者为研究对象,采用随机数字表法将患者分为对照组和研究组,每组45例。对照组患者给予西医常规治疗和常规护理,研究组患者在对照组护理基础上实施营养指导护理。比较2组患者护理6个月时的自我管理行为和生活质量改善情况。结果护理前,2组患者自我管理行为量表中遵从医嘱服药、处理高低蛋白血症、尿酸的监测、并发症护理与预防、饮食控制、规律锻炼6个维度评分及总分比较,2组患者生活质量测定量表中角色功能、情绪功能、健康状况、躯体功能4个维度评分及总分比较,差异均无统计学意义(P>0.05)。护理6个月时,2组患者遵从医嘱服药、处理高低蛋白血症、尿酸的监测、并发症护理与预防、饮食控制、规律锻炼6个维度评分及总分均高于护理前,2组患者角色功能、情绪功能、健康状况、躯体功能4个维度评分及总分均高于护理前,且研究组明显高于对照组,差异均有统计学意义(P<0.05)。结论营养指导可有效改善慢性肾脏病腹膜透析患者的自我管理行为,提高生活质量,值得临床推广应用。

Objective To explore the effect of nutrition-guided care on self-management behaviors and quality of life of peritoneal dialysis patients with chronic kidney disease.Methods Ninety patients with chronic kidney disease who underwent peritoneal dialysis in a hospital in Zhumadian from January 2016 to April 2018 were selected as the study subjects.The patients were divided into a control group and a study group using a random number table,with 45 cases in each group.Patients in the control group were given conventional Western medical treatment and routine care,while patients in the study group were given nutritional guidance care besides the control group’s care.The patients’self-management behaviors and quality of life in the two groups at six months of care were compared.Results Before nursing care,there was no statistically significant difference between the two groups in the total score and scores in the six dimensions of the self-management behavior scale(compliance with medical advice,management of high and low proteinemia,monitoring of uric acid,care and prevention of complications,dietary control,and regular exercise)or the total score and scores in the four dimensions of the quality of life scale(role function,emotional function,health status,and somatic function)(P>0.05).At six months of care,the total score and scores in the six dimensions of the self-management behavior scale,as well as the total score and scores in the four dimensions of the quality of life scale,increased significantly in both groups,and those in the study group were significantly higher than those in the control group(P<0.05).Conclusion Nutritional guidance care can effectively enhance self-management behaviors and improve the quality of life in peritoneal dialysis patients with chronic kidney disease.Therefore,it is worthy of clinical promotion and application.