认知行为干预在居家腹膜透析中的应用研究

Effect of Cognitive Behavior Intervention on Home Peritoneal Dialysis

目的探讨认知行为干预在居家腹膜透析中的应用及效果。方法采用抛硬币法将35例居家腹膜透析患者随机分为研究组(16例)和对照组(19例)。2组患者均予常规干预指导和随访管理,研究组在此基础上增加疾病认知和心理认知行为干预。收集2组并发症发生率、汉密尔顿抑郁量表及焦虑量表、匹兹堡睡眠质量指数量表、主观综合性营养评估表及改良Barthel指数评定量表等各项评分进行比较。结果并发症发生率:研究组中并发腹膜炎5例(31.3%),低钾血症4例(25.0%);对照组并发腹膜炎14例(73.7%),低钾血症11例(57.9%),2组比较有统计学意义(P<0.05)。生活质量评价:研究组患者出现抑郁5例(31.3%),躯体性焦虑3例(18.8%),精神性焦虑4例(25.0%);而对照组出现抑郁13例(68.4%),躯体性焦虑10例(52.6%),精神性焦虑12例(63.2%),2组比较有统计学意义(P<0.05)。结论有效的认知行为干预能降低居家腹膜透析并发症发生率,改善患者生活质量,从而提高腹膜透析质量。

Objective To explore the effect of cognitive behavior intervention on home peritoneal dialysis.Methods A total of 35 patients underwent peritoneal dialysis catheterization in our hospital of 2016-2017 and met the inclusion criteria with home peritoneal dialysis were randomly divided into study group and control group,including 16 in the study group and 19 in the control group.All patients were received the same routine treatments including operation,diet,family dialysis environment intervention and other follow-up managements(regular telephone follow-up or family visit).Beyond the routine treatments,the study group were received additional intervention by strengthening the disease cognition and psychological cognition including analyzing and correcting the wrong cognition.The quality of life was evaluated by the Hamilton depression scale and the anxiety scale,the Pittsburgh sleep quality index scale,the subjective comprehensive nutrition assessment table and the Barthel life quality index.Results The complication rates of peritonitis(31,3%)and hypokalemia(25.0%)in the study group were significantly lower than that in the control group.As well as the rates of depression(31.3%),somatic(18.8%)and psychic anxiety( 25.0 %)in the study group were significantly lower than that in the control group( P < 0.05 ).Conclusion Effective cognitive behavior intervention for home peritoneal dialysis patients can be helping reducing the incidence of complications and improving the quality of life by establishing correct cognition of disease and mental cognition.