动力取向干预联合量化运动指导在老年尿毒症维持性血液透析患者中的应用

Clinical Effects of Dynamic Orientation Intervention Combined with Quantitative Exercise Guidance on Elderly Patients with Uremia Undergoing Maintenance Hemodialysis

目的:探讨动力取向干预联合量化运动指导老在年尿毒症维持性血液透析患者中的应用效果。方法:选取2018年4月1日~2022年4月30日收治的行维持性血液透析治疗的80例老年尿毒症患者,采取随机数字表法分为对照组和研究组各40例,对照组采用常规护理干预,研究组实施动力取向干预联合量化运动指导;比较两组干预前后睡眠质量[采用匹兹堡睡眠质量指数量表(PSQI)]、疲劳程度[采用慢性病治疗功能评估-疲劳量表(FACIT-F)]、运动量、心理韧性[采用心理韧性量表(CD-RISC)]、依从性[采用肾脏病饮食依从行为量表(RABQ)、Morisky用药依从性量表(MMAS-8)、运动依从性分级]、生活质量(采用健康状况调查问卷)。结果:干预后,两组PSQI、FACIT-F、运动量评分均优于干预前(P<0.05),且研究组优于对照组(P<0.01);干预后,两组CD-RISC评分高于干预前(P<0.05),且研究组高于对照组(P<0.01);干预后,两组RABQ、MMAS-8、生活质量评分均高于干预前(P<0.05),且研究组高于对照组(P<0.01);干预后,研究组运动依从性分级优于对照组(P<0.05)。结论:对老年尿毒症维持性血液透析患者应用动力取向干预联合量化运动指导,不仅能提高患者睡眠质量,缓解疲劳状态,增加患者运动量,还能提高患者心理韧性及依从性,改善患者生活质量。

Objective:To explore the clinical value of dynamic orientation intervention combined with quantitative exercise guidance on elderly patients with uremia undergoing maintenance hemodialysis.Methods:A total of 80 elderly patients with uremia who received maintenance hemodialysis treatment from April 1,2018 to April 30,2022 were selected and divided into control group(n=40,routine nursing intervention)and study group(n=40,dynamic orientation intervention combined with quantitative exercise guidance)by the random number table method.The scores of sleep quality by Pittsburgh Sleep Quality Index(PSQI),fatigue degree by Functional Assessment Chronic Illness Therapy(Fatigue)(FACIT-F),amount of exercise,psychological resilience by Connor-Davidson Resilience Scale(CD-RISC),compliance by Renal Adherence Behaviour Questionnaire(RABQ),Morisky Medication Adherence Scale-8(MMAS-8),and exercise compliance grading,and quality of life(health status questionnaire)were compared between the two groups of patients before and after intervention.Results:After the intervention,the PSQI,the FACIT-F,and amount of exercise scores of both groups were lower than that before the intervention(P<0.05),and the study group was better than the control group(P<0.01).After intervention,the CD-RISC scores in both groups were higher than that before intervention(P<0.05),and the scores of study group was higher than that of the control group(P<0.01).After intervention,the RABQ,the MMAS-8,and the quality of life scores in both groups were higher than those before intervention(P<0.05),and the scores of study group was higher than that of the control group(P<0.01).After intervention,the study group′s exercise compliance rating was better than that of the control group(P<0.05).Conclusion:The application of dynamic orientation intervention combined with quantitative exercise guidance in elderly patients with uremia undergoing maintenance hemodialysis can not only improve their sleep quality,alleviate fatigue,increase their physical activity,but also enhance their psychological resilience and compliance,and improve their quality of life.