老年血液透析患者跌倒危险评估与预防干预

Assessment on falling risk in elderly patients with hemodialysisand nursing intervention

目的探讨做好老年血液透析患者防跌倒的规范性健康教育和干预措施对提高血液透析患者的生存质量的作用。方法选择2011年12月-2013年12月在新疆医科大学第一附属医院血液净化中心收治的进行血液透析的114例老年肾病患者,随机分为观察组和对照组,对照组采用常规血液透析护理,观察组在常规血液透析护理基础上采用规范性健康教育,对两组进行MORSE跌倒评估量表(MFS)评分后,比较两组患者的护理效果。结果 (1)规范化健康教育可以使跌倒发生率减少14%,能够保护67%的人不发生跌倒事件。(2)观察组在是否扶墙体和扶家具行走、是否给予静脉输液/置管/使用药物治疗及是否≥70岁/乏力/体位性低血压方面的得分低于干预前Morse跌倒评估量表的得分情况,差异有统计学意义。(3)对观察组实施干预后MORSE跌倒评估量表得分≤50分的人数明显下降(P<0.05)。观察组老年患者在生活质量明显高于对照组(P<0.05),跌倒发生率低于对照组(P<0.05)。结论在血液透析常规护理基础上进行规范性健康教育,能够显著提高血液透析老年患者的生活质量,降低跌倒的发生率。

Objective To standardize the health education for fall prevention and nursing intervention in elderly patients with hemodialysis for the improvement of their life quality.Methods 114 cases of elderly patients with hemodialysis in the First Affiliated Hospital to Xinjiang Medical University from 2011.12-2013.12 were collected and randomly grouped into control group and observation group,with conventional care in control group,conventional care in combination with the standardized health education in observa-tion group.MORSE was adopted to assess the nursing effects on patients in two groups.Results （1） Standardized health education can reduce the incidence of fall by 14% and protect 67% of the elderly from falling.（2）By comparing the scores in MORSE Scale in the pre-and post-intervention,the scores were lower in the post-intervention assessment than those in the pre-intervention assessment, with the statistical difference.（3）With the nursing intervention in the observation group,the number of patients who scored ≤50 points in the MORSE Scale Assessment decreased significantly （P 〈0.05）.In summary, the life quality in elderly patients was significantly improved （P 〈0.05）,with fewer incidence of falls in the observation group than that in the control group （P 〈0.05）.Conclusion The standardized health education on the basis of routine nursing for patients with hemodialysis was helpful to eliminate the risk factors,enhancing preventive awareness and preventive ability,reducing the incidence of falls and improving their life quality.