细节优化护理对血液透析患者人造血管内瘘及自我效能的影响

The effect of optimization specific to nursing practice on artificial vascular graft fistula and Self –efficacy of maintenance hemodialysis patients

目的探讨细节优化护理对维持性血液透析患者人造血管内瘘及自我效能的影响。方法将40例行人造血管内瘘术的维持性血液透析患者随机分为观察组和对照组各20例。对照组给予常规护理模式,观察组则在护理细节和评估心理状态后进行针对性心理护理,1年后对人造血管内瘘的阻塞率、并发症发生率及自我效能感量表评分进行比较。结果实施细节优化护理1年后,观察组患者人造血管内瘘阻塞率、并发症发生率显著低于对照组,差异有统计学意义(χ2=4.250,P<0.05),观察组患者自我效能感量表评分高于对照组,差异有统计学意义(χ2=8.095,P<0.05)。结论细节优化护理不仅延长了人造血管内瘘的使用寿命保证了血液透析的充分性,而且明显提升患者全面效能感和处理问题的自信心。

Objective To evaluate the effect of optimization specific to nursing practice on the artifi-cial vascular graft fistula and Self -efficacy of maintenance hemodialysis patients Methods Forty mainte-nance hemodialysis patients with artificial vascular graft fistula was randomly divided into the control group and the intervention group （n=20, respectively）. Patients in the control group received conventional methods of nursing, and patients the intervention group received individualized psychological caring after careful rou-tine nursing and psychological asessment. Then the proportion of fistula obstruction, the incidence of fistula–relevant complication, and the score of Self Efficacy Scale were evaluated. Results 1 year after optimization specific to nursing practice, compared with the control group, the proportion of fistula obstruction, the inci-dence of fistula-relevant complication in the intervention group were much lower （χ2=4.250, P〈0.05）, while the score of Self Efficacy Scale was higher （χ2=8.095, P〈0.05）. Conclusion Optimization specific to nurs-ing practice could prolong the life of the artificial vascular graft fistula of maintenance hemodialysis patients hence ensure the hemodialysis sufficiency, and improve the patients’consciousness of self efficacy and the confidence to handle difficulty.