个体化现状-背景-评估-建议沟通模式对血液透析居家照顾者照顾行为和负荷的影响

Influences of situation-background-assessment-recommendation communication mode on caring behavior and caring load of home caregivers for hemodialysis patients

目的探讨个体化现状一背景～评估一建议沟通模式对血液透析居家照顾者照顾行为和照顾负荷的影响。方法选取在哈尔滨医科大学附属第一医院进行治疗的血液透析患者的照顾者216名，随机分为观察组（n=108）和对照组（n=108），观察组实施个体化教育方案护理教育，对照组实施常规护理教育。采用LC-GADs量表和照顾者压力负荷量表比较干预后两组照顾者的照顾行为和照顾负荷。结果观察组照顾者抽象行为量表代言、评价、指导、形成常规、保持平衡5个抽象行为维度平均得分分别为（3．25±0．52），（3．58±0．41），（3．49±0．50），（3．21±0．71），（3．45±0．48）分，均高于对照组，差异有统计学意义（t值分别为－7．364，－4．011，－9．025，－4．254，－3．896；P〈0．01）。观察组具体行为量表得分也均高于对照组。观察组照顾者照顾负荷量表中情绪及经济压力、身体及个人时间压力、心理压力及家庭关系压力4种照顾压力负荷得分分别为（1．82±0．35），（1．93±0．35），（1．85±0．54）和（1．68±0．45）分，均低于对照组，差异有统计学意义（t值分别为4．365，3．563，3．657，4．615；P〈0．01）。结论 对血液透析患者的照顾者实施个体化现状一背景一评估一建议沟通模式能改善照顾者的照顾行为，降低照顾者的照顾负荷，提高其对患者的照顾质量。

Objective To explore the influences of situation-background-assessment-recommendation communication mode for caring behavior and caring load of hemodialysis patients home caregivers. Methods A total of 216 caregivers who took care of hemodialysis patients were selected in our hospital for treatment and were averagely divided into observation group （implement personalized education plan for nursing education） and control group （implement routine nursing education）. We compared caring behavior and caring load between two groups by LC-GADs and caregiver＇s pressure load scale. Results The 5 abstract behavior dimensions in patients of observation group including endorsement, evaluation, guidance, form a regular, keep balance were （3.25± 0.52）, （3.58 ±0.41）, （3.49 ±0.50）, （3.21 ±0.71）, （3.45±0.48） which were higher than those of the control group, the differences were statistically significant （ t = - 7. 364, - 4.011, - 9. 025, - 4. 254, -3. 896;P〈0.01）; the specific behavior scores in observation group were significantly higher than that of control group as well （P 〈 0.01 ）. In the observation group, emotions and economic stress, the body and personal time pressure, psychological pressure and family relationship were （ 1.82 ±0.35 ）, （ 1.93 ±0.35 ）, （1.85±0.54） and （1.68 ±0.45） which were lower than those of the control group （t =4.365, 3. 563, 3. 657, 4.615 ; P 〈 0.01 ）. Conclusions Caregivers of hemodialysis patients receive situation-background- assessment-recommendation communication mode which can obviously improve caregivers caring behavior, reduce caregivers caring load, and improve the quality of care.