基于TTM为导向的分阶段干预对维持性血液透析病人自我管理行为及钙磷水平的影响

Influence of staged intervention based on TTM model on self-management behaviors and calcium and phosphorus levels in maintenance hemodialysis patients

[目的]探究基于跨理论模型(TTM)为导向的分阶段干预对维持性血液透析病人自我管理行为及钙磷水平的影响。[方法]选取2014年8月—2016年6月收治的88例维持性血液透析病人,随机分为研究组和对照组,每组44例。对照组实施传统的护理照护,研究组则在对照组基础上引入基于TTM为导向的分阶段干预。两组病人均于干预前及干预后第3个月末接受自我行为管理量表测评,以及血钙水平、血磷水平测定。[结果]干预后研究组病人伙伴关系(16.3分±2.7分)、情绪处理(17.0分±2.6分)、问题解决(16.0分±2.4分)、执行自我照护活动(15.7分±2.5分)评分高于对照组伙伴关系(10.4分±1.7分)、情绪处理(9.2分±1.4分)、问题解决(9.0分±4.7分)、执行自我照护活动(10.2分±1.6分)评分,两组比较差异均有统计学意义(P<0.05);干预后,研究组病人的血磷值(1.7mmol/L±0.3mmol/L)低于对照组(2.2mmol/L±0.5mmol/L),两组比较差异有统计学意义(P<0.05)。[结论]维持性血液透析病人引入基于TTM为导向的分阶段干预,有助于提高病人的自我管理行为,降低血磷水平。

Objective： To explore the eefect of staged in te rv e n t io n based on tra n s th e o re t ica l model （T T M ） onself - management behaviors and calcium and phosphorus levels in maintenance hemodialysis p a t ie n ts. M e thods： A total of 88 cases of hemodialysis patients a dmit te d from A u g u s t 2014 to June 2016 were ra n d om ly divided into study group and control group ？44 cases in each. T he patients in co n tro l group received t ra d it io n a l nu rs in g care, while the patients in s tu d y group received staged in te rv e n t io n based on the T T M model on tional nursing care. Two groups of patients were assessed by self behavior management scale before in te rve n t io n and at the end of thi rd month af te r interv ent ion,as w e l l as measuring blood calcium levels and serum phospho-- us levels. Results： After intervent ion ,or studygrouppat ient the scores of par tn e rsh ip （ 1 6. 3 士 2. 7 ）,emot ional processing（1 7. 0士 2. 6） , problem solving （1 6. 0 士 2. 4） , imp leme n ta t io n o f self care a c t iv it ie s （1 5. 7 士 2. 5） were higher those that of the control group par tneship （1 0. 4 ± 1. 7 ）,emot ional processing（ 9. 2 ± 1. 4 ）,problem sol- ving （9. 0±4. 7） implementation of self care a c t iv i t ie s （10. 2 ± 1 6）,there was s ig n if ica n t difference between tw o groups （P 〈0. 05） after intervent ion,serum phosphorus value of patients in s tu d y g r o u p （1. 7 m m o l/L ±0. 3 mmol/L ） was lower than th a t in co n tro l group （2. 2 m m o l/L ±0. 5 m m o l/L） ,there was s igbetween two groups（P 〈0. 05）. Conclusions ： the staged in te rv e n t io n based on T T M is helpful to improve the s e l f- management behavior and reduce the levels of phosphorus in maintenance hemodialysis p a t ie n ts.