腹膜透析患者行延续性护理对患者自我效能及并发症风险的影响

Effect of continuous nursing on self-efficacy and risk of complications in patients undergoing peritoneal dialysis

目的:探讨延续性护理对持续性非卧床腹膜透析患者自我效能及并发症风险的影响。方法:纳入我院肾脏内科2005年12月至2015年12月接受的持续性非卧床腹膜透析患者160例为对象,按所接受护理方案分组,观察组80例接受延续性护理,对照组80例采用常规护理。采用肾脏病生活质量量表(KDQOL)调查患者出院前1 d、出院6周、12周时生活质量,采用自我管理能力问卷(SMBQ)调查患者出院12周时自我管理能力,采用一般自我效能量表(GSES)调查患者出院前1 d、出院12周时自我效能,同时统计患者腹膜炎及再入院发生率以评价并发症风险。结果:观察组出院6周、12周时躯体健康、症状与不适、肾脏疾病的影响评分,出院12周时心理健康评分均明显高于对照组,上述差异有统计学意义(P<0.05);出院12周时观察组SMBQ问卷透析行为和行为依从性维度得分明显高于对照组,差异有统计学意义(P<0.05);出院12周时观察组GSES量表得分明显高于对照组,差异有统计学意义(P<0.05);观察组出院12周内再入院率明显低于对照组,差异有统计学意义(P<0.05)。结论:延续性护理能够有效提升患者自我效能、降低并发症风险。

Objective： To investigate the effect of continuous nursing on self-efficacy and risk of complications in continuous ambulatory peritoneal dialysis patients. Methods： 160 continuous ambulatory peritoneal dialysis patients were involved during December 2005 to December 2015 and were divided into 2 groups. 80 cases in the observation group were treated with continuous nursing while 80 in the control group were treated with routine nursing. The Kidney Disease Quality of Life（ KDQOL） were used to measure patients＇ quality of life 1 day before leaving hospital,6 weeks and 12 weeks after leaving hospital. The Self-Management Behavior Questionare（ SMBQ） were used to measure patients＇ self-management ability 12 weeks after leaving hospital. The General Self-Efficacy Scale（ GSES） was used to measure patients＇ self-efficacy 1 day before leaving hospital and 12 weeks after leaving hospital.The occurrence of peritonitis and readmission were recorded to evaluate the risk of complications. Results： The scores of physical health,symptoms and discomfort,kidney disease impact of KDQOL 6 weeks and 12 weeks after leaving hospital,and scores of mental health of KDQOL 12 weeks after leaving hospital in the observation group were significantly higher than those in the control group,the differences were statistically significant（ P〈0. 05）. The scores of dialysis behavior and behavior compliance of SMBQ in the observation group were significantly higher than those in the control group,the differences were statistically significant（ P〈0. 05）. The GSES scores in the observation group were significantly higher than it in the control group at 12 weeks after leaving hospital,the difference was statistically significant（ P〈0. 05）. The readmission rate in the observation group 12 weeks after leaving hospital was significantly lower than it in the control group,the difference was statistically significant（ P〈0. 05）. Conclusion： The continuity nursing can effectively improve the patients＇ self-efficacy and reduce the risk of complications.