参与式健康教育在血液透析患者限磷饮食管理中的应用

Application of participatory health education in dietary phosphorus restriction in patients on maintenance hemodialysis

目的探讨参与式健康教育在维持性血液透析患者限磷饮食管理中的效果。方法选取2015年3—8月于上海交通大学医学院附属仁济医院行维持性血液透析(maintenance hemodialysis,MHD)的136例患者,采用自身前后对照的方法,进行3个月的参与式健康教育干预:患者参与制订切实可行的限磷饮食传播策略和工具;经专职护士基于护患共同开发的教育工具进行一对一限磷饮食健康教育。比较干预前后患者限磷饮食知识的知晓度以及患者的血清磷水平。结果 136例患者参与并完成本研究。经过3个月的健康教育,患者对限磷饮食知识的知晓度明显提高(P<0.05);而其血清磷水平明显降低(P<0.001)。结论在参与式健康教育模式中,患者在与护士学与教的互动中主动学习和体验知识,掌握了限磷饮食管理的技能,降低了血清磷水平,减少了高磷血症的发生,进一步提高了血液透析患者的生存率和生活质量。

Objective To explore the effects of participatory health education on dietary phosphorus restriction in the patients on maintenance hemodialysis. Methods A total of 136 patients on maintenance hemodialysis were chosen from Renji Hospital, Shanghai Jiao Tong University School of Medicine during March to August 2015. They receive 3-month participatory health education： participation in the formulation of health education plans and strategies ; one-to-one health education of dietary phosphorus restriction using the health education tool developed by specialist nurses and patients. The patients＇ knowledge of dietary phosphorus restriction and serum phosphorus level were evaluated before and after the intervention. Results After 3-month intervention, the patients ＇ knowledge of dietary phosphorus restriction was improved significantly （ P 〈 0. 05 ） , and a significant reduction on serum phosphorus level （ P 〈 0. 001 ） was observed. Conclusion In a participatory health education model, patients can actively gain knowledge during nurse-patient interactions and improve the skills of phosphorus management, which may subsequently lead to a reduction on serum phosphorus level. The adequate control of serum phosphorus level may further contribute to an improvement of survival and quality of life in the patients undergoing maintenance hemodialysis treatment.