思维导图在新置管的腹膜透析患者培训中的应用

Patient education in the incident patients on peritoneal dialysis: the effectiveness of the mind map

目的思维导图在腹膜透析新置管患者培训中的应用效果评价。方法将100例新置管的腹膜透析患者随机分为对照组和观察组进行培训,对照组:理论采用传统的腹透培训资料,口头讲述,操作以模具操作,观看DVD,床边操作指导培训。观察组:理论采用思维导图模式进行培训,操作同对照组。比较两组在手术后及出院后1月理论、操作考核得分差异。比较手术后1个月与出院后3个月2组患者自我管理能力和相关的实验室指标以及相关并发症发生率的差异。结果与对照组比较,观察组在出院前的换液操作得分(t/χ~2=2.231,P=0.028),换药操作得分(t/χ~2=3.043,P=0.003),理论得分(t/χ~2=2.627,P=0.010),在1个月后的换液操作得分(t/χ~2=2.520,P=0.013),换药操作得分(t/χ~2=2.044,P=0.044),理论得分(t/χ~2=3.044,P=0.003),分值均高于对照组。观察组在出院后1个月返院复查的自我管理量表得分(t=5.444,P<0.001),出院后3个月返院复查的自我管理量表得分(t=6.056,P<0.001),分值均高于对照组。观察组在出院后1个月返院复查实验室指标中,血清钾值(t/χ~2=2.128,P=0.036),血清白蛋白值(t/χ~2=2.444,P=0.016),在出院后3个月返院复查实验室指标中,血清钾值(t/χ~2=3.293,P=0.001),血清白蛋白值(t/χ~2=3.117,P=0.002)均高于对照组。而观察组在手术培训出院后6个月并发症中腹膜炎(χ~2=7.440,P=0.006),出口处感染(χ~2=5.316,P=0.021),水肿(χ~2=9.000,P=0.003)较对照组显著降低,具有统计学意义。结论采用思维导图课件培训,比传统的资料培训方式更系统,能提高患者对腹膜透析相关性理论知识的理解,从而降低相关并发症的发生,提高培训效果。

Objective To determine the effectiveness of the mind map for imparting knowledge to incident peritoneal dialysis（PD） patients. Methods One hundred incident PD patients were enrolled in this study.Participants were randomly assigned to receive traditional training（control group） or the mind map for knowledge of PD（observation group）. The knowledge was assessed by the exam twice. The ability of self-management, laboratory parameters and PD complications were compared between the two groups after the surgery for one month and after discharge from hospital for 3 months. Results The scores of peritoneal dialysate exchange（t/χ~2=2.231, P=0.028）, change of dressing（t/χ~2=3.043, P=0.003） and theoretical tests（t/χ~2=2.627, P=0.010） were significantly higher in observation group than in control group before discharge. The scores of peritoneal dialysate exchange（t/χ~2=2.520, P=0.013）, change of dressing（t/χ~2=2.044, P=0.044） and theoretical tests（t/χ~2=3.044, P=0.003） were significantly higher in observation group than in control group after discharge for one month. The scores of self-management scale after discharge for one month（t=5.444, P〈0.001）and three months（t=6.056, P〈0.001） were both significantly higher in observation group than in control group. Serum potassium（t/χ~2=2.128, P=0.036） and albumin（t/χ~2=2.444, P=0.016） were significantly higher in observation group than in control group after discharge for one month. Serum potassium（t/χ~2=3.293, P=0.001） and albumin（t/χ~2=3.117, P=0.002） were significantly higher in observation group than in control group after discharge for three months. The incidence of peritonitis（χ~2=7.440, P=0.006）, exit infection（χ~2=5.316, P=0.021） and edema（χ~2=9.000, P=0.003） were lower in observation group after discharge for six months. Conclusion Mind map education may be more effective for knowledge acquisition, resulting in the comprehension of PD performance and the decrease of complication rate in PD patients.