微信访视对成年血液透析患者焦虑情绪的影响

The effect of visits by Wechat on anxiety in adult patients with maintenance hemodialysis

目的探讨微信访视对成年维持性血液透析患者焦虑情绪影响的临床效果。方法选择84例18~45岁维持性血液透析患者为研究对象,采用随机数字表法分为试验组(42例)和对照组(42例),试验组建立一个患者微信群,进行微信访视;对照组进行常规健康护理指导。观察8个月。结果试验组患者焦虑情绪得到良好改善,干预后焦虑自评量表(self-rating anxiety scale,SAS)评分(46.79±6.09比59.55±4.74,t=10.710,P<0.001)优于对照组,差异有统计学意义;疾病认知水平高于对照组,差异有显著意义(χ~2=10.918,P=0.001;χ~2=7.941,P=0.005;χ~2=7.375,P=0.007;χ~2=9.143,P=0.002;χ~2=13.123,P<0.001;χ~2=15.774,P<0.001;χ~2=6.943,P<0.008);血尿素氮(blood urea nitrogen,BUN)指标水平(9.01±3.33比18.01±2.68,t=5.399,P=0.021)、血肌酐(serum creatinine,Scr)指标水平(336.45±82.31比426.45±70.26,t=3.984,P=0.026)、β_2微球蛋白(β_2-Micro Globulin,β_2-MG)指标水平(14.81±1.35比17.23±3.12,t=3.612,P=0.030)均低于对照组,且差异有统计学意义。结论通过微信访视形式,成年血液透析患者焦虑情绪有所改善,疾病认知水平有所提升,治疗效果及生存质量也相应提高。

Objective To explore the clinical effect of visits by Wechat on anxiety in adult patients with maintenance hemodialysis （MHD）. Methods A total of 84 MHD cases from Jan. to Aug., 2016 were recruit- ed as the research subjects. They were divided into experimental group （n=42） and control group （n=42） by us- ing a random number table. Patients in experimental group established a Wechat group to conduct visits by Wechat for 8 months, while patients in control group were treated with routine health care. Results Anxiety in patients in experimental group alleviated after the intervention. Compared with control group, the self-rat- ing anxiety scale （SAS） scores were statistically better in experimental group （46.79±6.09 vs. 59.55±4.74, t= 10.710, P〈0.001）; the cognitive level of the disease was statistically higher in experimental group （X^2= 10. 918, P =0. 001; X^2=7. 941, P =0. 005; ;X^2=7. 375, P =0. 007; Z2=9. 143, P =0. 002; ;t2=13. 123, P 〈 0. 001; X^2=15. 774, P 〈0. 001. X^2=6. 943, P 〈0. 008）; blood urea nitrogen （BUN） index （9.01±3.33 vs. 18.01±2.68, t=5.399, P=0.021）, serum creatinine （Scr） index （336.45±82.31 vs. 426.45±70.26,t=-3.984, P=0.026） and 132-microglobulin （132-MG） index （14.81±1.35 vs. 17.23±3.12, t=3.612, P=-0.030） were statistically lower in experimental group. Conclusion Through visits by Wechat, the anxiety in adult MHD patients ira- proved, and the cognitive level of the disease enhanced. The therapeutic effect and the quality of life improved as well.