循证护理模式在降低血透室内瘘针滑脱风险中的应用效果观察

The effect observation of evidence-based nursing model reducing the risk of internal fistula slipping in hemodialysis room

目的探讨循证护理模式在降低血透室内瘘针滑脱风险中的应用效果。方法选择2016年1月到2017年2月科室收治的血液透析治疗患者6067例,随机分为对照组3033例和观察组3034例。对照组采用常规方法护理,观察组采用循证护理模式,记录两组血透室内瘘针滑脱发生情况,采用医院自行拟定的护理满意度调查问卷对两组患者护理后满意度进行评估;采用世界卫生组织生活质量测定量表简表(WHOQOL-BREF)从心理、生理、社会关系及环境领域对两组护理前、后生活质量评分进行评估;采用汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评估患者焦虑、抑郁心理,比较两组内瘘针滑脱及对满意度、生活质量、心理波动的影响。结果观察组护理后血透室内瘘针滑脱及内瘘针半滑脱发生情况,均低于对照组(P<0.05);观察组护理后满意度均高于对照组(P<0.05);观察组护理后心理、生理、社会关系及环境领域评分,均高于对照组(P<0.05);观察组护理后HAMD,HAMA量表评分均低于对照组(P<0.05)。结论将循证护理模式用于血液透析室中有助于降低内瘘针滑脱发生率,能提高护理满意度,减少患者内心的负性情绪,值得推广应用。

Objective To explore the application effect of evidence-based nursing model reducing the risk of internal fistula slipping in hemodialysis room. Methods From January 2016 to February 2017,to select 6067 patients who accepted hemodialysis in out department,randomly divide them into control group（ with 3033 patients） and observation group（ with 3034 patients）. The control group was treated with conventional nursing methods,while the observation group was given evidence-based nursing model,to record the occurrence of internal fistula slipping in hemodialysis room. To evaluate the satisfaction after received nursing of both groups by means of the self-made satisfaction rating questionnaire. The World Health Organization quality of life questionnaire（ WHOQOL-BREF） was used to summarize the two groups of pre-and post-care quality of life scores in psychology,physiology,social relations,and the environment; anxiety and depression were assessed using the Hamilton anxiety scale（ HAMA） and the Hamilton depression scale（ HAMD）;the effect of internal fistula slipping and satisfaction,quality of life,and psychological fluctuations were compared between the two groups. Results The incidence of internal fistula slipping and half-internal fistula slipping of observation group after received nursing in hemodialysis room were lower than that of control group（ P〈0. 05）,the satisfaction of the observation group after nursing was higher than that of the control group（ P〈0. 05）; the scores of the psychological,physiology,social relation and environmental areas of the observation group after nursing were higher than those of the control group（ P〈0. 05）; the HAMD and HAMA scores of the observation group after nursing were lower than those of the control group（ P〈0. 05）. Conclusion The application of evidence-based nursing model in the hemodialysis room can reduce the incidence of internal fistula slipping,improve nursing satisfaction,and reduce the patient＇s negative emotions,which was worth popularizing and applying.