医护一体化管理模式在血液透析高磷血症患者中的效果

Effects of integration of medical-nursing care on hemodialysis patients with hyperphosphatemia

目的探讨医护一体化管理模式对提高血液透析高磷血症(血磷>1.78mmol/L)患者健康管理知识与降低血磷指标的效果。方法采用完全随机对照研究设计,将80例血液透析高磷血症患者随机分为对照组和干预组,对照组采用护士主导的常规健康教育,干预组成立医护一体化专项管理小组,制定医护一体化管理流程,共同参与学习培训,建立关键环节治疗指标,进行持续质量改进。干预时间持续6个月。结果干预组患者实施医护一体化管理后血磷指标为(1.80±0.16)mmol/L,低于对照组的(2.06±0.15)mmol/L,差异具有统计学意义(t=7.498,P<0.001);干预组的疾病知识得分(94.90±1.45比92.78±1.46,t=6.156,P<0.001)、饮食知识得分(93.53±1.48比92.15±1.33,t=3.486,P<0.001)、服药知识得分(93.90±1.39比92.45±1.28,t=4.853,P<0.001),运动规律知识得分(92.20±1.22比91.43±1.30,t=2.732,P=0.008)均显著高于对照组,差异均具有统计学意义。结论医护一体化管理有利于提高血液透析高磷血症患者的健康管理知识,控制血磷指标,值得临床进一步推广。

Purpose To explore the effects of integration of medical-nursing care on health-related knowledge and serum phosphorus in hemodialysis patients with hyperphosphatemia. Methods This study used a randomized controlled trial with 80 cases randomized into two groups. Results Serum phosphorus of the patients in the intervention group was 1.80±0.16 mmol/L, which was lower than that of the control group（2.06±0.15 mmol/L）, and the difference was statistically significant（t=7.498 P〈0.001）. In patients in the intervention group, the scores of disease knowledge（94.90 ± 1.45 vs. 92.78 ± 1.46, t=6.156, P〈0.001）, diet knowledge（93.53 ± 1.48 vs. 92.15 ± 1.33, t=3.486, P〈0.001）, medicine knowledge about hyperphosphatemia（93.90±1.39 vs. 92.45±1.28, t=4.853, P〈0.001）, and sports knowledge（92.20±1.22 vs. 91.43±1.30, t=2.732,P=0.008） were higher as compared with those in patients in the control group. Conclusions Integration of medical-nursing care can improve health-related knowledge and reduce serum phosphorus in hemodialysis patients with hyperphosphatemia.