认知行为干预对血液透析伴高磷血症病人疾病知识及自护能力的影响

Effect of cognitive behavioral intervention on disease management in patients with hemodialysis and hyperphosphatemia

[目的]探讨认知行为干预对血液透析伴高磷血症病人疾病知识水平、自护能力及病情控制的影响。[方法]选取本院收治的124例血液透析伴高磷血症病人,根据随机数字表法将病人分为观察组及对照组各62例,对照组行常规性护理指导,观察组在对照组基础上实施认知行为干预,干预时间为3个月,比较干预前后两组病人疾病管理能力及病情控制效果。[结果]观察组病人干预后科学饮食、运动锻炼、用药治疗、并发症监测等方面知识评分高于对照组(P<0.05)。观察组干预后自护能力总评分及治疗依从性评分较对照组明显提高(P<0.05)。观察组干预后血磷水平较对照组明显下降(P<0.05),而血钙水平、钙磷乘积较对照组升高(P<0.05)。[结论]认知行为干预能有效提高血液透析伴高磷血症病人疾病知识水平及治疗依从性,从而降低血磷水平,提高治疗效果。

To investigate the effect of cognitive behavioral intervention on disease management and disease control in herod- dialysis patients with hyperphosphatemia. Methods： 124 cases of patients with hemodialysis and hyperphosphatemia were divided into observtion group （n=62） and control group（n=62） according to random number table from September 2016 to June 2017. The con- trol group was underwented with routine nursing guidance and observation group was underwented with cognitive behavioral interven- tion on the basis of the control group. The intervention time was 3 months. The disease management ability and disease control effect of two groups before and after intervention were compared. Results ：The scores of management ability of observation group after in- tervention were higher than control group（P^0.05）, such as scientific diet,exercise training,drug treatment and complication moni- toring. The score of self- care ability and each dimension score of observauon group after intervention was higher than those of the control group（P〈0.05）. The levels of serum phosphorus of observation group was lower than control group（P〈0.05） ,but the ser- um calcium level and calcium-phosphorus product were higher than control group（P〈0. 05 ）. Conclusion. Cognitive and behavioral intervention can effectively improve the ability of disease management in hemodialysis patients with hyperphosphatemia, so as to re- duce the level of serum phosphorus and improve the therapeuuc effect of patients.