责任个体化护理模式对血液透析患者自我效能及血糖水平、生活质量的影响

Effect of individualized nursing mode on self-efficacy, blood glucose level and quality of life in hemodialysis patients

目的探讨责任个体化护理模式在血液透析患者中的护理效果及对患者自我效能、血糖水平和生活质量的影响。方法选择2016年7月—2018年2月收治的血液透析患者94例,采用随机数字表分为对照组(47例)和观察组(47例)。对照组给予常规护理,观察组采用责任个体化护理模式,15 d护理后对患者效果进行评估。采用慢性病自我效能量表(CDSES)对2组护理前、护理后15 d从情绪控制、合理休息、疼痛及不适的控制、自我保健、遵医用药管理及健康问题自我效能进行评估;采用生化检测测定2组护理前后尿素氮(BUN)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)及血清肌酐(Scr)水平;采用生活质量量表(QOL)对2组生活质量进行评估,比较2组护理效果及对自我效能、血管水平的影响。结果观察组护理后15 d情绪控制、合理休息、疼痛及不适的控制、自我保健、遵医用药管理及健康问题评分高于对照组(均P<0.05);观察组护理后BUN、FBG、HbA1c及Scr水平均低于对照组(均P<0.05),认知、角色、躯体、情绪及社会角度评分,均高于对照组(均P<0.05)。结论责任个体化护理模式用于血液透析患者中能提高患者自我效能,改善患者血糖水平,有助于患者生活质量的提高,值得推广应用。

Objective To explore the nursing effect of individualized nursing model of responsibility in hemodialysis patients and its effect on patient self-efficacy and blood glucose level. Methods A total of 94 hemodialysis patients admitted from March 2016 to February 2018 were enrolled. The random number table was divided into control group(n=47) and observation group(n=47). The control group received routine care, and the observation group used the responsibility individualized nursing mode to evaluate the patient’s effect after 15 days of nursing. The chronic disease self-efficacy energy table(CDSES) was used to evaluate emotional control, reasonable rest, pain and discomfort, self-care, compliance with medical drug management and self-efficacy of health problems before and after 15 days of care. The levels of urea nitrogen(BUN), fasting blood glucose(FBG), glycosylated hemoglobin(HbA1 c) and serum creatinine(Scr) were measured before and after 15 days of treatment. The quality of life of the two groups was assessed by quality of life scale(QOL). The effects of the two groups of nursing and their effects on self-efficacy and blood vessel levels were compared. Results The control of emotional control, reasonable rest, pain and discomfort, self-care, compliance with medical drug management and health problems scores in the observation group were higher than those in the control group(all P<0.05). In the observation group, BUN, FBG, the levels of HbA1 c and Scr were lower than those in the control group(all P<0.05). The scores of cognition, role, physical, emotional and social angles in the observation group were higher than those in the control group(all P<0.05). Conclusion The use of responsible individualized nursing mode in hemodialysis patients can improve patients’ self-efficacy, improve patients’ blood glucose levels, and contribute to the improvement of patients’ quality of life. It is worthy of popularization and application.