三段式康复教育模式对维持性血液透析病人知识掌握及生化指标的影响

Influence of three-stage rehabilitation education model on knowledge acquisition and biochemical indexes of patients with maintenance hemodialysis

目的探讨三段式康复教育模式运用于维持性血液透析病人中对知识掌握及生化指标的影响。方法选取海安市人民医院收治的维持性血液透析病人300例,其中2014年6月至2015年12月收治的150例为对照组,采用常规护理模式,2016年6月至2017年12月收治的150例为观察组,采用三段式康复教育模式。比较两组护理前后知识掌握、生化指标及生活质量变化。结果护理前,对照组透析原理、透析作用、用药知识、饮食原则、通路护理、充分性理解、注意事项掌握程度得分分别为(43.63±10.74)、(45.83±11.53)、(41.44±10.86)、(45.76±11.33)、(43.53±13.87)、(44.62±10.57)、(43.65±11.39)分,观察组得分分别为(44.53±10.54)、(45.46±10.95)、(42.62±10.46)、(44.56±11.23)、(45.65±13.47)、(43.52±12.36)、(45.63±11.15)分,护理6个月后,对照组得分分别为(64.73±8.74)、(67.23±8.65)、(68.54±7.46)、(66.64±8.36)、(64.56±9.72)、(64.72±7.54)、(66.45±7.59)分,观察组得分分别为(85.24±5.63)、(83.36±5.85)、(82.63±6.46)、(85.86±6.53)、(86.35±7.44)、(84.55±5.56)、(85.43±5.55)分,观察组各指标得分均高于对照组,差异有统计学意义(P<0.05);护理6个月后,观察组肌酐(SCr)、尿素氮(BUN)、血磷(P)及C反应蛋白(CRP)含量均低于对照组,血红蛋白(Hb)含量高于对照组,差异有统计学意义(P<0.05);护理6个月后,观察组生理、心理、独立性、社会关系、环境、精神支柱评分均高于对照组,差异有统计学意义(P<0.05)。结论三段式康复教育模式运用于维持性血液透析病人可有效提高病人对疾病知识的掌握程度,优化生化指标,提高生活质量,值得临床推广。

Objective To explore the effect of three-stage rehabilitation education model on knowledge acquisition and biochemical indicators in maintenance hemodialysis patients.Methods A total of 150 maintenance hemodialysis patients from June 2014 to December 2015 in Hai’an County Hospital who underwent routine nursing care were selected as the control group.The hemodialysis patients from June 2016 to December 2017,treated with the three-stage rehabilitation education model was recorded as the observation group.The changes of knowledge mastery,biochemical indexes and life quality before and after nursing were compared between the two groups.Results Before nursing,the scores of the dialysis principle,dialysis effect,medication knowledge,diet principle, pathway nursing,sufficiency understanding and precautionary degree of the control group were(43.63 ± 10.74),(45.83 ± 11.53),(41.44±10.86),(45.76±11.33),(43.53±13.87),(44.62±10.57),(43.65±11.39),respectively,while those scored in the observa- tion group were(44.53 ± 10.54),(45.46 ± 10.95),(42.62 ± 10.46),(44.56 ± 11.23),(45.65 ± 13.47),(43.52 ± 12.36),(45.63 ± 11.15)points,separately.After 6 months of nursing,the scores of the control group were(64.73±8.74),(67.23±8.65),(68.54± 7.46).(66.64±8.36),(64.56±9.72),(64.72±7.54),(66.45±7.59)points,and the scores of the observation group were(85.24± 5.63),(83.36±5.85),(82.63±6.46),(85.86±6.53),(86.35±7.44),(84.55±5.56),(85.43±5.55)points.The scores of all indica- tors in the observation group were higher than those of the control group,with statistically significant difference(P<0.05).After 6 months of nursing the level of creatinine(SCr),urea nitrogen(BUN),blood phosphorus(P)and reactive protein(CRP)of the observation group was lower than that of the control group,and the content of hemoglobin(Hb)was higher than that of the control group.The differences were statistically significant(P<0.05).After 6 months of nursing,the physiological,psychological,independent and social relationship of the observation group were observed.The scores of environmental and mental pillars were higher than those of the control group,and the differences were statistically significant(P<0.05).Conclusion The three-stage rehabilitation education model used in maintenance hemodialysis patients can effectively improve their disease knowledge,optimize biochemical indicators,improve quality of life,which is worthy of clinical promotion.