信息-动机-行为技巧模型的延伸服务对居家腹膜透析患者蛋白质与能量摄入的影响

Effect of information-motivation-behavioral skills model-based extended service on protein and energy intake in patients with home peritoneal dialysis

目的探讨基于信息-动机-行为技巧(IMB)模型的延伸服务对居家腹膜透析患者蛋白质与能量摄入的影响。方法选取90例居家腹膜透析患者,根据随机数字表法分为对照组和干预组,每组45例。对照组给予常规门诊、电话以及微信随访,干预组给予基于IMB模型的延伸服务。比较干预前后两组患者每日蛋白质摄入(DPI)、每日热量摄入(DEI)、胃肠道症状发生率、血红蛋白、ALB、血清前白蛋白、血钙、血磷水平以及主观综合营养评估(SGA)得分情况。结果干预3个月、6个月后,干预组患者DPI、DEI均高于对照组,SGA得分均低于对照组(均P<0.05)。干预3个月后,干预组患者ALB水平高于对照组(P<0.05)。干预6个月后,干预组患者胃肠道症状发生率低于对照组,血红蛋白、ALB、前白蛋白水平均高于对照组(均P<0.05)。治疗前后两组患者血钙、血磷水平差异无统计学意义(均P>0.05)。结论基于IMB模型的延伸服务可以提高居家腹膜透析患者蛋白质与能量摄入,在改善患者营养状态的同时不增加高磷血症发生风险。

Objective To investigate the effect of information-motivation-behavioral skills(IMB)model-based extended service on protein and energy intake in patients with home peritoneal dialysis.Methods Ninety patients with home peritoneal dialysis were divided into control group and intervention group by the random number table method,with 45 cases in each group.The control group was given routine outpatient follow-up,telephone follow-up and WeChat follow-up,while the intervention group was given IMB model-based extended services.Daily protein intake(DPI),daily energy intake(DEI),incidence rate of gastrointestinal symptoms,levels of hemoglobin,serum ALB,serum prealbumin,serum calcium and serum phosphorus,and Subjective Global Nutritional Assessment(SGA)scores were compared between the two groups before and after intervention.Results Three and 6 months after intervention,the intervention group had higher DPI and DEI but lower SGA scores than the control group(all P<0.05).Three months after intervention,the invention group reported a higher ALB level than the control group(P<0.05).Six months after intervention,the intervention group exhibited a lower incidence rate of gastrointestinal symptoms,and higher levels of hemoglobin,ALB and prealbumin in comparison with the control group(all P<0.05).There was no statistically significant difference in serum calcium or serum phosphorus level between the two groups before and after treatment(all P>0.05).Conclusion IMB model-based extended service can promote protein and energy intake in patients with home peritoneal dialysis,improving their nutritional state and not increasing the risk of developing hyperphosphatemia simultaneously.