动机性访谈对维持性血液透析患者自我管理能力及生活质量的影响

The impact of motivational interview on self-management ability and quality of life in maintenance hemodialysis patients

目的探讨动机性访谈对维持性血液透析患者自我管理能力及生活质量的影响。方法选取浙江省人民医院血液净化中心维持性血液透析患者100例,按照透析时间分为干预组50例和对照组50例。对照组采用传统的健康教育方法,干预组实施动机性访谈,干预前、干预6个月后用自我管理量表和肾脏疾病特异性调查表对患者自我管理能力和生活质量进行评价。结果自我管理能力评分中伙伴关系、问题解决、情绪处理、实施自我护理及总分干预组均高于对照组,差异有统计学意义(t值分别为20.131、13.645、12.213,15.012、17.043,P值分别为0.021、0.012、0.023、0.001、0.004),生活质量评分中躯体症状、疲劳、与他人的关系得分和总分干预组均高于对照组,差异有统计学意义(t值分别为10.586、3.560、3.959、4.574,P值分别为0.001、0.001、0.001、0.001)。结论动机性访谈可以提高维持性血液透析患者的自我管理能力和生活质量,值得在临床推广。

Objective To investigate the impact of motivational interview on self-management ability and quality of life in maintenance hemodialysis(MHD)patients.Methods A total of 100 MHD patients were recruited in a top-level hospital in Hangzhou city.According to the duration of hemodialysis,the patients were divided into the intervention group(n=50)and the control group(n=50).The control group adopted the traditional health education method,and the intervention group received the motivational interview.Self-management scale and kidney disease specific questionnaire were used to evaluate their self-management ability and quality of life before intervention and after the intervention for 6 months.Results In the scores of selfmanagement ability,partnership,problem solving,emotional processing,self-care and total score were statistically higher in the intervention group than in the control group(t=20.131,13.645,12.213,15.012 and 17.043 respectively;P=0.021,0.012,0.023,0.001 and 0.004 respectively).In the scores of quality of life,somatic symptoms,fatigue,relationship with others and total score were statistically higher in the intervention group than in the control group(t=10.586,3.560,3.959 and 4.574 respectively;P=0.001,0.001,0.001 and 0.001 respectively).Conclusion Motivational interview can improve the self-management ability and quality of life in MHD patients.