居家腹膜透析患者网络访视及护理干预的效果评价

Effect Evaluation of Online Visit and Nursing Intervention on Patients on Peritoneal Dialysis at Home

目的探讨基于微信平台的网络访视及护理干预在居家腹膜透析患者中的应用效果,以期提高患者的自我管理能力,减少透析相关并发症。方法采用方便抽样法选取2017年10月-2018年3月在复旦大学附属华山医院腹膜透析中心建档随访的30例居家腹膜透析患者为研究对象,运用微信群及视频通话等方式对其进行网络访视并针对性实施护理干预。采用自行编制的"居家腹膜透析患者考核表"于干预前、干预后1个月、3个月及6个月时分别对患者的各项操作进行在线考核评价。结果干预后1个月、3个月及6个月时,患者对于腹膜透析环境、透析液更换操作、透析导管出口处护理以及药物管理4项考核内容的平均得分均高于干预前,差异有统计学意义(P<0.001)。结论网络访视及护理干预有助于规范居家腹膜透析患者的透析操作流程,对提高患者的自我管理能力、减少并发症有积极促进作用。

Objective To investigate the effect of WeChat-based online visit and nursing intervention on patients receiving peritoneal dialysis at home,so as to improve patients'self-management ability and reduce dialysis-related complications.Methods A total of 30 patients on peritoneal dialysis at home who were archived at and followed up by the Peritoneal Dialysis Center of Huashan Hospital Affiliated to Fudan University from October 2017 to March 2018 were selected as the study subjects by convenience sampling.They were visited online in WeChat groups by video calls;besides,targeted nursing intervention was implemented.A self-developed Evaluation Form of Patients on PD at Home was used to conduct online evaluation of various operations of patients before intervention and at 1 month,3 months and 6 months after intervention.Results At 1 month,3 months and 6 months after intervention,the mean scores of 4 items including PD settings,dialysate replacement operation,nursing at dialysis catheter outlet and drug administration were higher than those before intervention,and the differences were of statistical significance(P<0.001).Conclusion Online visit and nursing intervention are helpful to standardize the operation process of PD at home,and can improve the self-management ability of patients and reduce complications.