自我管理个体干预在维持性血液透析患者中的应用

Application of self-management individual intervention in maintenance hemodialysis patients

目的:探讨自我管理个体干预对血液透析患者负性情绪及自护能力的影响。方法:采用便利抽样法,选取河南省某三级甲等综合医院2016年10月—2017年10月收治的100例慢性肾衰竭行血液透析治疗的患者作为对照组,另外选取2017年11月—2018年11月收治的慢性肾衰竭行血液透析治疗的患者100例作为观察组。两组患者入院后均接受规律维持性血液透析治疗,对照组治疗期间接受常规护理干预,观察组在对照组基础上行自我管理个体干预。比较两组干预前后的汉密顿焦虑量表(HAMA)、汉密顿抑郁量表(HAMD)及自我护理能力量表(ESCA)评分。结果:观察组干预后的HAMA、HAMD评分低于干预前及对照组干预后,差异有统计学意义(P<0.05)。观察组干预后的自我概念、自护技能、自护责任感、健康知识水平及ESCA总分高于干预前及对照组干预后,差异有统计学意义(P<0.05)。结论:慢性肾衰竭患者血液透析期间行自我管理个体干预能够缓解患者焦虑、抑郁情绪,提高患者自我护理能力,值得临床应用。

Objective:To explore the effect of self-management individual intervention on negative emotion and self-care ability of hemodialysis patients.Methods:By the convenient sampling method,a total of 100 patients with chronic renal failure who received hemodialysis from October 2016 to October 2017 in a Class Ⅲ Grade A general hospital were selected as the control group.In addition,100 patients with chronic renal failure who underwent hemodialysis from November 2017 to November 2018 were selected as the observation group.Patients in both groups received regular maintenance hemodialysis after admission.The control group was given routine nursing intervention during treatment,while the observation group was given self-managed individual intervention on the basis of the control group.The Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale(HAMD)and Exercise of Self-Care Agency Scale(ESCA)scores were compared between the two groups before and after intervention.Results:HAMA and HAMD scores after intervention in the observation group were lower than those before intervention and those in the control group after intervention,and the differences were statistically significant(P<0.05).After intervention,the dimensions scores of self-concept,self-care skills,self-care responsibility,health knowledge and total score of ESCA in the observation group were higher than those before intervention and those in the control group after the intervention,and the differences were statistically significant(P<0.05).Conclusions:Self-management individual intervention during hemodialysis in patients with chronic renal failure can alleviate anxiety and depression of patients and improve their self-care ability,which is worthy of clinical application.