基于跨理论模型的延续护理对急性肾衰竭血液透析患者生理功能和主观幸福感的影响

Effects of continuous nursing intervention based oncross-theoreticalmodel on physiological function and subjective well-being of acuterenal failure patients requiring hemodialysis

目的探讨基于跨理论模型的延续护理干预对急性肾衰竭血液透析患者生理功能的影响及主观幸福感的提升作用。方法将2016年12月—2018年1月于哈励逊国际和平医院进行血液透析治疗的急性肾衰竭患者102例纳入本研究,应用随机数字表法将其分成对照组与研究组,对照组仅给予基础性的护理干预,研究组给予以跨理论模型为基础的延续护理干预,观察分析2组患者营养状况、生活质量、肾功能及主观幸福感的变化。结果干预后2组患者的营养状况有所好转,研究组主观整体营养评估(SGA)、营养不良-炎症评分(MIS)同对照组比较均更低,差异有统计学意义(P<0.05);干预后研究组患者生活质量各维度的得分均高于对照组(P<0.05);干预前2组患者肾功能相关指标无明显差异,干预后研究组患者血肌酐(Cr)、尿素氮(BUN)明显低于对照组(P<0.05);干预后研究组患者自我效能、幸福感受、一般情况、自信心评分均高于对照组,差异均有统计学意义(P<0.05)。结论基于跨理论模型的延续护理方案可改善急性肾衰竭血液透析患者的生理功能、主观幸福感以及生活质量,是一种有效的护理手段,值得推广应用。

Objective To explore the effects of continuous nursing intervention based on cross-theoretical model on the physiological function and subjective well-being of acute renal failure patients requiring hemodialysis.Methods A total of 102 acute renal failure patients who underwent hemodialysis in Harrison International Peace Hospital from December 2016 to January 2018 were included in this study.According to the random number table method,they were divided into two groups:a control group and a research group.During the treatment,the control group was given basic nursing intervention,while continuous nursing measures were formulated based on the cross-theoretical model for the research group.The changes of nutritional status,quality of life,physiological function and subjective well-being were analyzed.Results After treatment and intervention,both groups presented improvement in nutritional status.The research group showed a lower score of subjective global nutrition assessment(SGA),malnutrition-inflammation score(MIS)than the control group(P<0.05).The research group also presented a higher average score in the eight dimensions of quality of life,compared with the control group(P<0.05).Before treatment,there was no significant difference in the indicators related to renal function between the two groups.However,after treatment,the research group produced remarkably decreased levels of serum creatinine(Cr)and urea nitrogen(BUN)(P<0.05),as well as increased scores of self-efficacy,well-being,general condition and self-confidence,compared with the control group(P<0.05).Conclusions nursing intervention based on cross-theoretical model is effective to improve the physiological function,subjective well-being and quality of life of acute renal failure patients requiring hemodialysis.