基于动机性访谈的护理干预对腹膜透析患者容量负荷及自我管理水平的影响

Influence of nursing intervention based on motivational interview on volume load and self-management level of peritoneal dialysis patients

目的探讨基于动机性访谈(MI)的护理干预在腹膜透析(PD)患者中的应用效果。方法选择2018年4月~2020年4月于中山大学附属第三医院粤东医院行PD治疗152例患者,按随机数字表法分为对照组(76例)和观察组(76例)。对照组采取常规干预,观察组在此基础上实施MI护理。比较两组干预前和干预3个月时容量负荷情况、自我管理能力[自我护理能力测定量表(ESCA)]和健康行为[健康促进生活方式量表Ⅱ(HPLP-Ⅱ)]评分。结果干预前两组的容量控制情况、ESCA、HPLP-Ⅱ评分比较,差异无统计学意义(P>0.05)。观察组干预后的收缩压为(132.05±5.74)mmHg、舒张压为(72.84±3.65)mmHg、体重为(63.32±3.22)kg、均低于对照组的(139.26±6.53)mmHg、(79.36±3.25)mmHg、(65.01±3.26)kg;超滤量为(615.88±45.67)mL、尿量为(738.69±57.28)mL,均少于对照组的(678.09±45.16)、(826.54±60.53)mL;ESCA为(114.68±9.05)分、HPLP-Ⅱ为(157.93±22.54)分,均高于对照组的(90.18±8.73)、(126.84±20.19)分,差异有统计学意义(P<0.05)。结论MI护理能够改善PD患者容量负荷情况,提升自我管理水平,促进患者健康行为改善。

Objective To explore the influence of nursing intervention based on motivational interview(MI)in peritoneal dialysis(PD)patients.Methods A total of 152 patients who underwent PD treated in Yuedong Hospital,the Third Affiliated Hospital of Sun Yat-sen University from April 2018 to April 2020 were selected.They were divided into the control group(n=76)and the observation group(n=76)according to the random number table method.In the control group,routine intervention was used,and in the observation group,MI-based nursing on this basis was implemented.The scores of volume load,self-management ability including exercise of self-care agency scale(ESCA),and health behavior tested by health promotion lifestyle profile scaleⅡ(HPLP-Ⅱ)were compared between the two groups before and at 3 months of intervention.Results There were no statistical differences between the two groups of volume control,ESCA or HPLP-Ⅱscore before intervention(P>0.05).After intervention,the systolic blood pressure was(132.05±5.74)mmHg,diastolic blood pressure was(72.84±3.65)mmHg,body weight was(63.32±3.22)kg in the observation group,which were all lower than those of the control group of(139.26±6.53)mmHg,(79.36±3.25)mmHg,(65.01±3.26)kg;ultrafiltration volume was(615.88±45.67)mL and urine volume was(738.69±57.28)mL in the observation group,which were less than those of the control group of(678.09±45.16)and(826.54±60.53)mL;the scores of ESCA and HPLP-Ⅱwere(114.68±9.05)and(157.93±22.54)points in the observation,both higher than those of the control group of(90.18±8.73)and(126.84±20.19)points,with statistical differences(P<0.05).Conclusion MI nursing can improve the volume load of PD patients,enhance the level of self-management,and promote the improvement of patients′health behavior.