Cox健康行为互动模式在维持性血液透析患者中的应用

Application of Cox interaction model of client health behavior in maintenance hemodialysis patients

目的探讨Cox健康行为互动模式(IMCHB)在维持性血液透析(MHD)患者中的应用效果。方法采用便利抽样法选取2019年9月—2020年9月在长治医学院附属和平医院行规律血液透析的137例患者为研究对象,将周二、四、六透析患者设为对照组(74例),将周一、三、五透析患者设为试验组(63例)。对照组采用常规护理干预,试验组在此基础上采用IMCHB护理干预。分别于干预前、干预3个月后采用血液透析患者自我管理行为量表、健康调查简表(SF-36)及实验室生化指标对两组患者进行评价。结果干预后,试验组的自我管理行为各维度得分均高于对照组,差异有统计学意义(P<0.05)。干预后,试验组的生理功能、生理职能、躯体疼痛、总体健康、社会功能、情感职能、精神健康得分均高于对照组,差异有统计学意义(P<0.05);而两组干预后的活力得分比较,差异无统计学意义(P>0.05)。干预后两组的尿素氮、钾水平比较,差异无统计学意义(P>0.05);试验组干预后的肌酐、血红蛋白、白蛋白、磷水平较对照组改善,差异均有统计学意义(P<0.05)。结论IMCHB可以提高MHD患者的自我管理能力,并且能够改善患者的生活质量及实验室生化指标。

Objective To explore the effect of Cox interaction model of client health behavior(IMCHB)on self-management and quality of life in maintenance hemodialysis(MHD)patients.Methods A total of 137 patients who received regular hemodialysis(HD)at Heping Hospital Affiliated to Changzhi Medical College from September 2019 to September 2020 were selected as the research objects by convenience sampling method.Patients received treatment on Tuesday,Thursday and Saturday were assigned into the control group(74 cases),while patients received treatment on Monday,Wednesday and Friday were assigned into the experimental group(63 cases).Routine nursing intervention was applied in the control group,and IMCHB was applied in the experimental group on the basis of control group.The patients were evaluated by the Self-Management Behavior Questionnaire for hemodialysis patients,the MOS 36-item Short Form Health Survey(SF-36)and laboratory biochemical indicators before the intervention and 3 months after the intervention.Results After intervention,scores of all dimensions of self-management behavior in the experimental group were higher than those in the control group,with statistical significance(P<0.05).After intervention,scores of physical functioning,role-physical,bodily pain,general health,social functioning,role-emotional,mental health of the experimental group were all higher than those of the control group,with statistical significance(P<0.05).There was no statistically significant difference in vitality between the two groups after intervention(P>0.05).There was no statistically significant difference in the levels of urea nitrogen and potassium between the two groups after intervention(P>0.05).After the intervention,the levels of creatinine,hemoglobin,albumin and phosphorus in the experimental group were improved compared with those in the control group,and the differences were statistically significant(P<0.05).Conclusions IMCHB can improve the self-management behavior of MHD patients,and improve the quality of life of patients and laboratory biochemical indicators.