多学科协作团队模式下透析期间运动干预改善老年维持性血液透析病人生活质量及睡眠质量的效果研究

Effects of exercise intervention during dialysis on quality of life and sleep quality in elderly patients receiving maintenance hemodialysis under the model of multi-disciplinary team

目的探究透析期间多学科协作团队模式下运动干预对老年维持性血液透析病人生活质量及睡眠质量的改善效果。方法将68例病人随机分为试验组和对照组,每组34例,分别在多学科协作团队和透析日责任护士带领下进行为期6个月的运动干预。选取第1、3、6个月作为时间节点,分别采用健康状况调查简表(SF-36)和匹兹堡睡眠质量指数(PSQI)评估2组生活质量及睡眠质量。结果干预结束时,试验组和对照组完成干预的病人数分别为32例和29例。干预1、3、6个月时,2组PSQI得分均逐渐减少(P<0.05)。试验组的生理健康评分(physical component summary,PCS)和心理健康评分(mental component summary,MCS)随干预时间逐渐增加(P<0.05),对照组干预3、6个月时的PCS评分均显著高于干预1个月时,干预6个月时的MCS评分显著高于干预1、3个月时(P<0.05)。干预6个月时,试验组PCS和MCS评分显著高于对照组(P<0.05);干预3、6个月时,试验组PSQI评分显著低于对照组(P<0.05)。结论多学科协作团队模式可以减少病人运动干预退出情况,且对老年维持性血液透析病人生活质量和睡眠质量的中、远期改善效果优于由责任护士主导的运动干预。

Objective To explore the improvement effect of exercise intervention during dialysis on quality of life and sleep quality in the elderly patients receiving maintenance hemodialysis under the model of multi-disciplinary team.Methods A total of 68 patients were randomly divided into two groups with 34 cases in each group,the experimental group receiving multi-disciplinary team intervention and the control group receiving the duty nurse on dialysis day intervention.They were given exercise intervention for 6 months.The scores of life quality investigated by Chinese version of SF-36 Health Survey Scale,and sleep quality investigated by Pittsburgh Sleep Quality Scale,PSQI of the two groups were compared 1,3 and 6 months after intervention.Results At the end of intervention,the number of patients in the experimental group and the control group who completed the intervention was 32 and 29,respectively.After 1,3 and 6 months of intervention,the scores of PSQI of the two groups were gradually and significantly decreased;The scores of physical component summary(PCS)and mental component summary(MCS)of the experimental group were gradually and significantly increased(P<0.05),while in the control group,the score of PCS 3,6 months after intervention was significantly higher than that of 1 month affter intervention,the score of MCS 6 months after intervention was significantly higher than that 1,3 months after intervention.After 6 months of intervention,PCS and MCS scores of the experimental group were significantly higher than those of the control group(P<0.05).3 and 6 months after intervention,PSQI score of the experimental group was significantly lower than that of the control group(P<0.05).Conclusions The multi-disciplinary team model can reduce patients’withdrawal from exercise intervention,and has a better middle and long term effect on the quality of life and sleep quality than the nurse intenvention model.