基于行为分阶段转变理论的低磷饮食干预对维持性血液透析患者皮肤瘙痒及睡眠障碍的影响

Effects of low-phosphorus diet intervention on skin pruritus and sleep disturbance in patients undergoing maintenance hemodialysis based on behavioral staged change theory

目的探讨基于行为分阶段转变理论的低磷饮食干预对维持性血液透析(MHD)患者血磷水平、皮肤瘙痒及睡眠障碍的影响。方法选取2019年11月至2020年12月80例MHD患者随机分为研究组和对照组,每组40例。对照组患者实施常规饮食干预,研究组患者在此基础上采用基于行为分阶段转变理论的低磷饮食干预措施。干预前后,检测2组患者血磷、血钙水平,采用四项目瘙痒量表(FIIQ)中文版评估2组患者瘙痒程度,采用匹兹堡睡眠质量指数量表(PQSI)评估2组患者睡眠状况。结果干预后研究组患者血磷水平(1.83±0.29)mmol/L、钙磷乘积(59.45±10.76)mg^(2)/dl^(2)低于对照组患者(2.42±0.37)mmol/L、(68.22±11.72)mg^(2)/dl^(2),差异有统计学意义(P<0.05);研究组患者FIIQ量表中瘙痒分布部位、严重程度、频率、对睡眠的影响评分及总分低于对照组,差异有统计学意义(P<0.05);研究组患者PSQI量表中睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、催眠药物、日间功能障碍评分及总分低于对照组,差异有统计学意义(P<0.05)。结论基于行为分阶段转变理论的低磷饮食干预有助于降低患者血磷水平,改善其皮肤瘙痒症状及睡眠障碍。

Objective To investigate the effects of low-phosphorus diet intervention on serum phosphorus level,skin pruritus and sleep disturbance in patients undergoing maintenance hemodialysis(MHD)based on the behavioral staged change theory.Methods A total of 80 patients who underwent MHD in our hospital from November 2019 to December 2020 were randomly divided into research group and control group,with 40 cases in each group.The patients in control group were given routine dietary intervention,while the patients in research group were given the low-phosphorus diet intervention based on the behavioral staged change theory.Before and after the intervention,the levels of serum phosphorus and calcium in the two groups were detected.The four-item itch questionnaire(FIIQ)(Chinese version)was used to evaluate the degree of pruritus in the two groups,and the Pittsburgh Sleep Quality Index(PSQI)was used to evaluate the sleep status of the two groups.Results After intervention,the serum levels of phosphorus and the calcium-phosphorus product in research group were significantly lower than those in control group(P<0.05).The region of distribution,severity,frequency,impact on sleep and total score of itching in the FIIQ scale in research group were significantly lower than those in control group(P<0.05).The sleep quality,sleep onset time,duration of sleep,sleep efficiency,sleep disturbance,hypnotic drugs,daytime dysfunction score and total score in PSQI scale in research group were significantly lower than those in control group(P<0.05).Conclusion Low-phosphorus diet intervention based on the behavioral staged change theory can help decrease the serum levels of phosphorus,so as to improve the symptoms of pruritus and sleep disturbances of patients.