聚焦解决模式下健康教育对非知识型老年维持性血液透析患者自我管理能力的影响

Influence of health education on self-management ability in non-know ledge-based elderly patients with maintenance hemodialysis in a solution-focused mode

目的探讨聚焦解决模式下健康教育对非知识型老年维持性血液透析患者自我管理能力的影响。方法选取2020年3月至2021年3月广水市第二人民医院的114例进行维持性血液透析的老年患者作为研究对象,采用随机分组将其分为观察组和对照组,每组各57例。对照组采用常规健康教育,观察组在此基础上采用聚焦解决模式下健康教育,比较两组患者健康知识掌握情况(疾病知识、饮食原则、用药方法、并发症预防知识、自我护理方法),比较两组的自我管理能力评分[遵医治疗、合理饮食和运动、用药依从性、正确护理内瘘]和干预前、干预3个月后肾功能情况[尿素氮(BUN)、白蛋白(ALB)和血肌酐(SCr)]。结果观察组疾病知识、饮食原则、用药方法、并发症预防知识和自我护理方法掌握程度评分高于对照组,差异有统计学意义(P<0.05)。观察组遵医治疗、合理饮食和运动、用药依从性和正确护理内瘘评分高于对照组,差异有统计学意义(P<0.05)。两组干预前BUN、ALB和SCr水平比较差异无统计学意义(P>0.05),两组干预后BUN、SCr水平均低于本组干预前,ALB水平高于本组干预前,差异有统计学意义(P<0.05),观察组干预后BUN、SCr水平低于对照组,ALB水平高于对照组,差异有统计学意义(P<0.05)。结论给予非知识型老年维持性血液透析患者聚焦解决模式下健康教育能够有效提高患者健康知识掌握程度和自我管理能力,促进患者肾功能改善。

Objective To explore the effect of health education under the solution-focused mode on the self-management ability of non-knowledge-based elderly patients with maintenance hemodialysis.Methods From March 2020 to March 2021,114 elderly patients undergoing maintenance hemodialysis in Guangshui Second People′s Hospital were selected as the research subjects,and randomly divided into observation group and control group(57 cases in each group).In the control group,routine health education was used,and in the observation group,health education under the focus-solution mode was additionally provided.The mastery of health knowledge such as disease knowledge,dietary principles,medication methods,complication prevention knowledge,and self-care methods between the two groups was compared.The self-management ability scores including medical compliance,reasonable diet and exercise,medication compliance,and correct nursing of internal fistula and renal functions such as blood urea nitrogen(BUN),albumin(ALB),and serum creatinine(SCr)before intervention and 3 months after intervention of the two group were compared.Results The scores of disease knowledge,dietary principles,medication methods,complication prevention knowledge and self-care methods in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The scores of medical compliance,reasonable diet and exercise,medication compliance,and correct nursing of internal fistula in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).There were no significant differences in the level of BUN,ALB or SCr between the two groups before intervention(P>0.05).The levels of BUN and SCr in the observation group and the control group after intervention were lower than those before intervention,and the level of ALB was higher than that in the group before intervention,the differences were statistically significant(P<0.05).After intervention,the levels of BUN and Scr in the observation group were lower than those in the control group, and the ALB level was higher than that in the control group, the differences were statistically significant (P<0.05). Conclusion Application of health education under the solution-focused mode in non-knowledge-based elderly patients with maintenance hemodialysis can effectively improve the patient’s health knowledge mastery and self-management ability, and promote the improvement of patient’s renal function.