认知图式健康宣讲对糖尿病肾衰竭血液透析患者心理状况、生活质量的影响

Effect of Cognitive Schema Health Education on Psychological Status and Quality of Life in Patients with Diabetic Renal Failure Undergoing Hemodialysis

目的 探究认知图式健康宣讲对糖尿病肾衰竭血液透析患者心理状况、生活质量的影响。方法 选取2019年8月—2020年8月于厦门大学附属第一医院予以用药指导等干预的糖尿病肾衰竭患者47例,纳入对照组;选取2020年9月—2021年9月于本院予以认知图式健康宣讲的糖尿病肾衰竭患者47例,纳入观察组。比较干预前、透析1次后、透析4次后两组患者心理状况;记录透析1次后及透析4次后,两组患者生活质量、干预认可度;对比干预前、透析4次后,两组患者血糖水平。结果 透析1次后及透析4次后较透析前,两组患者HAMD量表、HAMA量表评分均有下降,且观察组低于同时间点对照组,差异有统计学意义(P<0.05)。透析4次后较透析1次后,两组SF-36量表、SDM-Q-9问卷、CollaboRATE量表评分均有上升,且观察组高于对照组,差异有统计学意义(P<0.05)。透析4次后较干预前,两组患者FPG、2 hPG水平均有降低,且观察组低于对照组,差异有统计学意义(P<0.05)。结论 认知图式健康宣讲能帮助糖尿病肾衰竭患者在透析后改善心理状况,提高透析后生活质量,增加患者对干预模式及医护人员的认可程度。

Objective To explore the effect of cognitive schema health education on the psychological status and quality of life of diabetic renal failure patients with hemodialysis.Methods A total of 47 patients with diabetic renal failure who received interventions such as medication finger in the First Affiliated Hospital of Xiamen University from August 2019 to August 2020 were selected and included in the control group.A total of 47 patients with diabetic renal failure who received cognitive schema health education in the hospital from September 2020 to September 2021 were selected and included in the observation group.The psychological status of the two groups of patients was compared before the intervention,after 1 time of dialysis,and after 4 times of dialysis.The quality of life and intervention acceptance of the two groups of patients were recorded after 1 time of dialysis and 4 times of dialysis.The blood glucose levels of the two groups were compared before the intervention and after 4 times of dialysis.Results Compared with before dialysis,the scores of HAMD scale and HAMA scale in the two groups were decreased after 1 time of dialysis and4 times of dialysis.And the observation group was lower than the control group at the same time point,and the difference was statistically significant(P<0.05).After 4 times of dialysis compared with 1 time of dialysis,the scores of SF-36 scale,SDM-Q-9 questionnaire and CollaboRATE scale in the two groups all increased,and the observation group was higher than the control group,and the difference was statistically significant(P<0.05).After 4 times of dialysis,compared with before intervention,the levels of FPG and 2 hPG in the two groups were decreased,and the observation group was lower than the control group,the difference was statistically significant(P<0.05).Conclusion Cognitive schema health promotion can help diabetic renal failure patients improve their psychological status after dialysis,improve their quality of life after dialysis,and increase patients’ recognition of the intervention model and medical staff,which has clinical application value.