Orem支持-教育系统理论在血液透析患者自体动静脉内瘘护理中的应用

Application of nursing interventions based on Orem support-education system theory for patients with autogenous arteriovenous fistula for hemodialysis

目的探讨Orem自护理论中的支持-教育系统在血液透析患者自体动静脉内瘘护理中的应用效果。方法采用便利抽样法,抽取医院血液透析中心登记血液透析患者60例作为研究对象。按透析时间进行分组,透析时间为周一、三、五的30例患者为干预组,在常规教育基础上给予3个月支持-教育系统干预,透析时间为周二、四、六的30例患者为对照组,给予常规健康教育。干预3个月后对两组患者的AVF自我护理行为水平和瘘管失功情况进行比较。结果干预后,两组血液透析患者动静脉内瘘自我护理行为量表(ASBHD–AVF)得分均较干预前提高,且干预组ASBHD–AVF量表得分高于对照组,差异有统计学意义(P<0.05)。干预组内瘘狭窄、感染和血栓形成发生率较对照组低,差异有统计学意义(P<0.05)。结论Orem支持-教育系统不仅提高血液透析患者自体动静脉内瘘自我护理行为水平,而且对降低动静脉内瘘并发症的发生率具有重要意义。

Objective To evaluate the Orem support-education system theory in nursing of patients with autogenous arteriovenous fistula(AVF)for hemodialysis.Methods By the convenience sampling method,60 cases of registered hemodialysis patients were recruited and divided into two groups by dialysis date:30 cases in the control group(receiving dialysis on Tuesday,Thursday and Saturday)were given routine health education,and 30 cases in the intervention group(receiving dialysis on Monday,Wednesday and Friday)were given 3 months Orem support-education system intervention on the basis of conventional education.The self-care behavior level and dysfunction of arteriovenous fistula were measured and compared between two groups.Results After the intervention,the score of assessment of self-care behaviors with arteriovenous fistula in hemodialysis(ASBHD-AVF)increased in both two groups and ASBHD-AVF score was significantly higher in the intervention group than that in the control group(P<0.05).The incidence of internal fistula stenosis,infection and thrombosis in the intervention group was significantly lower than that in the control group(P<0.05).Conclusion Orem support-education system not only improves the level of self-care behavior of patients autogenous arteriovenous fistula for hemodialysis,but also plays an important role in reducing the incidence of arteriovenous fistula complications.