PDCA循环干预对血液透析动静脉内瘘患者自我管理能力、并发症、生命质量的影响

Effect of PDCA Circulation Intervention on Self-management Ability,Complications,and Quality of Life in Patients with Hemodialysis Arteriovenous Fistula

目的:分析血液透析动静脉瘘患者实施PDCA循环干预,对患者自我管理能力、生活质量及并发症的影响。方法:选取2020年7月—2021年7月南京医科大学第二附属医院血液净化中心门诊收治的150例血液透析动静脉内瘘患者作为观察对象。应用双色球法将其分为参照组及观察组,各75例。参照组给予常规护理,观察组给予PDCA循环干预。应用中文版癌症自我管理效能感量表(SUPPH)、生命质量测定量表(QLQ-C30)比较两组干预前后的自我管理能力及生命质量;比较两组血液透析期间并发症发生率。结果:干预前,两组自我管理能力及生命质量评分比较,差异无统计学意义(P>0.05);干预后,观察组自我减压、自我决策、正性态度评分均高于参照组,差异有统计学意义(P<0.05);干预后,观察组躯体、角色、认知、情绪、社会功能、疲劳、疼痛、恶心呕吐评分均优于对照组,差异有统计学意义(P<0.05);观察组并发症发生率低于参照组,差异有统计学意义(P<0.05)。结论:血液透析动静脉内瘘患者实施PDCA循环干预,可有效提升患者自我管理能力,提高患者生命质量,并降低血液透析期间的并发症发生率。

Objective:To analyze the effect of PDCA circulation intervention on self-management ability,quality of life and complications of patients with hemodialysis arteriovenous fistula.Method:A total of 150 patients with hemodialysis arteriovenous fistula admitted to the Blood Purification Center of the Second Affiliated Hospital of Nanjing Medical University from July 2020 to July 2021 were selected as the observation objects.The patients were divided into the reference group and the observation group according to the dichromatic method,with 75 cases in each group.The reference group was given routine nursing,and the observation group was given PDCA circulation intervention.The self-management ability and quality of life of the two groups before and after the intervention were evaluated and compared with the Chinese version of strategies used by people to promote health(SUPPH)and quality of life instruments for cancer patients(QLQ-C30).The complication rate during hemodialysis was compared between the two groups.Result:Before intervention,there were no significant differences between the two groups in self-management ability and quality of life scores(P>0.05);after intervention,the scores of self-decompression,self-decision-making and positive attitude in the observation group were significantly higher than those in the reference group,the differences were statistically significant(P<0.05);after intervention,the scores of body,role,cognition,emotion,social function,fatigue,pain,nausea and vomiting in the observation group were significantly better than those in the control group,the differences were statistically significant(P<0.05);the incidence of complications in the observation group was lower than that in the reference group,and the difference was statistically significant(P<0.05).Conclusion:The PDCA circulation intervention in patients with hemodialysis arteriovenous fistula can effectively improve their self-management ability,improve their quality of life,and reduce the rate of complications during hemodialysis.