认知行为干预对血液透析患者跌倒的影响

Effect of Cognitive Behavior Intervention on Falls in Hemodialysis Patients

目的探讨认知行为干预对血液透析患者跌倒的影响。方法选取粤北人民医院血液净化中心2021年7月-2022年10月收治的215例血液透析患者,进行自身对照研究。以2022年3月1日认知行为干预实施为界,对比同一组患者在2021年7月-2022年2月接受常规宣教期间,以及在2022年3-10月接受认识行为干预期间跌倒风险的差异。结果215例研究对象均完成相应的治疗、检查以及问卷调查。共发放调查问卷215份,收回215份,有效回收率100%。干预后,研究对象的跌倒风险评估单各项指标评分以及总分均低于干预前,差异有统计学意义(P<0.05)。干预前后研究对象的跌倒风险评估单评分分层比较,差异有统计学意义(P<0.05)。干预前的8个月内,跌倒事件发生率为13.49%;干预后的8个月内,跌倒事件发生率为2.79%;两组相比,干预后跌到不良事件的发生率更低(χ^(2)=16.454,P<0.001)。结论认知行为干预能够有效提升血液透析患者对跌倒风险的认识,进而改善行为,有效规避潜在的跌倒风险,避免因跌倒产生的不良事件,对患者预后具有积极意义。此文的研究结果为血液透析患者跌倒防护的后期标准制定提供了借鉴内容。

Objective To explore the effect of cognitive behavior intervention on falls in hemodialysis patients.Methods A prospective self-control study was conducted on 215 hemodialysis patients admitted to the blood purification center,Yuebei People's Hospital from July 2021 to October 2022.With the implementation of cognitive behavior intervention on March 1,2022 as the boundary,the fall risk difference of the same group of patients during the period of receiving routine education from July 2021 to February 2022 and during the period of receiving cognitive behavior intervention from March to October 2022 was compared.Results All 215 subjects completed the corresponding treatment,examination and questionnaire survey.A total of 215 questionnaires were issued and 215 were recovered,with an effective recovery rate of 100%.After the intervention,the scores of all indicators and the total scores of the fall risk assessment sheet of the study subjects were lower than those before the intervention,and the difference was statistically significant(P<0.05).There was also a statistically significant difference in the scores of fall risk assessment before and after intervention(P<0.05).In the eight months before intervention,the incidence of falls was 13.49%.Within 8 months after intervention,the incidence of falls was 2.79%.Compared with the two groups,the incidence of adverse events after intervention was lower(χ^(2)=16.454,P<0.001).Conclusion Cognitive behavioral intervention can effectively improve the understanding of fall risk of hemodialysis patients,thereby improving their behavior,effectively avoiding potential fall risks,and avoiding adverse events caused by falls,which is of positive significance for the prognosis of patients.The research results of this article provide reference content for the later development of standards for fall prevention in hemodialysis patients.