维持性血液透析患者基于循证理论的集束化延续护理措施的制订及应用

Formulation and application of clustered continuous nursing measures based on evidence-based theory for maintenance hemodialysis patients

目的构建维持性血液透析(MHD)患者基于循证理论的集束化延续护理措施,并探讨其应用效果。方法选择2020年1月至6月云南省某三甲医院收治的80例MHD患者作为研究对象,采用随机分组法将其分为对照组和干预组,每组40例。对照组采取常规护理模式,干预组采用基于循证理论的集束化延续护理措施。比较两组的自护能力、生存质量、透析期间体重增加(IDWG)值达标情况、动静脉瘘(AVF)并发症发生情况。结果干预6个月后,干预组的自我概念、自我护理技能、自我责任感、健康知识水平评分及总分明显高于对照组(P<0.05)。干预6个月后,干预组的肾脏病生存质量简表(KDQOL-SFTM)评分虽略高于对照组,但差异无统计学意义(P>0.05)。干预6个月后,干预组的IDWG值达标人数占比明显高于对照组(P<0.05)。干预组的AVF并发症总发生率虽略低于对照组,但差异无统计学意义(P>0.05)。结论基于循证理论的集束化延续护理措施能提高MHD患者的自护能力,改善生存质量,控制体重,减少AVF并发症的发生。

Objective To construct clustered continuous nursing measures based on evidence-based theory for maintenance hemodialysis(MHD)patients,and to explore its application effect.Methods A total of 80 MHD patients admitted to a tertiary hospital in Yunnan province from January to June 2020 were selected as the research objects,and the patients were divided into control group and intervention group by random grouping method,with 40 cases in each group.The control group adopted routine nursing mode,and the intervention group adopted clustered continuous nursing measures based on evidence-based theory.The self-care ability,quality of life,reaching the standard of interdjalytic weight gain(IDWG)value during dialysis and arteriovenous fistula(AVF)complications were compared between the two groups.Results After 6 months of intervention,the self-concept,self-care skills,sense of responsibility,health knowledge level scores,and total score of the intervention group were significantly higher than those of the control group(P<0.05).After 6 months of intervention,the Kidney Disease Quality of Life-Short Form(KDQOL-SFTM)score of the intervention group was slightly higher than that of the control group,but the difference was not statistically significant(P>0.05).After 6 months of intervention,the proportion of IDWG value reaching the standard in the intervention group was significantly higher than that in the control group(P<0.05).The total incidence of AVF complications in the intervention group was slightly lower than that in the control group,but the difference was not statistically significant(P>0.05).Conclusion The clustered continuous nursing measures based on evidence-based theory can improve the self-care ability of MHD patients,improve quality of life,control weight,and reduce the occurrence of AVF complications.