健康促进模型在维持性血液透析患者高磷血症护理中的应用

Application of nursing intervention based on Health Promotion Model in the management of patients with hyperphosphatemia receiving Maintenance Hemodialysis

目的:评价健康促进模型在维持性血液透析高磷血症患者护理中的应用效果,为高磷血症临床管理实践提供参考。方法:纳入2019年7月—11月某三级甲等医院血液净化中心行维持性血液透析治疗的高磷血症患者80例。按患者透析时间分为对照组和干预组,各40例,对照组实施常规护理,干预组接受基于健康促进模型的护理干预。比较两组患者干预前后血磷管理知识行为、自我效能、血磷水平、血磷达标率及血清白蛋白水平的差异。结果:干预1个月后干预组血磷管理知识行为得分高于对照组,血磷水平低于对照组,差异有统计学意义(P<0.05);干预4个月后,干预组血磷管理知识行为得分、自我效能、血磷达标率及血清白蛋白水平高于对照组,血磷水平低于对照组,差异有统计学意义(P<0.05)。结论:基于健康促进模型的护理干预可提升维持性血液透析高磷血症患者血磷管理知识行为及自我效能,降低血磷水平并改善营养状况。

Objective:To evaluate the effect of nursing intervention based on Health Promotion Model(HPM)on the management of patients with hyperphosphatemia receiving Maintenance Hemodialysis(MHD).Methods:This study included 80 patients with hyperphosphatemia who underwent MHD treatment in the hemodialysis center of a tertiary grade A hospital from July to November 2019.Patients receiving dialysis every Monday,Wednesday,and Friday were included in the control group(n=40),and patients receiving dialysis every Tuesday,Thursday,and Saturday were in the intervention group(n=40).The control group received routine nursing,while the intervention group received the nursing care based on Health Promotion Model(HPM).The knowledge,behavior,and self-efficacy scores of hyperphosphatemia management,serum phosphorus levels,serum phosphorus pass rate,and serum albumin levels of the two groups were compared before intervention,1 month and 4 months after intervention,respectively.Results:After 1 months of intervention,the knowledge and behavior scores in the intervention group were obviously higher than those in the control group,while the serum phosphate level was lower than that in the control group(P<0.05).After 4 months of intervention,the knowledge and behavior scores,self-efficacy scores,serum phosphorus pass rate and albumin levels were higher than those of the control group,yet the serum phosphorus level in the intervention group was lower than that in the control group,and the differences were statistically significant(P<0.05).Conclusion:The nursing intervention based on HPM can effectively improve patients'knowledge,behavior and self-efficacy level of hyperphosphatemia management,reduce the serum phosphorus level and improve their nutritional status.