基于护士主导的家属支持模式配合DOHaD理念导向的膳食护理对尿毒症血液透析患者饮食行为及疾病进展恐惧的影响

Effects of nurse-led family support model combined with DOHaD concept-oriented dietary nursing on dietary behavior and fear of disease progression in uremic patients undergoing hemodialysis

目的探讨基于护士主导的家属支持模式配合健康与疾病发育起源(DOHaD)理念导向的膳食护理对尿毒症血液透析患者饮食行为及疾病进展恐惧的影响。方法选择2022年9月至12月进行透析治疗的84例尿毒症患者为研究对象,按照随机数字表法将其分为对照组(40例)与观察组(44例)。对照组接受常规护理干预,观察组在对照组基础上实施基于护士主导的家属支持模式配合DOHaD理念导向的膳食护理。比较两组的干预效果。结果干预后,观察组的肾脏病饮食依从态度量表(RAAQ)、肾脏病饮食依从行为量表(RABQ)评分高于对照组(P<0.05)。干预后,观察组的血磷、甲状旁腺激素(iPTH)水平低于对照组,血钙水平高于对照组(P<0.05)。干预后,观察组的生理健康、社会家庭评分低于对照组(P<0.05)。观察组的透析总依从率高于对照组(P<0.05)。结论基于护士主导的家属支持模式配合DOHaD理念导向的膳食护理可改善尿毒症血液透析患者的饮食态度及行为,调节钙磷代谢,降低疾病进展恐惧,提高透析依从性,值得推广。

Objective To explore the effects of nurse-led family support model combined with developmental origins of health and disease(DOHaD)concept-oriented dietary nursing on dietary behavior and fear of disease progression in uremic patients undergoing hemodialysis.Methods A total of 84 uremic patients who underwent dialysis treatment from September to December 2022 were selected as the study objects.The patients were divided into control group(40 cases)and observation group(44 cases)according to the random number table method.The control group received routine nursing intervention,and the observation group implemented nurse-led family support model combined with DOHaD concept-oriented dietary nursing on the basis of the control group.The intervention effects of the two groups were compared.Results After intervention,the scores of Renal Adherence Altitudes Renal Questionnaire(RAAQ)and Renal Adherence Behavior Questionnaire(RABQ)in the observation group were higher than those in the control group(P<0.05).After intervention,the levels of serum phosphorus and intact parathyroid hormone(iPTH)in the observation group were lower than those in the control group,and the level of serum calcium was higher than that in the control group(P<0.05).After intervention,the physiological health and social family scores of the observation group were lower than those of the control group(P<0.05).The total dialysis compliance rate of the observation group was higher than that of the control group(P<0.05).Conclusion The nurse-led family support model combined with DOHaD concept-oriented dietary nursing can improve the dietary attitude and behavior of uremic patients undergoing hemodialysis,regulate calcium and phosphorus metabolism,reduce the fear of disease progression,and improve dialysis compliance.It is worth promoting.