提高血液透析患者液体摄入依从性的干预方式与效果评价

目的探讨阶段变化护理干预模式提高血液透析(HD)患者液体摄入依从性的近期效果。方法选择上海市三级甲等医院门诊透析中心HD患者58例,分为干预组30例和对照组28例,干预组由研究者实施以阶段变化理论为指导的为期3个月的护理干预。对照组接受常规宣教。比较两组患者透析间期体重增长(IDWG)与干体比值、不依从的天数与程度等。结果3个月后干预组患者IDWG与干体重的比值、不依从天数显著低于对照组(P<0.001);依从程度明显高于对照组(P<0.001);干预组患者的液体摄入依从行为所处阶段明显高于干预前(P<0.001)。结论阶段变化护理干预模式是提高HD患者液体摄入依从性行之有效的方法。

Effects of Transtheoretical Nursing Intervention Model on Hemodialysis Patients' Adherence to Fluid Intake

Objective To probe the short term effects of transtheoretical nursing intervention on hemodialysis patients' adherence to fluid intake.Methods Fifty-eight hemodialysis patients who were non-adherent to fluid intake were randomly divided into intervention group(n=30) and control group(n=28).In intervention group,a 3 months' nursing plan based on the transtheoretical model was implemented.Control group only received conventional education.The radio of interdialysis weight gain(IDWG) and dry weight,non-adherent days and degree of adherence were evaluated before and after the intervention.Results The ratio of IDWG and dry weight,non-adherent days in the intervention group were significantly lower than that the control group(P<0.001).The degree of adherence was obviously higher than that of the control group(P<0.001).The fluid-intake adherence behavior of the intervention group reached an advanced stage after the intervention(P<0.001).Conclusion The transtheoretical nursing intervention model is an effective method to improve hemodialysis patients'adherence to fluid intake.