全程无缝隙护理模式对维持性血液透析患者遵医行为依从性和舒适度的影响  

Effect of seamless nursing model on treatment compliance and comfort among patients with maintenance hemodialysis

作　　者：刘晓琴[1] 张洁[2] 张晓宁[1] 

机构地区：[1]山东省潍坊市益都中心医院护理部,262500 [2]山东省潍坊市益都中心医院血液净化中心,262500

出　　处：《中华现代护理杂志》2015年第5期555-558,共4页Chinese Journal of Modern Nursing

摘　　要：目的：探讨全程无缝隙护理模式对维持性血液透析患者遵医行为依从性和舒适度的影响。方法将100例血液透析患者采用随机数字法分为干预组和对照组,每组50例。对照组实施常规的健康教育,干预组采用从医院到家庭的无缝隙护理管理模式,比较干预前后两组患者遵医行为依从性、舒适度。结果干预后3个月,干预组与对照组遵医行为依从性比较,干预组患者合理饮食、规律运动、正确服药、自我监测、自我心理调节5个方面的遵医行为依从性分别为96.0%,88.0%,92.0%,94.0%,96.0%,显著高于对照组的80.0%,60.0%,72.0%,72.0%,64.0%,差异具有统计学意义（χ^2值分别为6.06,10.18,6.77,8.58,16.10；P〈0.05）；干预组与对照组干预后舒适度比较,干预组患者在生理舒适、心理舒适、社会舒适、环境舒适、整体舒适5个维度评分分别为（28.15±1.28）,（32.11±3.17）,（25.41±3.12）,（15.21±1.05）,（88.28±1.87）分,明显优于对照组的（18.16±3.24）,（22.58±3.19）,（19.32±2.19）,（12.21±1.48）,（72.91±1.44）分,差异具有统计学意义（t值分别为2.5148,3.7965,8.2947,5.9218,26.6055；P〈0.05）。结论应用全程无缝隙护理管理模式能够进一步提高患者的遵医行为依从性,改变患者的不良行为,改善患者的人际关系,减轻患者的焦虑状态,减少并发症的发生,提高患者舒适度和生活质量。Objective To investigate the seamless nursing model impact on the treatment compliance and comfort in patients with maintenance hemodialysis. Methods A total of 100 hemodialysis patients were randomly divided into two groups：intervention group and control group, 50 cases in each group. The seamless nursing model from the hospital to home was used in the intervention group while the routine health education was implemented to the control group. The treatment compliance and comfort in patients in two groups were respectively evaluated before and after intervention of 3 months. Results Five aspects of treatment compliance behaviors were compared between the intervention group and control group after intervention 3 months later, including reasonable diet （96. 0% vs 80. 0%,χ^2=6. 06,P〈0. 05）, regular exercise （88. 0% vs 60. 0%） （χ^2=10. 18,P〈0. 01）, the correct medication （92. 0% vs 72. 0%,χ^2 =6. 77,P〈0. 01）, self-monitoring （94. 0% vs 72. 0%,χ^2=8. 58,P〈0. 01）, and self adjustment （96. 0% vs 64. 0%,χ^2=16. 10,P〈0. 01）. Five dimensions of comfort, included physiological comfort, psychological comfort, social comfort, environment comfortable, and the overall comfort between two groups were compared. The data of intervention group were （28.15 ±1.28）, （32.11 ±3.17）, （25.41 ±3.12）, （15.21 ±1.05）, and （88.28 ±1.87） while the data of control group were （18. 16 ± 3. 24）, （22. 58 ± 3. 19）, （19. 32 ± 2. 19）, （12. 21 ± 1. 48）, and （72. 91 ± 1. 44） （t=2. 514 8, 3. 796 5, 8. 294 7, 5. 921 8, 26. 605 5,respectively;P〈0. 05）. Conclusions The application of the whole seamless nursing model can improve patient′s treatment compliance and relationship, change their bad behavior, and relieve anxiety. Thus, it can reduce the incidence of complications and greatly improve patient comfort and quality of life.

关 键 词：肾透析 生活质量 无缝隙护理 舒适度 

分 类 号：R473.5[医药卫生—护理学]