系统性护理在提高维持性血液透析患者社会回归率中的作用  

Effect of systematic nursing on improvement of the social regression rate for maintenance hemodialysis patients

作　　者：何庆宣 熊玉婉[2] 何兴来[3] 吕薇[4] HE Qing-xuan XIONG Yu-wan HE Xing-lai LYU Wei(Blood Purification Center, the First People＇s Hospital of Shaoguan City in Guangdong Province,Shaoguan 512000, China Blood Purification Center, People＇s Hospital of Zhongshan City in Guangdong Province,Zhongshan 528401, China Blood Purification Center,the Fifth Affiliated Hospital of Zhongshan University,Zhuhai 519000,China Blood Purification Center,Central People＇s Hospital of Huizhou City in Guangdong Province,Huizhou 516000,China)

机构地区：[1]广州省韶关市第一人民医院血液净化中心,广东韶关512000 [2]广东省中山市人民医院血液净化中心,广东中山528401 [3]中山大学第五附属医院血液净化中心,广东珠海519000 [4]广东省惠州市中心人民医院血液净化中心,广东惠州516000

出　　处：《中国当代医药》2017年第5期182-184,187,共4页China Modern Medicine

基　　金：广东省韶关市卫生计生科研项目(Y15152)

摘　　要：目的探讨系统性护理在提高维持性血液透析患者社会回归率中的作用。方法回顾性分析2014年1月~2016年1月在广东省四所三甲医院透析中心行维持性血液透析的患者300例,随机分为干预组和对照组,各150例,干预组在常规护理基础上采用系统护理干预,对照组仅采用常规护理,干预6个月后,比较两组患者社会回归情况、社会支持评分(SSRS)、社交回避及苦恼评分(SAD)、遵医行为及并发症发生率。结果两组社会回归率和SSRS评分较干预前均提高,差异有统计学意义(P<0.05),其中干预组提高更明显(P<0.05)。干预组规律透析率、合理饮食作息率、严格摄水率等遵医行为均显著高于对照组(P<0.05)。两组SAD评分较干预前均降低,差异有统计学意义(P<0.05),其中干预组降低更明显(P<0.05)。干预组并发症发生率显著低于对照组(P<0.05)。结论系统性护理干预可帮助患者增强自信,改善交往回避及苦恼,增强社会支持和医嘱依从性,减少并发症,提高生活质量,帮助患者更快回归社会,值得临床推广。Objective To explore the effect of systematic nursing on improvement of the social regression rate for maintenance hemodialysis patients.Methods Altogether 300 cases of maintenance hemodialysis patients who were treated in Maintenance Hemodialysis Center of four Grade Ⅲ A Hospitals in Guangdong Province from January 2014 to January2016 were retrospectively analyzed and randomly divided into intervention group and control group,150 cases in each group.The intervention group were received systematic nursing intervention based on routine nursing; while,the control group only were received routine nursing intervention.After 6 months of intervention,the social regression rate,SSRS（Social Support Rating Score）,SAD（Social Avoidance and Distress Scale）,medical compliance behavior and the incidence of complications of two groups were compared.Results The post-interventional social regression rate and SSRS score of the two groups were higher than pre-interventional ones,with significant difference（P〈0.05）,among which a more significant improvement was seen in intervention group（P〈0.05）.The regular hemodialysis rate,reasonable dietand work and rest rate,strict water intakerate of intervention group were higher than those of control group（P〈0.05）.The SAD scores of the two groups were lower than pre-interventional ones,with significant difference（P〈0.05）,among which a more significant reduction was seen in intervention group（P〈0.05）.The incidence of complications in intervention group was significantly lower than that in control group（P〈0.05）.Conclusion Systemic nursing intervention can help to enhance patients′self-confidence,improve communication avoidance and distress,strengthen social support and medical compliance,reduce the complications and improve the quality of life,which assistspatients to return to society earlier and it is worthy of promotion.

关 键 词：系统性护理 血液透析 社会回归率 干预 

分 类 号：R331.1[医药卫生—人体生理学]