健康信念模式结合多阶段改变理论教育模式在维持性血液透析高磷血症患者中的应用效果  

Effect of education model based on health belief model combined with multi-stage change theory applied to hyperphosphatemia patients with maintenance hemodialysis

作　　者：邹宝林[1] 黄燕林[2] 侯璐蒙 罗怡欣 ZOU Bao-lin;HUANG Yan-lin;HOU Lu-meng;LUO Yi-xin(Department of Geriatric Cardiology the First Affiliated Hospital of Guangxi Medical University, Nanning 530021,China;Department of Nephrology,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China;Graduate School,Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西医科大学第一附属医院老年心血管内科,南宁市530021 [2]广西医科大学第一附属医院肾内科,南宁市530021 [3]广西医科大学研究生学院,南宁市530021

出　　处：《广西医学》2018年第7期739-743,共5页Guangxi Medical Journal

基　　金：广西自然科学基金(2010GXNSFA013192)

摘　　要：目的探讨健康信念模式结合多阶段改变理论教育模式在维持性血液透析(MHD)高磷血症患者中的应用效果。方法将110例行MHD的高磷血症患者随机分成对照组和干预组,每组55例。对照组采用传统的教育模式,干预组采用健康信念模式与多阶段改变理论相结合的教育模式。比较两组患者护理干预前后血磷、钙磷乘积、血钙、行为改变及低磷饮食健康信念的情况。结果两组患者血磷、钙磷乘积随时间延长而降低(P<0.05),干预后干预组的血磷、钙磷乘积低于对照组(P<0.05);两组血钙、白蛋白水平比较,差异均无统计学意义,且无随时间变化的趋势(均P>0.05)。两组患者的健康信念总分、感知行为障碍得分、自我效能得分及感知行为益处得分均随干预时间延长而升高,且干预后干预组以上得分均高于对照组(均P<0.05);干预后干预组饮食行为优于对照组(P<0.05)。结论健康信念模式结合多阶段改变理论教育模式可提高行MHD的高磷血症患者的健康信念,促进低磷饮食行为,并有效降低患者血磷水平。Objective To explore the effect of education model,based on health belief model combined with multi-stage change theory,applied to hyperphosphatemia patients with maintenance hemodialysis(MHD).Methods A total of 110 hyperphosphatemia patients with MHD were randomly divided into control group and intervention group,with 55 cases in each group.The control group adopted the traditional education model,while the intervention group adopted the education model based on health belief model combined with multi-stage change theory.Serum phosphorus,calcium-phosphorus product,serum calcium,behavior changes,and health belief in low-phosphorus diet before and after nursing intervention were compared between the two groups.Results Serum phosphorus and calcium-phosphorus product decreased over time in the two groups(P<0.05),after intervention,serum phosphorus and calcium-phosphorus product in the intervention group were lower than those in the observation group(P<0.05);the level of serum calcium or albumin showed no statistically significant difference between the two groups,and did not change with time(all P>0.05).The total scores for health belief,cognitive behavior disorder,self-efficiency,and cognitive behavior benefit increased with the increasing intervention time in the two groups,and after intervention,the scores above in the intervention group were higher than those in the control group(all P<0.05);after intervention,the dietary behavior in the intervention group was superior to that in the control group(P<0.05).Conclusion For hyperphosphatemia patients with MHD,the education model based on health belief model combined with multi-stage change theory might improve patients′health belief,optimize their low-phosphorus dietary behavior,and effectively decrease the level of serum phosphorus.

关 键 词：高磷血症 血液透析 健康信念模式 多阶段改变理论 

分 类 号：R459.5[医药卫生—治疗学]