动机性访谈对维持性血液透析患者健康素养和生活质量的影响  

Effect of motivational interviewing on health literacy and quality of life of patients on maintenance hemodialysis

作　　者：周美玲[1] 许秀君[1] 陈燕芳[1] 贾艳清[1] 姜红芳[1] 沈华娟[1] Zhou Meiling;Xu Xiujun;Chen Yanfang;Jia Yanqing;Jiang Hongfang;Shen Huajuan(Blood Purification Center,Zhejiang Provincial People's Hospital,Hangzhou 310014,China)

机构地区：[1]浙江省人民医院血液净化中心,杭州310014

出　　处：《中华现代护理杂志》2019年第24期3156-3160,共5页Chinese Journal of Modern Nursing

基　　金：浙江省医药卫生科技计划(2015KYA026);浙江省人民医院护理科研基金(2014-HLB-005)。

摘　　要：目的探讨动机性访谈对维持性血液透析患者健康素养和生活质量的影响。方法采用便利抽样法,选取2016年3月—2018年3月在某三甲医院血液净化中心行维持性血液透析的患者100例。根据透析时间将患者分为干预组50例和对照组50例,干预组实施动机性访谈,对照组采用传统的健康教育方法,采用慢性病患者健康素养调查问卷和肾脏疾病特异性调查表分别对两组患者干预前后健康素养得分和生活质量得分进行比较。结果干预6个月后,干预组患者健康素养总分由(87.34±2.85)分提高到(97.34±3.02)分,其中信息获取能力、交流互动能力、改善健康意愿3个维度的得分和总分均较干预前提高,且干预后干预组健康素养总分和以上3个维度得分均高于对照组,差异均有统计学意义(P<0.05)。干预组患者生活质量总分由(100.64±17.62)分提高到(115.60±16.15)分,其中躯体症状、疲劳、与他人关系3个维度的得分均较干预前提高,且干预后干预组生活质量总分和以上3个维度得分均高于对照组,差异均有统计学意义(P<0.05)。结论动机性访谈可以提高维持性血液透析患者的健康素养水平,增强维持性血液透析患者的改善健康的意识,改变自身不良的行为方式,提高患者生活质量。Objective To investigate the effect of motivational interviewing on health literacy and quality of life of patients on maintenance hemodialysis.Methods Using convenience sampling method,100 patients on maintenance hemodialysis were selected from March 2016 to March 2018 in a blood purification center of a ClassⅢGrade A hospital.According to dialysis time,the patients were divided into the intervention group(n=50)and control group(n=50).Motivational interviews were conducted in the intervention group.Traditional health education methods were used in the control group.The two groups'scores in health literacy and quality of life from Health Literacy of Patients with Chronic Diseases Questionnaire and Kidney Disease Questionnaire(KDQ)before and after intervention were compared.Results After 6 months of intervention,the total score of health literacy in the intervention group increased from(87.34±2.85)to(97.34±3.02).The scores of three dimensions of"information acquisition ability","communication and interaction ability"and"willingness to improve health"were higher than those before intervention,and the total score of health literacy and above three dimensions in the intervention group were higher than those in the control group with statistical differences(P<0.05).The total score of quality of life in the intervention group increased from(100.64±17.62)to(115.60±16.15),among which the scores of"somatic symptoms","fatigue"and"relationship with others"in the intervention group were higher than those before intervention,and the total score of quality of life and the above three dimensions in the intervention group were higher than those in the control group,the differences were statistically significant(P<0.05).Conclusions Motivational interviews can improve the health literacy level of maintenance hemodialysis patients,enhance their awareness of improving health,change their bad behaviors,and improve their quality of life.

关 键 词：透析 生活质量 健康素养 动机性访谈 

分 类 号：R47[医药卫生—护理学]