不同行为干预措施对维持性血液透析患者生活质量影响的临床观察  

Clinical observation of the effect of different behavioral interventions on quality of life in patients with maintenance hemodialysis

作　　者：陈涛 陈青霞 程惠玲[1] 石明[1] CHEN Tao;CHEN Qing-xia;CHENG Hui-ling;SHI Ming(Hemodialysis Room,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院血液透析室,武汉430060

出　　处：《临床肾脏病杂志》2020年第6期494-497,共4页Journal Of Clinical Nephrology

摘　　要：目的观察并分析不同的行为干预措施对改善维持性血液透析患者生活、生存质量的不同影响。方法选取在武汉大学人民医院血液透析室进行血液透析(2~3次/周)治疗3个月以上的门诊透析患者94例,采用数字法随机分为对照组和研究组,每组47例,对照组采取在院常规健康行为指导干预措施,即在院常规健康指导,研究组采取全面行为干预措施,包括针对患者现存健康问题的心理疏通、饮食教育指导、血管通路的维护与锻炼指导、生理不适的干预指导以及透析并发症的及时干预等,两组干预时间均为3个月,采用生活质量量表(QOL)对两组患者干预前后生活质量进行评分,采用心理量表(抑郁自评量表SDS、焦虑自评量表SAS)对两组患者干预前后心理状况进行评分,比较两组患者干预前后透析质量指标情况、生活质量状况及心理状况的差异。结果研究组患者心理量表评分及透析质量指标明显好于对照组,差异有统计学意义(P<0.05),研究组患者生活质量评分明显高于对照组,差异有统计学意义(P<0.05)。结论全面行为干预措施相比常规干预措施能够显著提高维持性血液透析患者的透析质量,减少透析患者负性心理反应,提高透析患者的生活质量。Objective To observe and analyze the effect of different behavior interventions on improvement of quality of life and survival in patients with maintenance hemodialysis.Methods A total of 94 outpatient patients,who had received hemodialysis therapy(2~3 times/week)for more than 3 months in Hemodialysis Room,Renmin Hospital of Wuhan University,were selected.They were randomly divided into control group and study group with the digital method,with 47 cases in each group.The control group adopted the in-hospital routine intervention of healthy behavior instructions,i.e.the in-hospital routine health instructions.The study group adopted the comprehensive behavior intervention,including psychological counseling,dietary education,instructions on maintenance and exercises of vascular access,instruction on physiological discomfort and prompt intervention of dialysis complications.The intervention period for both the groups was 3 months.The quality of life(QOL)scale was used to score quality of life for the patients of the two groups before and after intervention.The psychological scales(self depression scale,SDS;self anxiety scale,SAS)were adopted to the psychological conditions of the two groups before and after intervention.Dialysis quality indices,quality of life and psychological conditions before and after intervention were compared between the two groups.Results The patients in the study group had much better psychological scaling scores and better dialysis quality indices than the control group,with statistically significant differences(P<0.05).The quality of life scores in the study group were by far higher than those in the control group,with statistically significant differences(P<0.05).Conclusions Compared to the comprehensive behavior intervention,the routine intervention can improve dialysis quality of the patients with maintenance hemodialysis significantly,reduce their negative psychological conditions,and raise their quality of life.

关 键 词：行为干预 维持性血液透析 负性情绪 生活质量 

分 类 号：R692.5[医药卫生—泌尿科学]