自我决定理论的护理在维持性血液透析继发甲状旁腺功能亢进患者中的干预效果  

Intervention effect of nursing based on self-determination theory in disease management of hyperparathyroidism secondary maintenance hemodialysis patients

作　　者：夏丹[1] 姜利[1] 邵忠雯 XIA Dan;JIANG Li;SHAO Zhongwen(Tongji Hospital,Tongji Medical College of HUST,Wuhan,430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院血液净化中心,湖北省武汉市430030

出　　处：《护理实践与研究》2022年第21期3227-3232,共6页Nursing Practice and Research

摘　　要：目的探讨基于自我决定理论的护理干预在维持性血液透析继发甲旁亢患者疾病管理中的应用效果。方法2021年1—12月选取维持血液透析(MHD)继发性甲状旁腺功能亢进(SHPT)患者64例,按照组间基线资料可比的原则分为观察组及对照组,各32例。对照组行血液透析常规护理管理,观察组在对照组基础上实施基于自我决定理论的护理干预,比较两组患者干预前后疾病管理能力、相关生化指标及生活质量改善情况。结果干预后,两组疾病管理能力总评分及健康调查简表(SF-36)相关维度评分均明显升高,且各指标均高于对照组,差异有统计学意义(P<0.05)。干预后,观察组血磷、钙磷乘积、全段甲状旁腺微素(iPTH)较对照组明显下降,血钙水平高于对照组,组间比较差异有统计学有意义(P<0.05)。结论基于自我决定理论的护理干预能有效提高MHD继发性SHPT患者疾病管理能力,有效改善患者钙磷代谢,抑制甲状旁腺组织增生,改善病情,提高生活质量。Objective To explore the effect of nursing based on self-determination theory in the disease management of hyperparathyroidism secondary to maintenance hemodialysis patients.Methods From January to December 2021,64 patients with Secondary Hyperparathyroidism(SHPT)Maintained Hemodialysis(MHD)were selected and divided into observation group and control group according to the principle of comparable baseline data between groups,with 32 cases in each group.The control group received routine nursing management of hemodialysis,the observation group received nursing intervention based on self-determination theory on the basis of the control group.The disease management ability,related biochemical indexes and the improvement of quality of life were compared between the two groups before and after intervention.Results After intervention,the total score of disease management ability and the score of SF-36 related dimensions in the two groups were significantly higher than the control group,and the differences were statistically significant(P<0.05).After the intervention,the blood phosphorus,calcium phosphorus product,intact Parathyroid Hormone(iPTH)of the observation group were significantly lower than the control group,and the blood calcium level of the observation group was higher than the control group,the differences between the groups were statistically significant(P<0.05).Conclusion Nursing intervention based on self-determination theory could ef fectively improve the disease management ability of MHD patients with secondary SHPT,ef fectively improve the calcium and phosphorus metabolism of patients,inhibit parathyroid tissue hyperplasia,improve the condition and quality of life.

关 键 词：自我决定理论 护理干预 维持性血液透析 甲旁亢 疾病管理能力 生活质量 

分 类 号：R471[医药卫生—护理学]