基于信息-动机-行为技巧模型的功能锻炼健康教育方案在血液透析患者自体动静脉内瘘成形术后功能锻炼中的应用研究  

Application of information-motivation-behavior skill model in functional exercise after after autologous arteriovenous fistula plasty in hemodialysis patients

作　　者：李萍[1,2] 曲彦[3] 于雁[4] 赵会丽[2] Li Ping;Qu Yan;Yu Yan;Zhao Huili(School of Nursing,Qingdao University,Qingdao 266071,China;Department of Blood Purification Center,Qingdao Municipal Hospital Affiliated to Qingdao University,Qingdao 266071,China;Department of Intensive Care Center,Qingdao Municipal Hospital,Qingdao 266071,China;Department of Quality Management and Assessment,Qingdao Municipal Hospital,Qingdao 266071,China)

机构地区：[1]青岛大学护理学院,青岛266071 [2]青岛市市立医院东院血液净化中心,青岛266071 [3]青岛市市立医院重症监护中心,青岛266071 [4]青岛市市立医院质量管理考核部,青岛266071

出　　处：《中国实用护理杂志》2022年第34期2665-2672,共8页Chinese Journal of Practical Nursing

摘　　要：目的制定基于信息-动机-行为技巧模型(IMB模型)的功能锻炼健康教育方案,并探讨其在血液透析患者自体动静脉内瘘(AVF)术后功能锻炼中的应用效果。方法采用方便抽样法,选取2020年6月至2021年6月在青岛市市立医院行AVF手术的患者100例为研究对象,将患者按就诊顺序编号,单号为观察组,双号为对照组,每组50例。对照组给予常规AVF术后内瘘护理及功能锻炼健康教育,观察组在常规内瘘护理的基础上实施以IMB模型为基础的AVF术后内瘘功能锻炼健康教育,比较2组患者的功能锻炼依从性、头静脉内径、内瘘成熟时间及内瘘并发症发生率。结果最终对照组入组49例,观察组入组50例。观察组功能锻炼依从性为94.0%(47/50),高于对照组的73.5%(36/49),差异有统计学意义(χ^(2)=7.70,P<0.05);观察组内瘘成熟时间为(5.18±1.14)周,短于对照组的(5.94±1.39)周,差异有统计学意义(t=2.98,P<0.05);观察组头静脉内径及透析泵控血流量分别为(5.19±0.28)mm,(218.40±24.19)ml/min,高于对照组的(4.99±0.34)mm、(200.41±23.89)ml/min,差异有统计学意义(t=-3.21、-3.72,均P<0.05);观察组内瘘并发症发生率为6.0%(3/50),低于对照组的22.4%(11/49),差异有统计学意义(χ^(2)=5.52,P<0.05)。结论将IMB模型应用于血液透析患者AVF成形术后功能锻炼,可以有效提高患者的依从性,增加头静脉内径,提高泵控血流量,缩短内瘘成熟时间,降低内瘘并发症发生率。Objective Health education program based on information-motivation-behavioral skills model(IMB model)was developed,and its application effect in functional exercise after autogenous arteriovenous fistula(AVF)in hemodialysis patients was explored.Methods Using the convenient sampling method,100 patients undergoing AVF surgery in hemodialysis center of Qingdao Municipal Hospital from June 2020 to June 2021 were selected as the study objects.The patients were numbered according to the order of visit.The single number was the observation group,and the double number was the control group.There were 50 patients in each group.The control group was given routine AVF function exercise education,and the observation group was given AVF function exercise education based on the IMB model.Patients′compliance with functional exercise,cephalic vein diameter,fistula maturation time,and the incidence of complications were compared between the two groups.Results Finally,49 cases in the control group and 50 cases in the observation group finished the research.The compliance of function exercise of the observation group was 94.0%(47/50),which was higher than 73.5%(36/49)in the control group,and the difference was statistically significant(χ^(2)=7.70,P<0.05).The maturation time of plasty in the observation group was(5.18±1.14)weeks,shorter than that in the control group(5.94±1.39)weeks,and the difference was statistically significant(t=2.98,P<0.05).The cephalic vein diameter and blood flow controlled by hemodialysis pump in the observation group were(5.19±0.28)mm and(218.40±24.19)ml/min,respectively,higher than those in the control group(4.99±0.34)mm and(200.41±23.89)ml/min,the differences were statistically significant(t=-3.21,-3.72,both P<0.05).The incidence of fistula complications in the observation group was 6.0%(3/50),lower than 22.4%(11/49)in the control group,and the difference was statistically significant(χ^(2)=5.52,P<0.05).Conclusions The application of IMB model in hemodialysis patients with functional exercise a

关 键 词：血液透析 动静脉内瘘 信息-动机-行为技巧模型 功能锻炼 

分 类 号：R473.5[医药卫生—护理学]