基于行为改变理论的护理模式对腹膜透析相关性腹膜炎患者心理弹性和遵医行为的影响  

The effect of nursing mode based on behavior change theory on psychological resilience and treatment compliance in patients with peritoneal dialysis-associated peritonitis

作　　者：高菊 祝亦安 杨坤[1] 梁蓓蓓[2] GAO Ju;ZHU Yi’an;YANG Kun(Department of Nephrology,Anqing Medical Center,Anhui Medical University,Anhui,Anqing 246001,China)

机构地区：[1]安徽医科大学安庆医学中心肾内科,安徽省安庆市246001 [2]安庆医药高等专科学校

出　　处：《河北医药》2023年第3期474-477,共4页Hebei Medical Journal

基　　金：安徽省高等学校省级质量工程教学研究重点项目(编号:2019jyxm0567)。

摘　　要：目的观察基于行为改变理论的护理模式对腹膜透析相关性腹膜炎(PDAP)患者心理弹性、遵医行为的影响。方法选取2018年1月至2021年12月收治的PDAP患者66例,以随机数字表法将患者分为对照组和研究组,每组33例。对照组给予常规护理,研究组在上述基础上予以基于行为改变理论的护理模式。2组患者干预前后采用心理弹性量表(CD-RISC)评估心理弹性(坚韧性、乐观性以及力量)、遵医行为(遵医服药、适当锻炼、控制饮食以及按时复查),采用健康状况调查简表(SF-36)和肾脏及透析相关生存质量表(KDTA)评估患者生活质量以及自制护理满意度调查问卷评估的护理满意度。结果经过护理后,研究组患者坚韧性、乐观性、力量性以及心理弹性总评分均升高,研究组评分显著高于对照组(P<0.05)。同时2组患者遵医服药、适当锻炼、控制饮食以及按时复查评分均升高,研究组评分均显著高于对照组(P<0.05),且2组SF-36与KDTA评分均升高,研究组评分均显著高于对照组(P<0.05)。护理后研究组护理满意度达93.94%,显著高于对照组的(72.73%)(P<0.05)。结论对PDAP患者实施基于行为改变理论的护理模式,能显著改善患者的心理弹性,提高患者的遵医行为以及生活质量,护理满意度高,值得推广。Objective To observe the effects of nursing mode based on behavior change theory on psychological resilience and treatment compliance in patients with peritoneal dialysis-associated peritonitis(PDAP).Methods A total of 66 PDAP patients admitted to the hospital between January 2018 and December 2021 were enrolled.They were randomly divided into control group and study group,with 33 cases in each group.Patients in the control group were given to routine nursing,and those in the study group were additionally given to nursing mode based on behavior change theory.Before and after interventions,psychological resilience(toughness,optimism,strength)and treatment compliance(prescribed medication,proper exercise,diet control,regular re-examination)were evaluated by the Connor-Davidson Resilience Scale(CD-RISC).The quality of life was assessed by the 36-item short-form health status survey(SF-36)and kidney and dialysis related quality of life scale(KDTA).The nursing satisfaction was assessed by self-made satisfaction questionnaire.Results After nursing,the scores of toughness,optimism and strength,and the total score of psychological resilience in study group increased,which were significantly higher than those in control group(all P<0.05).After nursing,the scores of prescribed medication,proper exercise,diet control and regular re-examination in both groups increased,which were significantly higher in study group than those in control group(all<0.05).After nursing,the scores of SF-36 and KDTA in both groups increased,which were significantly higher in study group than those in control group(all P<0.05).After nursing,the nursing satisfaction rate in study group was significantly higher than that in control group(93.94%vs 72.73%)(P<0.05).Conclusion The application of nursing mode based on behavior change theory in PDAP patients can significantly improve psychological resilience,treatment compliance and quality of life,with a high nursing satisfaction.

关 键 词：行为改变理论 腹膜透析 腹膜炎 心理弹性 遵医行为 

分 类 号：R473.5[医药卫生—护理学]