基于SHEL分析法的综合管理模式在提高MHD患者血管通路护理质量中的应用  

Application of Comprehensive Management Model based on SHEL Analysis in Improving the Quality of Vascular Access Nursing in MHD Patients

作　　者：鲁绍娟 李玲[1] 欧喜金 Lu Shaojuan;Li Ling;Ou Xijin(The First Affiliated Hospital of Anhui Medical University,Hefei Anhui 230022,China)

机构地区：[1]安徽医科大学第一附属医院,安徽合肥230022

出　　处：《齐鲁护理杂志》2023年第7期1-4,共4页Journal of Qilu Nursing

摘　　要：目的:探讨基于SHEL分析法的综合管理模式在提高维持性血液透析(MHD)患者血管通路护理质量中的应用效果。方法:选取2020年4月1日~2022年5月31日收治的100例MHD患者作为研究对象。将2020年4月1日~2021年4月30日采用常规护理管理的50例患者作为对照组,将2021年5月1日~2022年5月31日采用基于SHFL分析法的综合管理模式的50例患者作为观察组;比较两组血管通路再循环情况、并发症发生情况、干预前后自我管理行为及生活质量[采用健康调查简表(SF-36)]。结果:观察组血尿素氮(BUN)再循环率及血肌酐(Cr)再循环率均低于对照组(P<0.01);观察组并发症发生率低于对照组(P<0.01);干预后,两组自我管理量表中情绪处理、自我护理、问题解决、伙伴关系评分及总分均高于干预前(P<0.05),且观察组高于对照组(P<0.01);干预后,两组SF-36中总体健康、生命力、心理健康、躯体疼痛、生理机能、社会职能、情感职能、生理职能评分均高于干预前(P<0.05),且观察组高于对照组(P<0.01)。结论:采用基于SHEL分析法的综合管理模式对MHD患者进行干预,可降低血管通路再循环率、并发症发生率,提升患者自我管理行为、生活质量,提高患者血管通路的护理质量。Objective:To explore the application effect of comprehensive management model based on SHEL analysis in improving the quality of vascular access nursing in maintenance hemodialysis(MHD)patients.Methods:A total of 100 MHD patients admitted from April 1,2020 to May 31,2022 were selected as the research subjects.The patients who received conventional nursing management from April 1,2020 to April 30,2021 were included in the control group(n=50).Those who received comprehensive management model based on SHFL analysis from May 1,2021 to May 31,2022 were included in the observation group(n=50).The situation of vascular access re-circulation,complications,self-management behavior and quality of life by the 36-item short-form health survey(SF-36)were compared between the two groups.Results:The re-circulation rates of blood urea nitrogen(BUN)and serum creation(Cr)in the observation group were lower than those in the control group(P<0.01).The incidence of complications in the observation group was lower than that in the control group(P<0.01).After intervention,the scores for emotional processing,self-care,problem solving and partnership,and the total scores of the self-management scale in the observation group were higher than those in the control group(P<0.01).After intervention,the scores for general health,vitality,mental health,physical pain,physical function,social role,emotional role and physical role of the SF-36 were higher in both groups than those before intervention(P<0.05),and those in the observation group were higher than those in the control group(P<0.01).Conclusion:Application of the comprehensive management model based on SHEL analysis can reduce the vascular access re-circulation rate and the incidence of complications in MHD patients,and improve their self-management behaviors and quality of life,and improve the quality of vascular access nursing in MHD patients.

关 键 词：SHEL分析 综合管理 维持性血液透析 血管通路护理 

分 类 号：R473.5[医药卫生—护理学]