基于应激系统理论的护理干预对血液透析患者动静脉瘘穿刺疼痛、心理状态和治疗依从性的影响  

Effect of Nursing Intervention Based on Stress System Theory on Puncture Pain,Psychological State and Treatment Compliance of Hemodialysis Patients with Arteriovenous Fistula

作　　者：李媛[1] 范志文 LI Yuan;FAN Zhiwen(Blood Purification Centre,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院血液净化中心,河南郑州450052

出　　处：《河南医学研究》2023年第8期1488-1492,共5页Henan Medical Research

摘　　要：目的 探讨基于应激系统理论的护理干预对维持性血液透析(MHD)患者动静脉瘘穿刺疼痛、心理状态和治疗依从性的影响。方法 选取2020年7月至2022年7月于郑州大学第一附属医院通过动静脉瘘接受MHD治疗的128例患者,按照随机数字表法分为对照组(64例)和研究组(64例)。对照组患者接受常规护理,研究组在对照组基础上接受基于应激系统理论的护理干预。比较观察两组患者动脉静瘘穿刺后的疼痛程度、疼痛自我效能感、心理状态、治疗依从性等。结果 研究组患者的健康知识知晓率高于对照组(P<0.05)。两组患者动脉静瘘穿刺时疼痛程度比较,差异有统计学意义(P<0.05),其中,研究组中、重度疼痛患者占比低于对照组,而无痛和轻度疼痛占比高于对照组(P<0.05)。干预前两组患者慢性疼痛自我效能感量表(CPSS)、状态-特质焦虑量表(STAI)和成人心理弹性量表(RSA)评分比较,差异无统计学意义(P>0.05);干预后研究组CPSS和RSA评分高于对照组,STAI评分低于对照组(P<0.05)。研究组患者的治疗总依从性高于对照组(P<0.05)。干预前两组患者的心理健康、生理健康评分比较,差异无统计学意义(P>0.05);干预后研究组心理健康、生理健康评分高于对照组(P<0.05)。结论 基于应激系统理论的护理干预能够有效缓解MHD患者动脉静瘘穿刺疼痛和焦虑情绪,增强患者心理弹性,提高患者治疗依从性和生存质量。Objective To explore the effect of nursing intervention based on stress system theory on the pain,psychological state and treatment compliance of arteriovenous fistula puncture in patients with maintenance hemodialysis(MHD).Methods A total of 128 patients who received MHD treatment through arteriovenous fistula in the First Affiliated Hospital of Zhengzhou University from July 2020 to July 2022 were selectd,and they were divided into control group(64 cases)and study group(64 cases)according to random number table.The patients in the control group received routine nursing,and the study group received nursing intervention based on stress system theory on the basis of the control group.The pain degree,pain self-efficacy,psychological state and treatment compliance of the two groups after arteriovenous fistula puncture were compared and observed.Results The awareness rate of health knowledge in the study group was higher than that in the control group(P<0.05).There was a statistically difference between the two groups in the degree of pain during arteriovenous fistula puncture(P<0.05),the proportion of patients with moderate and severe pain in the study group was lower than that in the control group,while the proportion of patients with no pain and mild pain was higher than that in the control group(P<0.05).There were no differences between the two groups in the scores of chronic pain self-efficacy scale(CPSS),state-trait anxiety scale(STAI)and adult resilience scale(RSA)before intervention(P>0.05).After intervention,the CPSS and RSA scores in the study group were higher than those in the control group,and the STAI scores were lower than those in the control group(P<0.05).The total compliance of patients in the study group was higher than that in the control group(P<0.05).There were no differences in the scores of mental health and physical health between the two groups before intervention(P>0.05).After intervention,the scores of mental health and physical health in the study group were higher than those in the contr

关 键 词：血液透析 应激系统理论 动静脉瘘 疼痛 心理状态 治疗依从性 

分 类 号：R473.5[医药卫生—护理学]