接纳与承诺团体干预对维持性血液透析糖尿病肾病患者营养状况的影响  

Effects of acceptance and commitment group intervention on nutritional status of diabetic nephropathy patients undergoing maintenance hemodialysis

作　　者：张晓丽[1] 赵雪 董晓艳[1] 常玲玲[1] 贾玉臻[1] 刘敏[2] ZHANG Xiaoli;ZHAO Xue;DONG Xiaoyan;CHANG Lingling;JIA Yuzhen;LIU Min(Yidu Central Hospital of Weifang,Weifang 262500,China;Weifang Maternal and Child Health Hospital,Weifang 261011,China)

机构地区：[1]潍坊市益都中心医院,山东省潍坊市262500 [2]潍坊市妇幼保健院,山东省潍坊市261011

出　　处：《护理实践与研究》2024年第1期98-105,共8页Nursing Practice and Research

基　　金：潍坊市科学技术发展计划(医学类)(编号:2020YX124)。

摘　　要：目的研究接纳与承诺团体干预对糖尿病肾病维持性血液透析患者营养状况的影响,为提高患者的生活质量、延长其生存时间提供心理干预方法。方法选取2022年7—10月在山东省某三级甲等综合医院行血液透析的糖尿病肾病63例患者为研究对象,按照组间资料具有可比性的原则分为观察组31例和对照组32例。对照组接受常规的健康教育和心理指导,观察组在对照组基础上实施接纳与承诺团体干预。比较两组患者糖尿病肾病维持性血液透析营养管理知信行评分、营养不良-炎症评分(MIS),检查两组患者血磷、血钙、白蛋白、C反应蛋白(CRP)指标。结果透析3个月后,观察组患者营养管理知信行评分均高于对照组,差异具有统计学意义(P<0.05)。透析3个月后,观察组MIS评分低于对照组,差异具有统计学意义(P<0.05)。透析3个月后,观察组患者血钙高于对照组,血磷低于对照组,白蛋白及CRP优于对照组,差异具有统计学意义(P<0.05)。结论接纳与承诺疗法通过接纳、认知解离、体验当下、以己为景、澄清价值观和承诺行动6个过程,利用正念、隐喻、知识传授及有氧运动等方法,可以提高糖尿病肾病维持性血液透析患者营养管理知信行水平和营养管理依从性,改善营养状况,维持钙磷代谢平衡。Objective To study the impact of acceptance and commitment group intervention on the nutritional status of maintenance hemodialysis patients with diabetic nephropathy,and to provide psychological intervention methods to improve patients'quality of life and prolong their survival time was as the study purposes.Methods A total of 63 patients with diabetic nephropathy who underwent hemodialysis in a GradeⅢClass A comprehensive hospital in Shandong province from July to October 2022 were selected as the research subjects,accrding to the comparability of basic data between group 31 cases were divided into an observation group and 32 cases in a control group.The control group received routine health education and psychological guidance,and the observation group implemented acceptance and commitment group intervention based on the control group.The knowledge,attitude,and practice scores and malnutrition-inflammation score(MIS)of nutritional management of diabetic nephropathy maintenance hemodialysis of the two groups of patients was compared,and the blood phosphorus,blood calcium,albumin,and C-reactive protein(CRP)indicators of the two groups of patients were examined.Results After 3 months of dialysis,the nutritional management knowledge,attitude and practice scores of patients in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).After 3 months of dialysis,the MIS score in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).After 3 months of dialysis,the blood calcium in the observation group was higher than that in the control group,the blood phosphorus was lower than that in the control group,the albumin and CRP were better than those in the control group,the differences were statistically significant(P<0.05).Conclusion The application of acceptance and commitment therapy can improve the nutritional management knowledge, belief, and compliance of patients with diabetic nephropathy a

关 键 词：接纳与承诺团体干预 糖尿病肾病 维持性血液透析 营养状况 自我管理 

分 类 号：R473.5[医药卫生—护理学]