基于共享决策模式的自我管理干预在慢性肾脏病非透析患者中的应用  

SDM model-based self-management intervention in non-dialysis chronic kidney disease patient application

作　　者：金智梅 杨华 刘涛 桑碧燕 王秀群 李雪 饶灵春 蔡德芳[2] JIN Zhimei;YANG Hua;LIU Tao;SANG Biyan;WANG Xiuqun;LI Xue;RAO Lingchun;CAI Defang(Nujiang Lisu autonomous Prefecture People's Hospital,Luzhou 673100;The Sixth Affiliated Hospital of Kunming Medical University,Yuxi 653100,China)

机构地区：[1]怒江傈僳族自治州人民医院,673100 [2]昆明医科大学第六附属医院,653100

出　　处：《中国老年保健医学》2024年第4期152-156,共5页Chinese Journal of Geriatric Care

基　　金：昆明医科大学护理学院研究生创新基金项目(编号:2022HLYJS13)。

摘　　要：目的探讨基于共享决策(SDM)模式的自我管理方案在慢性肾脏病非透析患者中的应用效果。方法纳入2022年1月至6月云南省某三甲医院肾内科住院患者100例,按随机数字表法分为对照组和观察组,每组50例。对照组采用常规慢性肾脏病自我管理方案进行干预,观察组在对照组方案的基础上实施基于SDM模式的干预。干预3个月后,比较两组患者的自我管理能力、健康状况、血尿素氮水平。结果观察组患者的自我管理能力得分高于对照组,两组自我管理能力得分比较差异有统计学意义(t=-1.949,P<0.001);观察组患者健康调查简表(SF-36)得分,包括生理职能、生理功能、躯体疼痛、一般健康状况、精力、社会功能、精神健康领域的得分均显著高于对照组,差异具有统计学意义(P<0.05);观察组患者的血尿素氮水平低于对照组,两组血尿素氮值的比较差异有统计学意义(Z=-2.117,P<0.05)。结论基于SDM模式的自我管理干预方案可提高慢性肾脏病非透析患者的自我管理能力,提高患者健康状况,降低血尿素氮水平,具有较高的临床应用价值。Objective To explore the application effect of self-management program based on SDM model in non-dialysis patients with chronic kidney disease.Methods A total of 100 patients hospitalized in the renal department of a Grade-Ⅲhospital in Yunnan Province from January to June 2022 were selected.They were divided into the control group and the observation group,with 50 cases respectively according to random number table method.The control group was treated with Chronic kidney Disease(CKD)self-management program under conventional health education mode,and the observation group was treated with SDM-based intervention program based on the intervention content of the control group.After 3 months of intervention,the self-management ability,health literacy,blood urea nitrogen levels of the two groups were compared.Results The scores of self-management ability in the intervention group were higher than those in the control group,and there was a significant difference between the two groups(t=-1.949,P<0.05).The scores of physical function,physical function,physical pain,general health,energy,social function and mental health in the intervention group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).The blood urea nitrogen level in the intervention group was lower than that in the control group,and the difference between the two groups was statistically significant(Z=-2.117,P<0.05).Conclusion Self-management intervention program based on SDM can improve the self-management ability of non-dialysis patients with chronic kidney disease,improve the health status of patients,and reduce the blood urea nitrogen level,which has high clinical application value.

关 键 词：慢性肾脏病 自我管理 健康状况 

分 类 号：R473.5[医药卫生—护理学]