正念干预联合跨理论模型健康教育对糖尿病肾病血液透析患者症状负担及动静脉内瘘并发症的影响分析  

Effect of Mindfulness Intervention Combined with the Transtheoretical Model Health Education on Symptom Burden and Arteriovenous Fistula Complications in Hemodialysis Patients with Diabetes Nephropathy

作　　者：刘克青[1] 刘科梅 LIU Keqing;LIU Kemei(Shandong Linyi Traditional Chinese Medicine Hospital,Linyi,Shandong,276000,China;Yishui County Mazhan People's Hospital,Linyi,Shandong,276000,China)

机构地区：[1]山东省临沂市中医医院,山东临沂276000 [2]沂水县马站人民医院,山东临沂276000

出　　处：《中外医疗》2024年第28期115-119,共5页China & Foreign Medical Treatment

摘　　要：目的探讨正念干预联合跨理论模型(the transtheoretical model,TTM)健康教育对糖尿病肾病血液透析患者症状负担及动静脉内瘘(arteriovenous fistula,AVF)并发症的影响。方法方便选取2022年1月—2023年8月山东省临沂市中医医院收治的者74例糖尿病肾病血液透析患为研究对象,依据不同护理方法分为两组,各37例。对照组实施常规护理,观察组在对照组基础上实施正念干预联合TTM健康教育护理,两组均干预3个月。对比两组症状负担[采用透析患者症状负担调查表评分(Dialysis Frequency Severity and Symptom Burden Index,DFSSBI)评估]、自我护理能力评分[采用血液透析患者AVF自我护理行为量表(Assessment Selfcare Behaviors Hemodialysis with Arteriovenous Fistual,ASBHD-AVF)评估]、AVF并发症发生情况。结果干预后,观察组DFSSBI中躯体症状、心理症状评分及总分均低于对照组,差异有统计学意义(P均<0.05)。干预后,观察组ASBHD-AVF评分中症状体征管理、并发症预防及总分均高于对照组,差异有统计学意义(P均<0.05)。观察组AVF并发症发生率为10.81%(3/37),低于对照组的32.43%(10/37),差异有统计学意义(χ^(2)=4.573,P<0.05)。结论糖尿病肾病血液透析患者实施正念干预联合TTM健康教育护理,能减轻患者症状负担,提高自我管理能力,减少并发症的发生。Objective To explore the effect of mindfulness intervention combined with the transtheoretical model(TTM)health education on the burden of symptoms and complications of arteriovenous fistula(AVF)in hemodialysis patients with diabetes nephropathy.Methods A total of 74 diabetic nephropathy hemodialysis patients admitted to Linyi Traditional Chinese Medicine Hospital of Shandong Province from January 2022 to August 2023 were conveniently selected as the study objects,and were divided into two groups according to different nursing methods,37 cases in each group.The control group received routine nursing,and the observation group received mindfulness intervention combined with TTM health education nursing on the basis of the control group.Both groups received intervention for 3 months.Symptom burden[assessed by Dialysis Frequency Severity and Symptom Burden Indexs(DFSSBI)],self-care ability score[assessed by Assessment Self-care Behaviors Hemodialysis with Arteriovenous Fistual(ASBHD-AVF)],and occurrence of complications of AVF were compared between the two groups.Results After intervention,the scores of somatic symptoms,psychological symptoms and total scores of DFSSBI in the observation group were lower than those in the control group,and the differences were statistically significant(all P<0.05).After intervention,the scores of symptom and sign management,complication prevention and total score of ASBHD-AVF score in the observation group were higher than those in the control group,and the differences were statistically significant(all P<0.05).The complication rate of AVF in the observation group was 10.81%(3/37),lower than that in the control group 32.43%(10/37),and the difference was statistically significant(χ^(2)=4.573,P<0.05).Conclusion The implementation of mindfulness intervention combined with TTM health education and nursing can reduce the burden of symptoms,improve self-management ability and reduce the occurrence of complications in patients with diabetic nephropathy on hemodialysis.

关 键 词：糖尿病肾病 血液透析 正念干预 跨理论模型健康教育 症状负担 自我管理能力 

分 类 号：R47[医药卫生—护理学]