基于Snyder理论的IMCHB模式对慢性肾衰竭血透患者失志综合征、生命质量及相关并发症的影响  

Impact of the IMCHB model based on Snyder's theory on the demoralization syndrome,quality of life,and related complications in patients with chronic renal failure undergoing hemodialysis

作　　者：赵鲁豫 胡元元 姜玲芝 王晓阳[1] ZHAO Lu-yu;HUYuan-Yuan;JIANG Ling-zhi;WANG Xiao-yang(Department of Nephrology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan,CHINA)

机构地区：[1]郑州大学第一附属医院肾脏内二科,河南郑州450000

出　　处：《海南医学》2025年第2期281-286,共6页Hainan Medical Journal

基　　金：2023年度河南省医学科技攻关计划省部共建重点项目(编号:SBGJ202302046)。

摘　　要：目的探究基于Snyder理论的健康行为互动模式(IMCHB)模式对慢性肾衰竭血透患者失志综合征、生命质量及相关并发症的影响。方法前瞻性选取2022年6月至2023年10月郑州大学第一附属医院收治的98例慢性肾衰竭血透患者为研究对象,按随机数表法分为常规组和观察组各49例。常规组患者予以常规护理,观察组患者予以基于Snyder理论的IMCHB模式进行干预,干预时间6个月。比较两组患者干预前后失志综合征量表(DS)、健康促进生活方式量表(HPLP-Ⅱ)、五维度五水平健康量表(EQ-5D-5L)评分及并发症发生率。结果干预后,观察组患者DS量表中失败感、无助感、无意义感、沮丧感、情绪不安感评分分别为(5.66±1.02)分、(4.26±1.15)分、(6.26±1.74)分、(3.98±1.25)分、(4.26±1.68)分,明显低于常规组的(9.75±1.58)分、(7.29±1.52)分、(9.00±1.18)分、(9.54±2.18)分、(7.09±1.24)分,差异均有统计学意义(P<0.05);干预后,观察组患者HPLP-Ⅱ量表中人际关系、营养、健康责任、体育运动、压力管理、精神成长评分分别为(16.57±2.33)分、(20.24±3.51)分、(31.45±4.29)分、(25.24±3.76)分、(15.26±2.36)分、(15.98±3.17)分,明显高于常规组的(13.70±3.18)分、(15.32±4.18)分、(24.26±3.96)分、(18.57±4.10)分、(11.43±2.10)分、(13.01±2.97)分,差异均有统计学意义(P<0.05);干预后,观察组患者EQ-5D-5L量表中视觉模拟标尺(EQ-VAS)、行动能力、自我照顾、日常生活、疼痛或不适、焦虑或抑郁评分分别为(71.87±5.26)分、(0.86±0.21)分、(0.83±0.18)分、(0.90±0.09)分、(0.75±0.14)分、(0.82±0.17)分,明显高于常规组的(63.76±6.49)分、(0.62±0.18)分、(0.70±0.16)分、(0.65±0.13)分、(0.53±0.16)分、(0.53±0.11)分,差异均有统计学意义(P<0.05);观察组患者并发症总发生率为6.12%,明显低于常规组的22.45%,差异有统计学意义(P<0.05)。结论基于Snyder理论的IMCHB模式可减轻慢性肾衰竭血透患者�Objective To explore the impact of the Interactive Model of Cognitive Health Behavior(IMCHB)based on Snyder's theory on the demoralization syndrome,quality of life,and related complications in patients with chronic renal failure undergoing hemodialysis.Methods A prospective study was conducted on 98 patients with chronic renal failure undergoing hemodialysis who were admitted to the First Affiliated Hospital of Zhengzhou University from June 2022 to October 2023.They were randomly divided into a control group and an observation group,with 49 patients in each group.The patients in the control group received routine care,while those in the observation group received intervention based on the IMCHB model of Snyder's theory for 6 months.The incidence of complications and the scores of the Dizziness Symptom Scale(DS),Health-Promoting Lifestyle Profile-Ⅱ(HPLP-Ⅱ),and Five-Dimensional Five-Level Health Assessment Scale(EQ-5D-5L)before and after intervention were compared between the two groups.Results After the intervention,the scores of sense of failure,helplessness,meaninglessness,depression,and emotional uneasiness in the DS scale of patients in the observation group were(5.66±1.02)points,(4.26±1.15)points,(6.26±1.74)points,(3.98±1.25)points,and(4.26±1.68)points,respectively,which were significantly lower than corresponding(9.75±1.58)points,(7.29±1.52)points,(9.00±1.18)points,(9.54±2.18)points,and(7.09±1.24)points in the control group(P<0.05).Likewise,after the intervention,the scores of interpersonal relationship,nutrition,health responsibility,physical exercise,stress management,and spiritual growth in the HPLP-Ⅱ scale for patients in the observation group were(16.57±2.33)points,(20.24±3.51)points,(31.45±4.29)points,(25.24±3.76)points,(15.26±2.36)points,and(15.98±3.17)points,respectively,which were significantly higher than corresponding(13.70±3.18)points,(15.32±4.18)points,(24.26±3.96)points,(18.57±4.10)points,(11.43±2.10)points,and(13.01±2.97)points in the control group,with statistical

关 键 词：慢性肾衰竭 血透 Snyder理论 失志综合征 生命质量 并发症 

分 类 号：R692.5[医药卫生—泌尿科学]