CICARE沟通模式对血液透析患者心理状态、依从性及应对方式的影响  

The Impact of the CICARE Communication Model on the Psychological State,Compliance,and Coping Styles of Hemodialysis Patients

作　　者：郭仁留 刘巧惠[1] 马福英 GUO Renliu;LIU Qiaohui;MA Fuying(Emergency ICU,Zhongshan Hospital Xiamen University,Xiamen,Fujian 361000,China)

机构地区：[1]厦门大学附属中山医院急诊ICU,福建厦门361000

出　　处：《生物医学工程学进展》2025年第1期68-74,共7页Progress in Biomedical Engineering

摘　　要：目的探讨CICARE沟通模式对尿毒症血液透析患者心理状态、依从性及应对方式的影响。方法将入组的104例尿毒症血液透析患者随机分为观察组和对照组,每组各52例。对照组给予常规护理,观察组在常规护理的基础上实施CICARE沟通模式。干预持续12周,分别于干预前、干预3个月后评估患者心理状态(焦虑、抑郁、自我感受负担)、治疗依从性和应对方式。结果①心理状态:干预后,观察组焦虑评分[(43.26±5.99)vs(48.87±6.78)]、抑郁评分[(42.36±5.88)vs(50.74±7.03)]和自我感受负担评分[(32.23±3.47)vs(37.66±3.21)]均显著低于对照组(P<0.05)。②治疗依从性:干预后,观察组在用药、饮食、透析方案和液体摄入方面的评分显著高于对照组(P<0.05),治疗依从性总分[(96.37±13.37)vs(91.16±12.65)]提高显著(P<0.05)。③应对方式:干预后,观察组在面对方面的评分[(24.06±3.32)vs(20.85±2.88)]显著高于对照组,在回避方面的评分[(8.42±1.15)vs(11.25±1.54)]和屈服方面的评分[(6.03±1.04)vs(6.85±1.13)]显著低于对照组(P<0.05)。结论CICARE沟通模式能够有效改善尿毒症血液透析患者的心理状态,提高治疗依从性,促进积极应对方式的形成,值得在临床实践中推广应用。Objective To explore the effects of the CICARE communication model on the psychological state,compliance,and coping styles of uremic hemodialysis patients.Methods A total of 104 uremic hemodialysis patients were randomly divided into an observation group and a control group,with 52 cases in each group.The control group received routine care,while the observation group received the CICARE communication model in addition to routine care.The intervention lasted for 12 weeks.Patients’psychological state(measured by SAS,SDS,and SPB scales),dialysis compliance,and coping styles(measured by MCMQ)were assessed before and 3 months after the intervention.Results①Psychological State:After the intervention,the observation group had significantly lower scores in anxiety[(43.26±5.99)vs[(48.87±6.78)],depression[(42.36±5.88)vs(50.74±7.03)],and self-perceived burden[(32.23±3.47)vs(37.66±3.21)]compared to the control group(P<0.05).②Dialysis compliance:Post-intervention,the observation group had significantly higher scores in medication adherence,diet,dialysis regimen,and fluid intake compared to the control group(P<0.05).The overall compliance score[(96.37±13.37)vs(91.16±12.65)]also improved significantly(P<0.05).③Coping Styles:After the intervention,the observation group scored significantly higher in confrontation[(24.06±3.32)vs(20.85±2.88)]and significantly lower in avoidance[(8.42±1.15)vs(11.25±1.54)]and resignation[(6.03±1.04)vs(6.85±1.13)]compared to the control group(P<0.05).Conclusion The CICARE communication model effectively improves the psychological state of uremic hemodialysis patients,enhances treatment compliance,and promotes the development of positive coping styles.It is recommended for broader clinical application.

关 键 词：CICARE沟通模式 尿毒症 血液透析 心理状态 依从性 应对方式 医患沟通 健康管理 

分 类 号：R473.5[医药卫生—护理学]