问题解决模式在血液透析患者自我管理与容量管理中的效果分析  

Application of problem solving mode in self⁃management and volume management of hemodialysis patients

作　　者：黄家懿[1] 汪思 吴志山 丁悦凤 Huang Jiayi;Wang Si;Wu Zhishan;Ding Yuefeng(Department of Blood Purification,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China)

机构地区：[1]上海交通大学医学院附属新华医院血液净化部,上海200092

出　　处：《海军医学杂志》2025年第3期286-291,共6页Journal of Navy Medicine

基　　金：上海交通大学医学院科技基金项目(JYHZ2115)。

摘　　要：目的 探讨基于自我调节理论的问题解决模式在维持性血液透析(MHD)患者中的应用效果。方法 采用便利抽样法选取2022年1-10月在上海交通大学医学院附属新华医院进行血液透析的患者为研究对象,根据随机数字表法分为对照组与观察组,各53例。对照组采用常规护理管理,观察组实施基于自我调节理论的问题解决模式进行干预,共干预4周。比较2组干预后4、12周自我管理行为、容量管理行为、疾病感知及习得性无助水平。结果 对照组脱落5例,观察组脱落3例;干预前,2组患者自我管理行为得分、容量管理行为得分差异无统计学意义(P>0.05),干预后4周及12周,观察组自我管理行为得分、容量管理行为得分均高于对照组,差异有统计学意义(P<0.05);干预前,2组患者疾病感知得分、习得性无助得分差异无统计学意义(P>0.05),干预后4周及12周,观察组疾病感知得分、习得性无助得分均低于对照组,差异有统计学意义(P<0.05)。结论 基于自我调节理论的问题解决模式可提高MHD患者自我管理能力与容量管理水平,降低负性疾病感知与习得性无助,且在干预结束后仍能获得认知、心理、行为的持续性改善。Objective To explore the application of problem solving mode based on self-regulation theory in maintenance hemodialysis(MHD)patients.Methods The convenient sampling method was used to enroll the patients who underwent hemodialysis in Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January to October 2022.According to the random number table,they were assigned to the control group or observation group.Routine nursing was used in the control group,and the nursing care of problem-solving mode based on self-regulation theory was applied in the observation group for 4 week.Self-management behavior,volume management behavior,disease perception and learned helplessness were compared between the two groups at 4 and 12 weeks after intervention.Results Eight patients(5 cases in the control group and 3 cases in the observation group)failed to be followed up.There was no significant difference in the score of self-management behavior,volume management behavior,disease perception or learned helplessness between the two groups before the intervention(P>0.05).At 4 and 12 weeks after the intervention,the scores of self-management behavior and volume management behavior in the observation group were significantly higher than those in the control group,while the scores of disease perception and learned helplessness in the observation group were significantly lower than those in the control group(P<0.05).Conclusion The problem-solving mode based on self-regulation theory can improve self-management and volume management of MHD patients,reduce negative disease perception and learning helplessness,and achieve continuous improvement in cognition,psychology and behavior after the intervention.

关 键 词：自我调节 问题解决模式 血液透析 自我管理 疾病感知 习得性无助 

分 类 号：R459.5[医药卫生—治疗学]