中国血液净化

中国血液净化 ›› 2020, Vol. 19 ›› Issue (09): 641-644.doi: 10.3969/j.issn.1671-4091.2020.09.017

• 护理研究 • 上一篇    下一篇

家属参与护理在血液净化中心的应用效果观察

王晓君1,李剑1,马莉1,王研2,侯淼1   

  1. 1辽宁省丹东市中心医院血液净化室
    2辽宁省丹东市辽东学院医学院护理系
  • 收稿日期:2020-04-09 修回日期:2020-06-28 出版日期:2020-09-12 发布日期:2020-09-03
  • 通讯作者: 王晓君 wxj8039@126.com E-mail:wanyac1968@163.com

The effects of family members participating in nursing in a blood purification center

  1.  1Department of Blood purification, Dandong Central Hospital of Liaoning Province, Dandong 118002, China;  2Department of Nursing, School of Medicine, Liaodong College, Dandong City, Liaoning Province, Dandong 118002, China
  • Received:2020-04-09 Revised:2020-06-28 Online:2020-09-12 Published:2020-09-03

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摘要： 【摘要】目的观察以护士为中心家属参与的护理模式在血液净化治疗中心的应用效果。方法从2018 年1 月1 日开始，截至2018 年12 月31 日，共纳入辽宁省丹东市中心医院血液净化中心进行维持性血液透析(maintenance hemodialysis，MHD)患者80 例，随机分对照组40 例，观察组40 例，随访12 个月。对照组进行常规护理，观察组进行以护士为中心家属配合参与的护理模式。干预前后比较2 组透析效果、肾功能指标、营养学指标，抑郁自评量表(self-rating depression scale，SDS)评分、焦虑自评量表(self-rating anxiety scale，SAS)评分及肾病相关生存质量量表(kidney disease quality of life short form，KDQOL-SFTM)评分。结果干预12 月后观察组尿素清除指数Kt/V 及尿素氮下降(urea reduction ratio,URR)的达标率高于对照组(χ2=42.105、56.597，均P＜0.001)；体质量指数、在线尿素清除率检测值(on- line clearance monitoring,OCM)、血红蛋白、血清白蛋白水平均高于对照组 (t=25.043、24.845、41.337、32.714，均P＜0.001)；观察组营养不良炎症评分(malnutrition inflammation score,MIS)低于对照组(t=38.256，P＜0.001)。干预6 月及12 月后观察组SDS 评分及SAS 评分均低于对照组，差异具有统计学意义(t=11.469、9.224，均P＜0.001；t=32.962、22.965，均P＜0.001)。干预6月及12 月后观察组KDQOL- SFTM 评分均高于对照组，差异具有统计学意义(t=18.556、16.268，均P＜0.001)。结论以护士为中心、家属积极配合参与的护理可改善患者的透析充分性、营养指标、心理状况与生活质量。

关键词: 护士, 护理模式, 血液透析

Abstract: 【Abstract】Object To explore the effects of family members participating in nursing in a blood purification center. Methods A total of 80 maintenance hemodialysis (MHD) patients treated in the Department of Blood Purification of Dandong Central Hospital in the period from January 1, 2018 to December 31, 2018 were randomly divided into control group (n=40) and observation group (n=40). Patients in control group were treated with routine care, and those in observation group were treated with the model of nursecentered care plus family members participating in nursing. Before and after the intervention, dialysis effect, renal function index, nutrition index, self-rating depression scale (SDS) score, self-rating anxiety scale (SAS) score, and kidney disease quality of life short form (KDQOL-SFTM) score were compared between the two groups. Results After 12 months of intervention, the compliance rates of urea clearance index (Kt/V) and urea reduction rate (URR) were significantly higher in observation group than in control group (χ2=42.105 and 56.597, P＜0.001); body mass index, online clearance monitoring (OCM) value, hemoglobin and albumin levels were significantly higher in observation group than in control group (t=25.043, 24.845, 41.337 and 32.714 respectively, P＜0.001); malnutrition inflammation score (MIS) was significantly lower in observation group than in control group (t=38.256, P＜0.001). After 6 and 12 months of intervention, SDS score and SAS score were significantly lower in observation group than in control group (t=11.469 and 9.224, P＜0.001, after 6 months of intervention; t=32.962 and 22.965, P＜0.001, after 12 months of intervention); KDQOL-SFTM scores were significantly higher in observation group than in control group (t=18.556 and 16.268 respectively, P<0.001). Conclusion The model of nursing-centered care plus family members actively participating in nursing can improve dialysis sufficiency, nutrition index, psychological status and quality of life of the MHD patients.

Key words: Nurse, Nursing model, Blood purification

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