中国血液净化

中国血液净化 ›› 2020, Vol. 19 ›› Issue (02): 134-137.doi: 10.3969/j.issn.1671-4091.2020.02.017

• 护理研究 • 上一篇    下一篇

多元化教育模式对长期留置涤纶套双腔导管维持性血液透析患者依从性及不良心理的影响

叶婉荷1, 高琴1 ,刘君1   

  1. 1东莞市人民医院肾内科
  • 收稿日期:2019-04-19 修回日期:2019-12-04 出版日期:2020-02-20 发布日期:2020-02-12
  • 通讯作者: 叶婉荷 hao.zhou@wego-healthcare.com E-mail:hao.zhou@wego-healthcare.com

Effect of diversified education mode on treatment compliance and adverse psychology of patients undergoing maintenance hemodialysis with long-term indwelling polyester double-lumen catheter

  1. 1Department of Nephrology, Dongguan People's Hospital, Dongguan 523000, China
  • Received:2019-04-19 Revised:2019-12-04 Online:2020-02-20 Published:2020-02-12

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摘要： 【摘要】目的研究多元化教育模式对长期留置涤纶套双腔导管维持性血液透析(maintenance hemodialysis, MHD)患者的治疗依从性及心理状态的影响。方法选取东莞市人民医院2016年7月～2018年7 月长期留置涤纶套双腔导管行MHD 的患者100 例，按照随机数字表抽取法均分为2 组，各50 例，观察组采取多元化教育模式，对照组采取常规健康教育，对比2 组的护理效果。结果2 组患者干预后状态焦虑量表、特质焦虑量表总分与干预前组内比较均有降低(观察组t 值分别为7.858, 8.790；P值分别为＜0.001，＜0.001；对照组t 值分别为3.974，5.116；P 值分别为0.003，0.001)，观察组比较对照组在干预后下降水平更为显著(t 值分别为4.389，3.550；P 值分别为0.002，0.001)；2 组内患者干预后血液透析知识掌握程度均比干预前有所提高(t 值分别为25.525，17.559；P 值分别为＜0.001，＜0.001)，观察组相比对照组干预后提高水平更为显著(t=9.501，P＜0.001)；2 组患者干预后置管期间导管感染率、细菌检出率、导管血栓形成发生率、治疗依从性、护理满意度比较，均有统计学差异(χ2值分别为4.396，4.433，5.741， 11.111, 21.951；P 值分别为0.041，0.038，0.017，＜0.001，＜0.001)。结论多元化教育模式能有助于降低长期留置涤纶套双腔导管行MHD 患者的置管期间并发症发生率，提高患者自我护理意识，从而提高治疗依从性，减少不良心理发生。

关键词: 多元化教育, 涤纶套双腔导管, 维持性血液透析, 依从性, 不良心理

Abstract: 【Abstract】Objective To study the effect of diversified education mode on treatment compliance and psychological status of patients undergoing maintenance hemodialysis (MHD) using long- term indwelling polyester double-lumen catheter. Methods A total of 100 MHD patients using long-term indwelling polyester double-lumen catheter in the People's Hospital of Dongguan City from July 2016 to July 2018 were enrolled in this study. They were divided into two groups according to the random number table extraction method. Each group contained 50 cases. The observation group adopted diversified education mode, while the control group adopted routine health education. The nursing effect was compared between the two groups. Results The total scores of S-AI and T-AI after intervention were lower than those before intervention in the two groups (observation group: t= 7.858 and 8.790 respectively; P＜0.001; control group: t=3.974 and 5.116 respectively; P=0.003 and 0.001 respectively), and the lowering of S-AI and T-AI scores after intervention were more in the observation group than in the control group (t= 4.389 and 3.550 respectively; P=0.002 and 0.001 respectively). The knowledge of hemodialysis after intervention became better than that before intervention in the two groups (observation group: t=25.525, P＜0.001; control group: t=17.559, P＜0.001), and
the improvement degree after intervention was more significant in the observation group than in the control group (t=9.501, P＜0.001). After intervention, catheter infections during catheterization (χ2=4.396, P=0.041), bacterial positive rate (χ2=4.433, P=0.038), thrombosis in catheters (χ2=5.741,P=0.017), treatment compliance (χ2=11.111, P＜0.001) and nursing satisfaction (χ2=21.951, P＜0.001) were statistically different between the two groups. Conclusion Diversified education mode was effective to reduce the incidence of complications during long- term indwelling polyester double-lumen catheterization, improve their self- care consciousness, increase the treatment compliance, and avoid the adverse psychology in MHD patients.

Key words: Diversified education, Polyester double-lumen catheter, Maintenance hemodialysis, Compliance, Unhealthy psychology

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