中国血液净化

中国血液净化 ›› 2020, Vol. 19 ›› Issue (04): 266-269.doi: 10.3969/j.issn.1671-4091.2020.04.015

• 护理研究 • 上一篇    下一篇

感恩拓延-建构理论疗法改善腹膜透析患者不良情绪及自我管理行为的观察研究

龚文姜1,杨杰1,蔡明玉1   

  1. 1陆军军医大学大坪医院肾内科
  • 收稿日期:2019-12-09 修回日期:2020-02-06 出版日期:2020-04-12 发布日期:2020-04-12
  • 通讯作者: 蔡明玉 yuyu66231524@126.com E-mail:yuyu66231524@126.com

theoretical therapy in improving adverse emotions and self-management behavior of patients with peritoneal dialysis

  1.  1Department of Nephrology, Daping Hospital, Army Medical University, Chongqing 400042, China
  • Received:2019-12-09 Revised:2020-02-06 Online:2020-04-12 Published:2020-04-12

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摘要： 【摘要】目的探讨感恩拓延-建构理论疗法对腹膜透析患者不良情绪及自我管理的影响。方法纳入陆军军医大学大坪医院腹膜透析中心108 名腹膜透析患者，随机分成研究组和对照组。2 组患者均接受相同的标准治疗方案、饮食指导和常规活动指导建议。采用随机配对分组，对照组采用传统宣教模式；研究组在传统宣教模式基础上增加感恩拓延-建构理论疗法。入组后0、3、6、12 月采用焦虑自评量表(self-rating anxiety scale，SAS)、抑郁自评量表(self-rating depression scale,SDS)、感恩问卷(the gratitude questionnaire-six item form，GQ-6)和腹膜透析患者自我管理行为量表进行评分。结果入组前2 组患者的SAS 评分(t=-0.742, P=0.518)和SDS 评分(t=-0.862,P =0.721)统计学无明显差异。入组后3、6、12 月研究组的SAS 评分(t=-1.792, P=0.042；t= -2.852,P=0.029；t= -3.221,P＜0.001)和SDS 评分(t=-1.781,P =0.046；t=-2.921,P =0.012；t=-3.111, P =0.007)均低于对照组；入组后3、6、12 月研究组的GQ-6 评分均高于对照组(t=-1.981,P=0.021; t=-3.321, P=0.007；t=-4.011,P=0.001)；入组后12 月研究组的SMSPD 评分中换液护理(t=2.962, P=0.004)、出口护理(t=2.835, P=0.006)、导管护理(t=2.813, P=0.007)、导管护理(t=2.813, P= 0.007)、遵医嘱服降压药(t=2.549, P=0.040)、遵医嘱服降磷药(t=2.922, P=0.005)、蛋白质摄入(t=2.853, P= 0.007)、体质量(t=3.116,P=0.003)、超滤量(t=2.911, P=0.005)和并发症(t=2.647,P=0.022)均高于对照组。结论感恩拓延-建构理论疗法能够改善腹膜透析患者不良情绪，提高自我管理能力，具有一定的临床意义和现实意义。

关键词: 感恩策略, 腹膜透析患者, 不良情绪, 自我管理

Abstract: 【Abstract】Objective To explore the effect of gratitude extension-construction theory therapy on adverse mood and self-management in patients with peritoneal dialysis (PD). Methods A total of 108 PD patients in our center were randomly divided into a study group and a control group. Both groups of patients received the same standard treatment regimens, dietary guidance, and routine activity guidance recommendations. The groups were randomly matched; the control group used the traditional missionary model, and the study group added gratitude extension-construction theory therapy based on the traditional missionary model. The anxiety scale, depression scale, gratitude questionnaire (GQ-6) and self-management behavior scale for PD patients were used at 0-12 months after check-in. Results There were no significant differences in Self-rating Anxiety
Scale(SAS) scores(t=-0.742, P=0.518) and Self-rating Depression Scale(SDS) scores (t=-0.862, P=0.721) in the control and study groups before enrollment. The SAS scores (t=- 1.792, P=0.042; t=- 2.852, P=0.029; t=- 3.221,P＜0.01) and SDS scores (t=- 1.781,P=0.046;t=- 2.921, P=0.012;t=- 3.111, P=0.007) in the study group were significantly lower than those in the control group 3, 6 and 12 months after enrollment. The GQ-6 scores of the study group were significantly higher than those of the control group after admission (t=-1.981, P=0.021; t=- 3.321, P=0.007; t=- 4.011, P=0.001). After enrollment for 12 months, the SMSPD scores of fluid change nursing (t=2.962,P=0.004), exit nursing (t=2.835,P=0.006), catheter nursing (t=2.813, P=0.007), taking antihypertensive drugs as prescribed by the doctor (t=2.549,P=0.040), taking phosphate-reducing drugs as prescribed by the doctor (t=2.922,P=0.005), protein intake(t=2.853,P=0.007), body weight (t=3.116,P=0.003),
ultrafiltration volume(t=2.911,P=0.005), and complications (t=2.647, P=0.022) in the study group were higher than those in the control group. Conclusion Gratitude extension-construction theory therapy can improve the adverse mood and the self-management ability of PD patients, which has certain clinical significance and practical significance.

Key words: Gratitude strategy, Peritoneal dialysis patient, Adverse mood, Self-management

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