Abstract: 【Abstract】Objective To investigate the effect of the transtheoretical model and stages of change (TTM) on improving the symptoms and quality of life in patients with peritoneal dialysis (PD). Methods A total of 284 PD patients treated in our hospital were recruited and randomly divided into study group or control group. Both groups received the standard protocol of treatment plan, dietary and general activity guidance; the study group used TTM intervention in addition to the standard protocol. Interventions were carried out through five steps: unintended phase, intent phase, preparation phase, action phase and maintenance phase. Behavior change, incidence and degree of clinical symptoms, and quality of life score were compared between the two groups after the intervention for 12 months. Results There were no significant differences in the incidence and degree of clinical symptoms between the two groups before the intervention (P>0.05). After the intervention for 12 months, exercise increased (t=-3.011, P＜0.001), and the rates of smoking (χ2=34.841, P<0.001) and drinking (χ2=11.17, P=0.001) decreased in study group compared to those in control group; the incidence and severity of dry skin (χ2=0.271, P=0.697; t=1.325, P=0.166), insomnia (χ2=0.147, P=0.797; t=0.484,P=0.881), fatigue (χ2=0.147, P=0.798; t=0.345, P=0.667), skin itch (χ2=0.138, P=0.804; t=0.251, P=0.487), lower extremity edema (χ2=0.059, P=0.903; t=0.244, P=0.491), dry mouth (χ2=0.014, P=0.905; t=1.137, P=0.202), joint pain (χ2=0.057, P=0.905; t=0.631, P=0.587), cough (χ2=0.057, P=0.905; t=0.635, P=0.399), breath shortness (χ2=0.018, P=0.895; t=1.229, P=0.111) and dizziness (χ2=0.059, P=0.903; t=1.363, P=0.269) were significantly lower in study group than in control group. At the time of enrollment, scores of the 8 dimensions in the quality of life SF- 36 scale were lower in both groups. After the enrollment for 6 months, the scores of PF (t= 2.542, P=0.016), RP (t=3.778, P＜0.001) and REP (t=2.741, P=0.003) were significantly higher in study group than in control group. After the enrollment for 12 months, the scores of PF (t=4.207, P＜0.001), RP (t=1.921, P＜0.001), BP (t= 2.532, P=0.017), GHP (t=2.921, P=0.027), VT (t=2.214, P=0.027)and REP (t=2.031, P=0.019) were significantly higher in study group than in control group. Conclusion TTM can change the abnormal behavior and lifestyle, reduce the incidence of symptom groups, and improve quality of life in PD patients.

Key words: TTM, Peritoneal dialysis patient, Symptom group, Quality of life