责任个体化护理模式对血液透析患者自我效能及血糖水平、生活质量的影响
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摘要
目的探讨责任个体化护理模式在血液透析患者中的护理效果及对患者自我效能、血糖水平和生活质量的影响。方法选择2016年7月—2018年2月收治的血液透析患者94例,采用随机数字表分为对照组(47例)和观察组(47例)。对照组给予常规护理,观察组采用责任个体化护理模式,15 d护理后对患者效果进行评估。采用慢性病自我效能量表(CDSES)对2组护理前、护理后15 d从情绪控制、合理休息、疼痛及不适的控制、自我保健、遵医用药管理及健康问题自我效能进行评估;采用生化检测测定2组护理前后尿素氮(BUN)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)及血清肌酐(Scr)水平;采用生活质量量表(QOL)对2组生活质量进行评估,比较2组护理效果及对自我效能、血管水平的影响。结果观察组护理后15 d情绪控制、合理休息、疼痛及不适的控制、自我保健、遵医用药管理及健康问题评分高于对照组(均P<0.05);观察组护理后BUN、FBG、HbA1c及Scr水平均低于对照组(均P<0.05),认知、角色、躯体、情绪及社会角度评分,均高于对照组(均P<0.05)。结论责任个体化护理模式用于血液透析患者中能提高患者自我效能,改善患者血糖水平,有助于患者生活质量的提高,值得推广应用。
Objective To explore the nursing effect of individualized nursing model of responsibility in hemodialysis patients and its effect on patient self-efficacy and blood glucose level. Methods A total of 94 hemodialysis patients admitted from March 2016 to February 2018 were enrolled. The random number table was divided into control group(n=47) and observation group(n=47). The control group received routine care, and the observation group used the responsibility individualized nursing mode to evaluate the patient's effect after 15 days of nursing. The chronic disease self-efficacy energy table(CDSES) was used to evaluate emotional control, reasonable rest, pain and discomfort, self-care, compliance with medical drug management and self-efficacy of health problems before and after 15 days of care. The levels of urea nitrogen(BUN), fasting blood glucose(FBG), glycosylated hemoglobin(HbA1 c) and serum creatinine(Scr) were measured before and after 15 days of treatment. The quality of life of the two groups was assessed by quality of life scale(QOL). The effects of the two groups of nursing and their effects on self-efficacy and blood vessel levels were compared. Results The control of emotional control, reasonable rest, pain and discomfort, self-care, compliance with medical drug management and health problems scores in the observation group were higher than those in the control group(all P<0.05). In the observation group, BUN, FBG, the levels of HbA1 c and Scr were lower than those in the control group(all P<0.05). The scores of cognition, role, physical, emotional and social angles in the observation group were higher than those in the control group(all P<0.05). Conclusion The use of responsible individualized nursing mode in hemodialysis patients can improve patients' self-efficacy, improve patients' blood glucose levels, and contribute to the improvement of patients' quality of life. It is worthy of popularization and application.
Objective To explore the nursing effect of individualized nursing model of responsibility in hemodialysis patients and its effect on patient self-efficacy and blood glucose level. Methods A total of 94 hemodialysis patients admitted from March 2016 to February 2018 were enrolled. The random number table was divided into control group(n=47) and observation group(n=47). The control group received routine care, and the observation group used the responsibility individualized nursing mode to evaluate the patient's effect after 15 days of nursing. The chronic disease self-efficacy energy table(CDSES) was used to evaluate emotional control, reasonable rest, pain and discomfort, self-care, compliance with medical drug management and self-efficacy of health problems before and after 15 days of care. The levels of urea nitrogen(BUN), fasting blood glucose(FBG), glycosylated hemoglobin(HbA1 c) and serum creatinine(Scr) were measured before and after 15 days of treatment. The quality of life of the two groups was assessed by quality of life scale(QOL). The effects of the two groups of nursing and their effects on self-efficacy and blood vessel levels were compared. Results The control of emotional control, reasonable rest, pain and discomfort, self-care, compliance with medical drug management and health problems scores in the observation group were higher than those in the control group(all P<0.05). In the observation group, BUN, FBG, the levels of HbA1 c and Scr were lower than those in the control group(all P<0.05). The scores of cognition, role, physical, emotional and social angles in the observation group were higher than those in the control group(all P<0.05). Conclusion The use of responsible individualized nursing mode in hemodialysis patients can improve patients' self-efficacy, improve patients' blood glucose levels, and contribute to the improvement of patients' quality of life. It is worthy of popularization and application.
引文
[1] 聂敏,路瑶,李春雨.协同护理模式联合个体化护理对糖尿病足患者生存质量的影响[J].重庆医学,2017,46(19):2730-2732.
[2] 韩玉亭,孙正凯,宫振霞,等.个体化健康管理模式对糖尿病合并冠心病患者自我效能感及遵医行为的影响[J].山东医药,2016,56(38):65-67.
[3] INRA J,PELLETIER S,KUMAR N L,et al.Tu1116 one-on-one individualized coaching of faculty improves self-reported teaching and presentation skills among presenters[J].Gastroenterology,2016,150(4):S847-S848.
[4] 倪云霞,刘素珍,李继平,等.护士主导的管理模式对社区糖尿病患者血糖控制及就医行为的影响[J].中华护理杂志,2017,52(2):222-227.
[5] 罗怡欣,黄燕林,刘玲玲,等.奥马哈系统个案管理模式在维持性血液透析患者中的应用[J].实用医学杂志,2017,33(19):3311-3313.
[6] 游书秋,杜茜倩,李胜玲,等.家庭访视护理对社区老年糖尿病患者自我效能的影响[J].实用医学杂志,2016,32(12):2058-2060.
[7] HASHEMI-GHASEMABADI M,TALEGHANI F,YOUSEFY A,et al.Transition to the new role of caregiving for families of patients with breast cancer:a qualitative descriptive exploratory study[J].Support Care Cancer,2016,24(3):1269-1276.
[8] 叶任高,沈清瑞.肾脏病诊断与治疗学[M].北京:人民卫生出版社,1994.
[9] 杨艳,赵琨,吕娅,等.多学科协作模式在老年糖尿病患者护理中的应用[J].医学研究生学报,2016,29(12):1318-1320.
[10] 董勤.治未病理论在糖尿病患者负性情绪护理中的应用效果[J].中华全科医学,2017,15(7):1266-1268.
[11] 刘冬梅,张佳淇,李胜玲,等.基于授权理论实施社区老年糖尿病患者家庭访视护理的实践[J].中华全科医学,2017,15(7):1245-1248.
[12] CHIRICO A,SERPENTINI S,MERLUZZI T,et al.Self-efficacy for coping moderates the effects of distress on quality of life in palliative cancer care[J].Anticancer Res,2017,37(4):1609-1615.
[13] 刘婷婷,肖瑛,刘丽.品管圈活动在老年糖尿病患者饮食健康教育中的应用[J].中国基层医药,2017,24(18):2868-2871.
[14] 杨碧萍,林小云,王辉.以赋权理论为指导的干预模式在高血压患者中的应用效果[J].广东医学,2016,37(15):2365-2368.
[15] 李弋南,张俊,张燕林.维持性血液透析患者合并肺结核伴血压异常升高一例[J].中华全科医师杂志,2017,16(2):148-150.
[16] SAHARA S,SUGIMOTO M,ICHIKAWA H,et al.Efficacy of reduced dosage of amoxicillin in an eradication therapy for helicobacter pylori infection in patients on hemodialysis:a randomized controlled trial[J].Digestion,2018,97(2):163-169.
[17] 罗怡欣,黄燕林.奥马哈系统护理模式对持续不卧床腹膜透析患者营养状态和透析充分性的影响[J].广东医学,2017,38(19):3055-3059.
[18] 郭晓蕙,陈莉明,陈丽,等.移动医疗患者管理模式对2型糖尿病基础胰岛素治疗依从性及血糖控制12周的效果评估[J].中华内分泌代谢杂志,2016,32(8):639-646.
[19] LI X,HE M,WANG H.Application of failure mode and effect analysis in managing catheter-related blood stream infection in intensive care unit[J].Medicine,2017,96(51):e9339.
[20] 张建芳,刘永泉,王淑华.持续不卧床腹膜透析患者肺动脉高压的影响因素分析[J].河北医药,2015,37(2):238-240.
[2] 韩玉亭,孙正凯,宫振霞,等.个体化健康管理模式对糖尿病合并冠心病患者自我效能感及遵医行为的影响[J].山东医药,2016,56(38):65-67.
[3] INRA J,PELLETIER S,KUMAR N L,et al.Tu1116 one-on-one individualized coaching of faculty improves self-reported teaching and presentation skills among presenters[J].Gastroenterology,2016,150(4):S847-S848.
[4] 倪云霞,刘素珍,李继平,等.护士主导的管理模式对社区糖尿病患者血糖控制及就医行为的影响[J].中华护理杂志,2017,52(2):222-227.
[5] 罗怡欣,黄燕林,刘玲玲,等.奥马哈系统个案管理模式在维持性血液透析患者中的应用[J].实用医学杂志,2017,33(19):3311-3313.
[6] 游书秋,杜茜倩,李胜玲,等.家庭访视护理对社区老年糖尿病患者自我效能的影响[J].实用医学杂志,2016,32(12):2058-2060.
[7] HASHEMI-GHASEMABADI M,TALEGHANI F,YOUSEFY A,et al.Transition to the new role of caregiving for families of patients with breast cancer:a qualitative descriptive exploratory study[J].Support Care Cancer,2016,24(3):1269-1276.
[8] 叶任高,沈清瑞.肾脏病诊断与治疗学[M].北京:人民卫生出版社,1994.
[9] 杨艳,赵琨,吕娅,等.多学科协作模式在老年糖尿病患者护理中的应用[J].医学研究生学报,2016,29(12):1318-1320.
[10] 董勤.治未病理论在糖尿病患者负性情绪护理中的应用效果[J].中华全科医学,2017,15(7):1266-1268.
[11] 刘冬梅,张佳淇,李胜玲,等.基于授权理论实施社区老年糖尿病患者家庭访视护理的实践[J].中华全科医学,2017,15(7):1245-1248.
[12] CHIRICO A,SERPENTINI S,MERLUZZI T,et al.Self-efficacy for coping moderates the effects of distress on quality of life in palliative cancer care[J].Anticancer Res,2017,37(4):1609-1615.
[13] 刘婷婷,肖瑛,刘丽.品管圈活动在老年糖尿病患者饮食健康教育中的应用[J].中国基层医药,2017,24(18):2868-2871.
[14] 杨碧萍,林小云,王辉.以赋权理论为指导的干预模式在高血压患者中的应用效果[J].广东医学,2016,37(15):2365-2368.
[15] 李弋南,张俊,张燕林.维持性血液透析患者合并肺结核伴血压异常升高一例[J].中华全科医师杂志,2017,16(2):148-150.
[16] SAHARA S,SUGIMOTO M,ICHIKAWA H,et al.Efficacy of reduced dosage of amoxicillin in an eradication therapy for helicobacter pylori infection in patients on hemodialysis:a randomized controlled trial[J].Digestion,2018,97(2):163-169.
[17] 罗怡欣,黄燕林.奥马哈系统护理模式对持续不卧床腹膜透析患者营养状态和透析充分性的影响[J].广东医学,2017,38(19):3055-3059.
[18] 郭晓蕙,陈莉明,陈丽,等.移动医疗患者管理模式对2型糖尿病基础胰岛素治疗依从性及血糖控制12周的效果评估[J].中华内分泌代谢杂志,2016,32(8):639-646.
[19] LI X,HE M,WANG H.Application of failure mode and effect analysis in managing catheter-related blood stream infection in intensive care unit[J].Medicine,2017,96(51):e9339.
[20] 张建芳,刘永泉,王淑华.持续不卧床腹膜透析患者肺动脉高压的影响因素分析[J].河北医药,2015,37(2):238-240.