行为转变理论模式对血液透析患者钙磷水平的效果研究
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- 英文论文题名：Research on effect of the transtheoretical model and stages of change in maintenance hemodialysis patients
- 论文作者：吴少丽 ; 冯燕英 ; 时光 ; 叶燕芬
- 英文论文作者：Wu Shaoli ; Feng Yanying ; Shi Guang ; Ye Yanfen ; Department of Rheumatism and Kidney Disease ; Central Hospital of Panyu District
- 年：2016
- 作者机构：广州市番禺区中心医院肾病风湿科;
- 论文关键词：肾透析 ; 血磷 ; 行为转变理论模式
- 英文论文关键词：Renal dialysis ; Serum phosphorus ; Transtheoretical model and stages of change
- 会议召开时间：2016-11-29
- 会议录名称：广州市第十届健康教育学术交流会文集
- 语种：中文
- 分类号：R692.5
- 学会代码：SJKS
- 会议名称：广州市第十届健康教育学术交流会
- 会议地点：中国广东广州
- 主办单位：广州市健康教育所、广州市预防医学会健康教育专业委员会
- 学会名称：广州市健康教育所
- 页数：4
- 文件大小：377k
- 原文格式：O
- 会议级别：地方
摘要
目的探讨行为转变理论模式(transtheoretical model and stages of change,TTM)对维持性血液透析(maintenance hemodialysis,MHD)患者自我管理行为及钙磷水平的影响。方法将140例MHD患者按照随机数字表分成实验组和对照组各70例,实验组共65例患者完成研究,采用TTM干预,对照组共63例患者完成研究,采用常规护理。采用钙磷代谢相关知识问卷及自我管理量表对2组患者进行测评,并比较2组患者钙磷水平差异。结果实验组患者自我管理行为在干预后3个月得分高于对照组,其中问题解决、执行自我照顾活动、伙伴关系及情绪处理得分分别为(2.97±0.28)、(2.99±0.28)、(3.13±0.35)、(2.80±0.32)分,明显高于对照组同期的(2.63±0.32)、(2.67±0.38)、(2.76±0.42)、(2.44±0.36)分,t值分别为-9.07、-7.68、-6.03和-8.43,差异有统计学意义,P<0.05。同样,干预后3个月实验组患者血磷水平、钙磷乘积、甲状旁腺激素明显下降,实验组分别为(1.81±0.49)mmol/L、(5533±14.45)mg~2/dl~2、238.00(130.35,413.85)ng/L,明显低于对照组同期的(2.56±0.69)mmol/L、(72.35±20.94)mg~2/dl~2、297.75(155.02,760.37)ng/L,t值分别为11.01和8.43,Z值为-2.09,差异有统计学意义,P<0.05。结论 TTM干预有利于促进MHD患者行为改变,提高其自我管理行为,并有助于降低血磷水平。
Objective To investigate effect of the transtheoretical model and stages of change(TTM) on self-management paradigm,serum calcium and phosphorus levels in patients undergoing maintenance hemodialysis(MHD).Methods Total 140 MHD patients were separated into two groups as the intervention group(65 of 70 cases completed with TTM) and the control group(63 of 70 cases completed with routine nursing care) by random number table.Data obtained by using hyperphosphatemia related knowledge questionnaires and Self-management Rating Scale before and after intervention.The levels of serum calcium and phosphorus between the above groups were compared.Results The scores of selfmanagement behavior were higher in control group after 3 months intervention,the differences was statistically significant(P<0.05),in which the scores of problem solving(2.97±0.28),self care activities(2.99±0.28),relationships(3.13±0.35) and emotional treatment(2.80±0.32) in experimental group was apparently higher than control group at the same time,the scores were(2.63±0.32),(2.67±0.38),(2.76±0.42),(2.44±0.36) respectively in conrtol group,t values were-0.907,-7.68,-6.03 and-8.43,respectively.And also,there was statistically significant difference between the two groups in serum phosphorus level[(1.81±0.49) mmol/L vs.(2.56±0.69) mmol/L],the product of calcium and phosphorus[(55.33±14.45) mg~2/dl~2 vs.(72.35±20.94) mg~2/dl~2],serum parathyroid hormone[238.00(130.35,413.85) ng/L vs.297.75(155.02,760.37) ng/L](t= 11.01,8.43,Z=-2.09,P<0.05).Conclusions TTM is conducive to promote behavior change,improve selfmanagement conduct,and also reduce serum phosphorus level in MHD patients.
Objective To investigate effect of the transtheoretical model and stages of change(TTM) on self-management paradigm,serum calcium and phosphorus levels in patients undergoing maintenance hemodialysis(MHD).Methods Total 140 MHD patients were separated into two groups as the intervention group(65 of 70 cases completed with TTM) and the control group(63 of 70 cases completed with routine nursing care) by random number table.Data obtained by using hyperphosphatemia related knowledge questionnaires and Self-management Rating Scale before and after intervention.The levels of serum calcium and phosphorus between the above groups were compared.Results The scores of selfmanagement behavior were higher in control group after 3 months intervention,the differences was statistically significant(P<0.05),in which the scores of problem solving(2.97±0.28),self care activities(2.99±0.28),relationships(3.13±0.35) and emotional treatment(2.80±0.32) in experimental group was apparently higher than control group at the same time,the scores were(2.63±0.32),(2.67±0.38),(2.76±0.42),(2.44±0.36) respectively in conrtol group,t values were-0.907,-7.68,-6.03 and-8.43,respectively.And also,there was statistically significant difference between the two groups in serum phosphorus level[(1.81±0.49) mmol/L vs.(2.56±0.69) mmol/L],the product of calcium and phosphorus[(55.33±14.45) mg~2/dl~2 vs.(72.35±20.94) mg~2/dl~2],serum parathyroid hormone[238.00(130.35,413.85) ng/L vs.297.75(155.02,760.37) ng/L](t= 11.01,8.43,Z=-2.09,P<0.05).Conclusions TTM is conducive to promote behavior change,improve selfmanagement conduct,and also reduce serum phosphorus level in MHD patients.
引文
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[8]冯婉娜,钟宇芳,许元文,等.维持性血液透析患者磷代谢知晓度对血磷水平的影响[J].中华现代护理杂志,2009,15(21):2023-2024.
[9]赵琳,崔妙玲,王自秀,等.跨理论模型的健康教育对慢性阻塞性肺疾病患者自我管理的影响[J].中国实用护理杂志,2013,29(35):14-16.
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[12]Carter T,Ratnam S.Caleiphylaxis:a devastating complication of derangements of calcium-phosphorus metabolism-a case report and review oftheliterature[J].Nephrol Nurs J,2013,40(5):431-435.
[2]陈孟华.透析患者的钙磷代谢紊乱与钙化性血管病[J].中国血液净化,2009,10(8):529-530.
[3]Kong X,Zhang L,Zhang L,et al.Mineral and bone disorder in Chinese dialysis patients:a multicenter study[J].BMC Nephrol,2012,13:116.
[4]马芳琴.授权教育在血液透析患者自我管理中的应用研究[D].苏州:苏州大学,2014.
[5]Singer EA.The transtheoretical model and primary care:"The Times They Are A Changin"[J].J Am Acad Nurse Pract,2007,19(1):11-14.
[6]宋艺君.血液透析病患者自我管理量表之建构与测试[D].台湾:高雄医学大学,2009.
[7]马芳琴,薛小玲,徐琴娟,等,血液透析患者自我管理行为横断面研究及因子分析[J].中国实用护理杂志,2013,29(26):48-51.
[8]冯婉娜,钟宇芳,许元文,等.维持性血液透析患者磷代谢知晓度对血磷水平的影响[J].中华现代护理杂志,2009,15(21):2023-2024.
[9]赵琳,崔妙玲,王自秀,等.跨理论模型的健康教育对慢性阻塞性肺疾病患者自我管理的影响[J].中国实用护理杂志,2013,29(35):14-16.
[10]尹博.健康行为改变的跨理论模型[J].中国心理卫生杂志,2007,21(3):194-199.
[11]王素琴,潘以娟,林毕群.行为分阶段转变理论在血液透析患者中的应用[J].中华现代护理杂志,2014,20(3):284-286.
[12]Carter T,Ratnam S.Caleiphylaxis:a devastating complication of derangements of calcium-phosphorus metabolism-a case report and review oftheliterature[J].Nephrol Nurs J,2013,40(5):431-435.