協(xié)同護(hù)理對(duì)血液透析患者自我管理能力及生活質(zhì)量的影響

王景紅

[摘要] 目的 探討協(xié)同護(hù)理對(duì)血液透析患者自我管理能力及生活質(zhì)量的影響。 方法 選擇2017年1月～2019年1月本院收治的晚期腎功能衰竭實(shí)施長(zhǎng)期血液透析者80例，隨機(jī)分為兩組，各40例。對(duì)照組行常規(guī)護(hù)理干預(yù)，觀察組實(shí)施協(xié)同護(hù)理，對(duì)所有患者出院后隨訪1個(gè)月，比較患者自我管理能力、Barthel指數(shù)及腎功能變化情況。結(jié)果 干預(yù)后觀察組自我管理能力各分項(xiàng)得分均明顯高于對(duì)照組（P<0.05），干預(yù)后觀察組腎功能指標(biāo)基本恢復(fù)正常，且尿素氮水平低于對(duì)照組（P<0.05），肌酐水平低于對(duì)照組（P<0.05），干預(yù)后觀察組Barthel指數(shù)明顯高于干預(yù)前和干預(yù)后對(duì)照組（P<0.05）。 結(jié)論 針對(duì)尿毒癥血液透析者，實(shí)施協(xié)同護(hù)理，對(duì)提高患者自我管理能力及生活質(zhì)量，改善治療效果等均有重要價(jià)值。

[關(guān)鍵詞] 協(xié)同護(hù)理;血液透析;自我管理能力;生活質(zhì)量

[中圖分類號(hào)] R473.5? ? ? ? ? [文獻(xiàn)標(biāo)識(shí)碼] B? ? ? ? ? [文章編號(hào)] 1673-9701（2020）03-0174-03

[Abstract] Objective To explore the effect of collaborative nursing on self-management ability and quality of life of hemodialysis patients. Methods 80 patients with advanced renal failure who underwent long-term hemodialysis from January 2017 to January 2019 were randomly divided into two groups， with 40 cases in each group. The control group underwent routine nursing intervention， and the observation group underwent collaborative nursing. All patients were followed up for 1 month after discharge， and the patients' self-management ability， Barthel index and renal function were compared. Results After intervention， the scores of self-management ability of the observation group were significantly higher than those of the control group（P<0.05）. After intervention， the renal function index of the observation group returned to normal， and the urea nitrogen level was lower than that of the control group（P<0.05）. The creatinine level of the observation group was lower than that of the control group（P<0.05）. The Barthel index in the observation group after intervention was significantly higher than that before intervention and that of the control group after intervention（P<0.05）. Conclusion For uremic hemodialysis patients， the implementation of collaborative nursing has important value in improving patients' self-management ability， quality of life and improving treatment effect.

[Key words] Collaborative nursing; Hemodialysis; Self-management ability; Quality of life

超過80%的慢性腎功能衰竭患者需要長(zhǎng)期的血液透析維系生命[1]。雖然長(zhǎng)期血液透析被認(rèn)為是治療晚期腎功能衰竭尿毒癥者最有效的方法，且終末期腎臟疾病實(shí)施長(zhǎng)期血液透析，費(fèi)用昂貴，尤其隨著病程的延長(zhǎng)，患者疾病的進(jìn)展，其出現(xiàn)焦慮、抑郁、敵對(duì)等負(fù)面心理比例明顯增加，加之腎功能衰竭對(duì)生理功能造成的影響，患者承受多方面的心理與經(jīng)濟(jì)壓力，生活質(zhì)量顯著降低，自我管理能力不利于疾病康復(fù)[2]。所以針對(duì)晚期腎功能衰竭尿毒癥行長(zhǎng)期血液透析者，實(shí)施有效的護(hù)理干預(yù)，對(duì)提高患者自我管理能力，減少并發(fā)癥有重要意義[3]。本研究主要探討協(xié)同護(hù)理干預(yù)對(duì)血液透析患者護(hù)理能力及生活質(zhì)量的影響，現(xiàn)報(bào)告如下 。

1 資料與方法

1.1 一般資料

選擇2017年1月～2019年1月本院收治的晚期腎功能衰竭實(shí)施長(zhǎng)期血液透析者80例，所有患者均以臨床表現(xiàn)、既往治療史通過尿常規(guī)、腎功能結(jié)合臨床病史診斷尿毒癥?！?br>