CAJ | 학술논문

背景:在接受肾移植前后的终末期肾衰竭患者大多要做血液透析治疗,此时患者的不依从现象是比较常见的,不依从行为与患者的死亡率密切相关,改善血液透析患者的自我管理行为有益于改善生存率,并提高生活质量.目的:调查分析护理干预对实施肾移植前后血液透析患者自我管理行为和健康相关生活质量的影响.设计:随机对照,对比分析.单位:中国医科大学附属第一医院护理部和血液透析室.对象:选择2006-02/04在中国医科大学附属第一医院血液透析室因肾功能衰竭进行血液透析的患者48例,其中男29例,女19例;年龄22～77岁.均能读懂问卷并愿意参加;患者对治疗和调查项目知情同意;实验经医院伦理委员会批准.采用随机抽签法将患者分为2组:干预组和对照组,各24例.方法:干预组给予6个月的护理干预,即根据患者的实际情况采用发放健康宣传材料、个别指导、集中指导等多种形式进行健康教育.对照组给予常规健康教育.主要观察指标:分别在护理干预前和干预3,6个月后采用自我管理行为问卷和简明健康调查问卷评估患者的自我管理行为和健康相关生活质量.结果:血液透析患者48例均进入结果分析.护理干预前和干预3个月后干预组和对照组的自我管理行为问卷和简明健康调查问卷总分比较,差异无显著性意义(P＞0.05).干预6个月后两组的自我管理行为问卷评分和简明健康调查问卷总分比较,差异有显著性意义(P＜0.01,0.05).干预组干预6个月后的自我管理行为问卷总分较干预前有显著提高(P＜0.01).结论:护理干预明显改善了肾移植前后血液透析患者的自我管理行为,提高健康相关生活质量.
배경:재접수신이식전후적종말기신쇠갈환자대다요주혈액투석치료,차시환자적불의종현상시비교상견적,불의종행위여환자적사망솔밀절상관,개선혈액투석환자적자아관리행위유익우개선생존솔,병제고생활질량.목적:조사분석호리간예대실시신이식전후혈액투석환자자아관리행위화건강상관생활질량적영향.설계:수궤대조,대비분석.단위:중국의과대학부속제일의원호리부화혈액투석실.대상:선택2006-02/04재중국의과대학부속제일의원혈액투석실인신공능쇠갈진행혈액투석적환자48례,기중남29례,녀19례;년령22～77세.균능독동문권병원의삼가;환자대치료화조사항목지정동의;실험경의원윤리위원회비준.채용수궤추첨법장환자분위2조:간예조화대조조,각24례.방법:간예조급여6개월적호리간예,즉근거환자적실제정황채용발방건강선전재료、개별지도、집중지도등다충형식진행건강교육.대조조급여상규건강교육.주요관찰지표:분별재호리간예전화간예3,6개월후채용자아관리행위문권화간명건강조사문권평고환자적자아관리행위화건강상관생활질량.결과:혈액투석환자48례균진입결과분석.호리간예전화간예3개월후간예조화대조조적자아관리행위문권화간명건강조사문권총분비교,차이무현저성의의(P＞0.05).간예6개월후량조적자아관리행위문권평분화간명건강조사문권총분비교,차이유현저성의의(P＜0.01,0.05).간예조간예6개월후적자아관리행위문권총분교간예전유현저제고(P＜0.01).결론:호리간예명현개선료신이식전후혈액투석환자적자아관리행위,제고건강상관생활질량.
BACKGROUND:Most end-stage renal failure patients must undergo hemodialysis before and after kidney transplantation.Noncompliance is common in patients who undergo hemodialysis,and it correlated with mortality.The improvement in self-management behavior is beneficial to the improvement of survival rate and quailty of life of hemodialysis patients.OBJECTIVE:To investigate and analyze the effect of nursing intervention on self-management behavior and health-related quality of life in hemodialysis patients before and after kidney transplantation.DESIGN:A randomized and controlled analysis.SETTING:Department of Nursing and Hemodialysis Center,First Affiliated Hospital of China Medical University.PARTICIPANTS:Forty-eight renal failure patients who underwent hemodialysis in the Hemodialysis Center,First Affiliated Hospital of China Medical University between February and April 2006 were recruited in this study.The involved patients.including 29 males and 19 females,aged 22-77 years,able to read and write the questionnaires,voluntarily participated in this study.Written informed consents of treatments and investigation items were obtained from each patient.The study was approved by the Ethics Committee of the hospital.The involved patients were randomly assigned into 2 groups with 24 patients in each:intervention group and control group.METHODS:Patients in the intervention group were given 6 months of nursing(i.e.according to actual conditions,each patient was given health education by handing out health promoting stuffs,giving individual or centralized guidance as well as other modalities).Patients in the control group were given routine health education.MAIN OUTCOME MEASURES:Self-management behavior and health-related quality of life were assessed before,3 and 6 months after nursing intervention using self-management behavior questionnaire and short-form 36 health survey.RESULTS:Forty-eight patients who underwent hemodialysis participated in the final analysis.There were no significant differences in the total scores of self-management behavior questionnaire and short-form 36 health survey between intervention group and control group before and 3 months after nursing intervention(P＞0.05).Significant difference in the total scores of self-management behavior questionnaire and short-form 36 health survey existed in each group 6 months after nursing intervention in comparison with baseline(P＜0.01,0.05).The total scores of self-management behavior questionnaire of intervention group were significantly increased 6 months after nursing intervention in comparison with the baseline (P＜0.01).CONCLUSION:Nursing intervention markedly improve the self-management behavior and quailty of life of patients who undergo hemodialysis before and after kidney transplantation.