CAJ | 학술논문

目的：探讨情境体验式健康教育联合心理辅导在维持性血液透析患者中的应用效果。方法选取终末期肾病并行维持性血液透析的患者80例,根据随机数字表法分为观察组及对照组各40例。对照组接受常规健康教育,观察组在常规健康教育的基础上,行情境体验式健康教育并同时进行心理辅导。比较两组患者年龄等一般资料,使用简明健康调查量表、焦虑自评量表、抑郁自评量表对患者行问卷调查。结果两组患者在年龄等一般资料之间比较差异无统计学意义(P>0.05)。观察组实施干预后在活力、生理功能、社会功能、躯体疼痛、精神健康、生理职能、情感职能及总体健康等8个维度的健康生活质量测评方面得分均高于对照组( t 值分别为6.102,4.484,5.311,5.268,5.339,3.939,7.885,6.952；P<0.01)。干预后观察组焦虑自评量表得分为(53.7±9.1)分,与对照组的(58.9±11.0)分比较差异有统计学意义(t =4.621,P <0.01)。观察组护理后抑郁自评量表得分为(45.4±6.8)分,较对照组的(54.6±7.6)分有明显改善,差异有统计学意义(t=5.623,P<0.01)。干预后观察组患者高血压、低血压、低血糖、内瘘闭塞等并发症的发生率明显低于对照组,差异有统计学意义(χ2值分别为6.023,7.352,5.364,5.964；P<0.05)。结论对维持性血液透析患者开展情境体验式健康教育联合心理辅导,显著提高了患者的生活质量,改善其心理状态。
목적：탐토정경체험식건강교육연합심리보도재유지성혈액투석환자중적응용효과。방법선취종말기신병병행유지성혈액투석적환자80례,근거수궤수자표법분위관찰조급대조조각40례。대조조접수상규건강교육,관찰조재상규건강교육적기출상,행정경체험식건강교육병동시진행심리보도。비교량조환자년령등일반자료,사용간명건강조사량표、초필자평량표、억욱자평량표대환자행문권조사。결과량조환자재년령등일반자료지간비교차이무통계학의의(P>0.05)。관찰조실시간예후재활력、생리공능、사회공능、구체동통、정신건강、생리직능、정감직능급총체건강등8개유도적건강생활질량측평방면득분균고우대조조( t 치분별위6.102,4.484,5.311,5.268,5.339,3.939,7.885,6.952；P<0.01)。간예후관찰조초필자평량표득분위(53.7±9.1)분,여대조조적(58.9±11.0)분비교차이유통계학의의(t =4.621,P <0.01)。관찰조호리후억욱자평량표득분위(45.4±6.8)분,교대조조적(54.6±7.6)분유명현개선,차이유통계학의의(t=5.623,P<0.01)。간예후관찰조환자고혈압、저혈압、저혈당、내루폐새등병발증적발생솔명현저우대조조,차이유통계학의의(χ2치분별위6.023,7.352,5.364,5.964；P<0.05)。결론대유지성혈액투석환자개전정경체험식건강교육연합심리보도,현저제고료환자적생활질량,개선기심리상태。
Objective To explore the application effect situational experiencing health education with psychological counseling in maintenance hemodialysis patients. Methods A total of 80 patients, who had the final stage of renal failure and treated by maintenance hemodialysis in Tongde Hospital of Zhejiang Province in January 2013 to February 2014, were selected and randomly divided into observation group and control group on average. The patients of control group received conventional health education, while the patients of observation group were on the basis of conventional health education, received health education market environment and simultaneously experiencing psychological counseling. We compared the patients′general information such as the age, and utilized concise health SF-36 quality of life questionnaire and self-rating anxiety scale ( SAS ) and self-rating depression scale ( SDS) to questionnaire. Results The difference between the patient′s age and other general information were not statistically significant (P>0. 05). Scores of observation group were higher than these of the control group in vitality, physical function, social function, bodily pain, mental health, physical function, role emotional and general health aspects of eight dimensions ( t =6. 102, 4. 484, 5. 311, 5. 268, 5. 339, 3. 939, 7. 885, 6. 952;P <0. 01). After nursing intervention, the score of SAS acquired (53. 7 ± 9.1), higher than (58. 9 ± 11. 0) of control group (t =4. 621,P <0. 01). The score of SDS improved significantly compared the score of control group (45. 4 ± 6. 8) vs. (54. 6 ± 7. 6), which had statistical significance between two group (t =5. 623,P <0. 01). The complication incidences of observation group patients were apparently lower than those the control group including high blood pressure, low blood pressure, low blood glucose, and fistula occlusion (χ2 =6. 023, 7. 352, 5. 364, 5. 964;P<0. 05). Conclusions The situational experience health education with psychological counseling can improve maintenance hemodialysis patients′quality of life and mental health.