Morgan L
Salisbury State University, Salisbury, MD, USA.
Nephrol Nurs J. 2000 Jun;27(3):299-304.
Hemodialysis patients are asked to adhere to a very difficult treatment regimen consisting of fluid and diet restrictions, many daily medications, and, usually, 3- or 4-hour hemodialysis sessions three times each week. Many hemodialysis patients fail to adhere to their prescribed treatment. Although this regimen is difficult, it is necessary for patients to adhere to the prescribed regimen for optimal health and well-being. It is important for nephrology nurses to know what interventions help patients overcome the barriers that keep them from adhering to the prescribed treatment. The purpose of this paper is to review the literature to examine the research that has been published on methods to improve adherence to the treatment regimen among hemodialysis patients. Behavioral approaches, education, and primary nursing are interventions that have been researched. More research has been reported on the demographics of noncompliant hemodialysis patients than on effective methods that help patients improve adherence to the treatment regimen. Demographic characteristics do not consistently predict compliance for individual patients. Each patient is unique. Research supports the idea that the nephrology nurse should spend time with the patient on a regular basis in order to understand the factors that hinder the individual patient from adhering to the treatment regimen. The nurse who knows the patient well is empowered to develop individualized interventions aimed at reducing barriers that interfere with the patient's ability to adhere the prescribed treatment regimen.
血液透析患者需要严格遵守一套非常困难的治疗方案，包括限制液体摄入和饮食、每天服用多种药物，并且通常每周要进行三次每次时长3至4小时的血液透析治疗。许多血液透析患者无法坚持他们规定的治疗方案。尽管这个方案很困难，但患者坚持规定的方案对于保持最佳健康状态和幸福生活是必要的。肾病科护士了解哪些干预措施有助于患者克服阻碍他们坚持规定治疗的障碍非常重要。本文的目的是回顾文献，审视已发表的关于提高血液透析患者对治疗方案依从性方法的研究。行为方法、教育和责任制护理是已被研究的干预措施。关于不依从治疗的血液透析患者的人口统计学特征的研究报告比关于帮助患者提高对治疗方案依从性的有效方法的研究报告更多。人口统计学特征并不能始终如一地预测个体患者的依从性。每个患者都是独特的。研究支持这样一种观点，即肾病科护士应该定期与患者交流，以便了解阻碍个体患者坚持治疗方案的因素。充分了解患者的护士有能力制定个性化的干预措施，旨在减少干扰患者坚持规定治疗方案能力的障碍。
