Barnett Tony, Li Yoong Tang, Pinikahana Jaya, Si-Yen Tan
School of Nursing and Midwifery, Monash University, Churchill, Victoria, Australia.
J Adv Nurs. 2008 Feb;61(3):300-6. doi: 10.1111/j.1365-2648.2007.04528.x.
This paper is a report of a study to examine the effectiveness of a patient education programme on fluid compliance as assessed by interdialytic weight gain, mean predialysis blood pressure and rate of fluid adherence.
Patients with end stage renal disease who receive haemodialysis are often non-compliant with their treatment regime, especially adherence to fluid restrictions.
An exploratory study was conducted in 2004-05 using a quasi-experimental, single group design to examine the effectiveness of patient education on fluid compliance in a dialysis centre located in a major teaching hospital in Kuala Lumpur, Malaysia. Twenty-six patients with an interdialytic weight gain of greater than 2.5 kg were identified as non-compliant and recruited to the study. The intervention was carried out over a 2-month period and included teaching and weekly reinforcement about diet, fluids and control of weight gain.
Patients' mean interdialytic weight gain decreased following the educational intervention from 2.64 kg to 2.21 kg (P < 0.05) and adherence to fluid restrictions increased from 47% to 71% following the intervention. Predialysis mean blood pressure did not improve following the intervention, although the maximum recording for predialysis systolic pressure dropped from 220 mmHg to 161 mmHg. Whilst no statistically significant associations were detected between interdialytic weight gain and age, educational level, marital status or employment status, women demonstrated a greater decrease in mean interdialytic weight gain than men.
Nephrology nurses often have long-term relationships with their patients and are ideally placed to provide ongoing education and encouragement, especially for those experiencing difficulties in adhering to fluid and dietary restrictions.
本文报告一项研究，该研究旨在通过透析间期体重增加、透析前平均血压和液体依从率来评估患者教育计划对液体依从性的有效性。
接受血液透析的终末期肾病患者往往不遵守治疗方案，尤其是在遵守液体限制方面。
2004年至2005年进行了一项探索性研究，采用准实验单组设计，以检验马来西亚吉隆坡一家主要教学医院的透析中心开展的患者教育对液体依从性的有效性。26名透析间期体重增加超过2.5千克的患者被确定为不依从，并被招募到该研究中。干预为期2个月，包括关于饮食、液体和体重增加控制的教学及每周强化指导。
教育干预后，患者的透析间期平均体重增加从2.64千克降至2.21千克（P<0.05），干预后对液体限制的依从性从47%提高到71%。干预后透析前平均血压没有改善，尽管透析前收缩压的最高记录从220毫米汞柱降至161毫米汞柱。虽然在透析间期体重增加与年龄、教育程度、婚姻状况或就业状况之间未检测到统计学上的显著关联，但女性的透析间期平均体重增加降幅大于男性。
肾病科护士通常与患者建立长期关系，非常适合提供持续教育和鼓励，尤其是对那些在遵守液体和饮食限制方面遇到困难的患者。
