Natashia Dhea, Yen Miaofen, Chen Hsing-Mei, Fetzer Susan J
Doctoral Student Department of Nursing, College of Medicine, National Cheng Kung University, Tainan City, Taiwan, and Lecturer, Department Medical Surgical Nursing, Faculty of Nursing, Muhammadiyah University of Jakarta, Jakarta, Indonesia.
Lambda Beta-At-Large, Professor, Department of Nursing, College of Medicine, National Cheng Kung University, Tainan City, Taiwan.
J Nurs Scholarsh. 2019 Jul;51(4):417-426. doi: 10.1111/jnu.12464. Epub 2019 Feb 18.
The purpose of this study was to understand the influence of demographic and psychological factors on self-management behaviors and interdialytic weight gain (IDWG) as a fluid adherence marker among patients undergoing hemodialysis in Indonesia.
A quantitative correlational study.
A convenience sample of 145 patients undergoing hemodialysis was recruited from the dialysis units in two hospitals in Jakarta from September to December 2015. Questionnaires were used to examine self-management behaviors, depression, anxiety, and stress. Data for IDWG were obtained by subtracting the individual's predialysis weight from his or her postdialysis weight from the previous session. Hierarchical multiple linear regression identified the predictors of IDWG.
Self-advocacy was ranked the least performed self-management behavior, while medication adherence was ranked the most likely to be performed. Among the subscales of the Self-Management Behavior Indices, positive correlations were found between the communication dimension with all psychological factors (depression, anxiety, and stress), while self-advocacy had positive correlation with anxiety. Subjects gained a mean of 4.5% of their postdialysis weight, with over 50% exceeding the recommended 4% IDWG. Overall, 53.6% of the IDWG was explained by the weekly duration of hemodialysis, level of depression, communication, partnership in care, and self-advocacy.
Self-management behaviors are potential predictors that can be modified by nephrology nurses in order to enhance clinical outcomes, with the specific outcome being IDWG. Self-management behaviors contribute to the promotion of appropriate IDWG. Depressed patients are less likely to adhere to weight gain restrictions.
Education combined with training in self-management behaviors-particularly communication, becoming a partner in care, and advocating for care-may improve adherence to IDWG guidelines among Indonesian hemodialysis patients. Interventions targeting depressed patients are needed.
本研究旨在了解人口统计学和心理因素对印度尼西亚接受血液透析患者的自我管理行为以及作为液体依从性指标的透析间期体重增加（IDWG）的影响。
定量相关性研究。
2015年9月至12月，从雅加达两家医院的透析科室招募了145名接受血液透析的患者作为便利样本。使用问卷来检查自我管理行为、抑郁、焦虑和压力。IDWG的数据通过用上一次透析后的体重减去透析前的体重获得。分层多元线性回归确定了IDWG的预测因素。
自我主张被列为执行最少的自我管理行为，而药物依从性被列为最有可能执行的行为。在自我管理行为指标的子量表中，沟通维度与所有心理因素（抑郁、焦虑和压力）之间存在正相关，而自我主张与焦虑呈正相关。受试者透析后的体重平均增加了4.5%，超过50%的人超过了推荐的4%的IDWG。总体而言，53.6%的IDWG可由血液透析的每周时长、抑郁程度、沟通、护理伙伴关系和自我主张来解释。
自我管理行为是肾病护士可以改变的潜在预测因素，以改善临床结果，具体结果是IDWG。自我管理行为有助于促进适当的IDWG。抑郁患者不太可能遵守体重增加限制。
结合自我管理行为培训的教育——特别是沟通、成为护理伙伴和倡导护理——可能会提高印度尼西亚血液透析患者对IDWG指南的依从性。需要针对抑郁患者进行干预。
