Schmid-Mohler Gabriela, Zala Patrizia, Graf Nicole, Witschi Patrick, Mueller Thomas F, Peter Wüthrich Rudolf, Huber Laura, Fehr Thomas, Spirig Rebecca
Center of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland.
Division of Nephrology, University Hospital Zurich, Zurich, Switzerland.
Transplant Direct. 2019 Nov 15;5(12):e507. doi: 10.1097/TXD.0000000000000936. eCollection 2019 Dec.
In the first year following renal transplantation, preventing weight gain to minimize overweight or obesity is particularly important. The aim of this study is to test the effect of an 8-month behavioral intervention BMI and physical activity.
This randomized controlled study included 123 adult kidney or kidney-pancreas recipients. Patients were randomized to usual (1 educational session, then weight self-monitoring) and intervention care (usual care plus 7-8 counseling sessions). Alongside weight, body composition, and physical activity, satisfaction and perceptions regarding care were measured at weeks 2-6 (baseline), then at months 8 and 12.
Both groups reported comparably high satisfaction. The intervention group (IG) reported more chronic care-related activities. In patients with BMIs ≥ 18.5, mean weight gain (from baseline) was unexpectedly low in both groups: at month 8, +0.04 kg/m in IG patients and +0.14 kg/m in the control group ( = 0.590), and respectively, +0.03 kg/m and +0.19 kg/m at month 12 ( = 0.454). Both groups were physically active, walking averages of 10 807 (IG) and 11 093 (control group) steps per day at month 8 ( = 0.823), and respectively 9773 and 11 217 at month 12 ( = 0.195).
The behavioral intervention had high patient acceptance and supported patients in maintaining their weight, but had no superior effect on a single educational session. Further research is needed to assess patient weight gain risk profiles to stratify the intervention.
在肾移植后的第一年，防止体重增加以尽量减少超重或肥胖尤为重要。本研究的目的是测试为期8个月的行为干预对体重指数（BMI）和身体活动的影响。
这项随机对照研究纳入了123名成年肾或肾胰联合移植受者。患者被随机分为常规护理组（1次教育课程，然后进行体重自我监测）和干预护理组（常规护理加7 - 8次咨询课程）。除体重、身体成分和身体活动外，在第2 - 6周（基线）、第8个月和第12个月测量对护理的满意度和认知。
两组的满意度都相当高。干预组报告了更多与慢性护理相关的活动。在BMI≥18.5的患者中，两组的平均体重增加（相对于基线）出人意料地低：在第8个月，干预组患者为+0.04kg/m²，对照组为+0.14kg/m²（P = 0.590）；在第12个月，分别为+0.03kg/m²和+0.19kg/m²（P = 0.454）。两组都有身体活动，在第8个月，干预组平均每天步行10807步，对照组为11093步（P = 0.823）；在第12个月，分别为9773步和11217步（P = 0.195）。
行为干预具有较高的患者接受度，并有助于患者维持体重，但对单次教育课程没有显著优势。需要进一步研究以评估患者体重增加风险概况，以便对干预进行分层。
