强化教育方案在血液透析患者磷控制中的实施和效果：一项非随机、单臂、单中心试验。
Implementation and effectiveness of an intensive education program on phosphate control among hemodialysis patients: a non-randomized, single-arm, single-center trial.
机构信息
Blood purification center, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China.
Blood purification center, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
出版信息
BMC Nephrol. 2021 Jul 1;22(1):243. doi: 10.1186/s12882-021-02441-8.
BACKGROUND
Hyperphosphatemia is a common complication in patients on maintenance hemodialysis. Patients' adherence to phosphorus control can be improved by consistent education. However, few studies have focused on the model construction and effects of health education on phosphate control for hemodialysis patients.
OBJECTIVE
To develop an intensive education program focusing on phosphate control among hemodialysis patients and to analyze the effectiveness of this program.
DESIGN
A non-randomized, single-arm, single-center trial lasting for 6 months.
SETTING
This program was conducted in a hemodialysis center in a teaching hospital in Zhuhai, China.
PARTICIPANTS
Patients on maintenance hemodialysis with hyperphosphatemia.
METHODS
An intensive hyperphosphatemia control education program lasting for 6 months was conducted among 366 hemodialysis patients applying the First Principles of Instruction model, which focused on mastering four stages: (a) activation of prior experience, (b) demonstration of skills, (c) application of skills and (d) integration of these skills into real-world activities. The controlled percentage of serum phosphorus, knowledge of hyperphosphatemia, and adherence to phosphate binders before and after the education program were assessed.
RESULTS
The proportion of controlled serum phosphorus was significantly increased from 43.5 to 54.9% (P<0.001). The scores on the knowledge of phosphate control were improved significantly from 59.0 ± 18.9 to 80.6 ± 12.4 (P < 0.001). The proportion of high adherence to phosphate binders was increased dramatically from 21.9 to 44.5% (P < 0.001).
CONCLUSION
The intensive education program can effectively improve serum phosphorus, knowledge of hyperphosphatemia, and adherence to phosphate binders among hemodialysis patients.
TRIAL REGISTRATION
Chinese Clinical Trial Registry, ChiCTR2100042017 . Retrospectively registered January 12th, 2021.
背景
高磷血症是维持性血液透析患者的常见并发症。通过持续教育，可以提高患者对磷控制的依从性。然而，很少有研究关注构建模型和健康教育对血液透析患者磷控制的效果。
目的
制定针对血液透析患者的强化磷控制教育方案，并分析该方案的效果。
设计
非随机、单臂、单中心试验，持续 6 个月。
地点
该方案在中国珠海某教学医院的血液透析中心进行。
参与者
患有高磷血症的维持性血液透析患者。
方法
采用第一原则教学模型，对 366 名血液透析患者进行为期 6 个月的强化高磷血症控制教育方案，重点掌握四个阶段：（a）激活先前经验，（b）演示技能，（c）应用技能，（d）将这些技能整合到现实活动中。在教育计划前后评估血清磷的控制百分比、高磷血症的知识和对磷酸盐结合剂的依从性。
结果
控制血清磷的比例从 43.5%显著增加到 54.9%（P<0.001）。对磷酸盐控制知识的评分从 59.0±18.9显著提高到 80.6±12.4（P<0.001）。高磷酸盐结合剂依从性的比例从 21.9%显著增加到 44.5%（P<0.001）。
结论
强化教育方案可有效提高血液透析患者的血清磷、高磷血症知识和对磷酸盐结合剂的依从性。
临床试验注册
中国临床试验注册中心，ChiCTR2100042017 。于 2021 年 1 月 12 日进行了回顾性注册。
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