护士主导的非药物多学科整体护理对接受血液透析的疲劳患者的影响：一项随机、平行组对照试验。
The impact of nurse-led nonpharmacological multidisciplinary holistic nursing care on fatigue patients receiving hemodialysis: a randomized, parallel-group, controlled trial.
作者信息
Zuo Manhua, Zhu Wensheng, Lin Jinrong, Zhuo Jing, He Xirui, Jing Xinghui, Tang Jun, Deng Renli
机构信息
Department of Nursing, Zhuhai Campus of Zunyi Medical University, No. 368 Jinwan Road, Sanzao Town, Jinwan District, Zhuhai, 519041, China.
Dialysis center, Shanghai Hospital, No. 112 Shanghai Avenue, Wanzhou District, Chongqing, 445000, China.
出版信息
BMC Nurs. 2022 Dec 12;21(1):352. doi: 10.1186/s12912-022-01126-3.
BACKGROUND
Fatigue is a symptom characterized by an elevated prevalence in patients undergoing hemodialysis, which may cause extreme mental and muscular debilitation, significantly influencing social interaction, life quality and well-being. However, the significance of fatigue to patients undergoing hemodialysis has not been recognized yet, and prevention and management of fatigue in this population have not been thoroughly investigated. Additionally, previous studies mainly focused on muscular fatigue, while mental fatigue has been seldom discussed. This study aims to investigate the interaction between nurses and multidisciplinary of nonpharmacological integrated care interventions (NICIs) and assess the impact of fatigue on patients undergoing hemodialysis.
METHODS
The integrative nonpharmacological care interventions in this study included walking, motivational interviewing (MI) and health education regarding behavioral self-management. A single-center randomized controlled trial was conducted in the dialysis center of the nephrological department in a tertiary affiliated hospital of medical university from January to June 2019. A total of 118 patients were selected and randomly divided into the intervention group (IG) and the control group (CG). Four patients dropped out during the study, and 114 patients were enrolled for the eventual analysis. The 60 patients in the IG received routine nursing combined with integrated care interventions, while the 54 patients in the CG received routine nursing only. This study lasted for six months.
RESULTS
The experimental group exhibited significant reductions of overall fatigue (2.26 vs. 0.48), mental fatigue (1.41 vs. 0.54), muscular fatigue (2.13 vs. 0.75), and some biochemical indicators (e.g., serum urea) (P<0.05), compared with the CG.
CONCLUSIONS
Nurses and multidisciplinary teams have been demonstrated to play a key role and interplay function in chronic disease management. Hence, the nurse-led multidisciplinary NICIs significantly alleviated total fatigue (muscular fatigue and mental fatigue) and improved other parameters.
TRIAL REGISTRATION
ChiCTR-IOR-16008621 (March 18, 2016).
背景
疲劳是一种症状，在接受血液透析的患者中患病率较高，可能导致极度的精神和肌肉衰弱，严重影响社交互动、生活质量和幸福感。然而，疲劳对接受血液透析患者的重要性尚未得到认可，并且该人群疲劳的预防和管理也未得到充分研究。此外，以往研究主要集中在肌肉疲劳，而对精神疲劳的讨论较少。本研究旨在探讨护士与多学科非药物综合护理干预（NICIs）之间的相互作用，并评估疲劳对接受血液透析患者的影响。
方法
本研究中的综合非药物护理干预包括散步、动机性访谈（MI）以及行为自我管理的健康教育。2019年1月至6月，在某医科大学附属三级医院肾内科透析中心进行了一项单中心随机对照试验。共选取118例患者，随机分为干预组（IG）和对照组（CG）。研究期间有4例患者退出，最终纳入114例患者进行分析。IG组的60例患者接受常规护理并结合综合护理干预，而CG组的54例患者仅接受常规护理。本研究持续6个月。
结果
与CG组相比，实验组的总体疲劳（2.26对0.48）、精神疲劳（1.41对0.54）、肌肉疲劳（2.13对0.75）以及一些生化指标（如血清尿素）均显著降低（P<0.05）。
结论
护士和多学科团队已被证明在慢性病管理中发挥关键作用和相互作用功能。因此，由护士主导的多学科NICIs显著减轻了总疲劳（肌肉疲劳和精神疲劳）并改善了其他指标。
试验注册
ChiCTR-IOR-16008621（2016年3月18日）。
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