Li Hui, Liu Xian-Li, Huang Si-Feng, Wen Yi-Jun
Department of Nephrology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Int Wound J. 2024 Mar;21(3):e14697. doi: 10.1111/iwj.14697.
This study analyses the effects of a continuous quality improvement nursing model on wound pain at the arteriovenous fistula (AVF) puncture site in patients undergoing haemodialysis. Forty haemodialysis patients from the First Affiliated Hospital of Chongqing Medical University, from September 2020 to December 2022, were selected as study subjects. They were randomly divided into an observation group and a control group. The control group received conventional nursing care, while the observation group was treated with a continuous quality improvement nursing model. The study compared the impact of these nursing approaches on pain intensity post-AVF puncture, wound visual analogue scale scores, self-rating anxiety scale, self-rating depression scale, quality of life scores and patient satisfaction with nursing care. In the observation group, the proportion of patients experiencing moderate to severe pain during AVF puncture was lower than that in the control group, whereas the proportion of patients with no pain or mild pain was higher (P = 0.008). After nursing, the observation group exhibited significantly lower wound visual analogue scale scores, self-rating anxiety scale scores, and self-rating depression scale scores compared to the control group (P < 0.001), with a significantly higher quality of life score (P < 0.05). The nursing satisfaction rate was 95.00% in the observation group, significantly higher than the 65.00% in the control group (P = 0.018). The continuous quality improvement nursing model significantly reduces wound pain at the AVF puncture site in haemodialysis patients, alleviates negative emotions, enhances the quality of life, and achieves high patient satisfaction. It is thus a highly recommendable approach in nursing practice.
本研究分析了持续质量改进护理模式对血液透析患者动静脉内瘘（AVF）穿刺部位伤口疼痛的影响。选取2020年9月至2022年12月重庆医科大学附属第一医院的40例血液透析患者作为研究对象。将他们随机分为观察组和对照组。对照组接受常规护理，而观察组采用持续质量改进护理模式。该研究比较了这些护理方法对AVF穿刺后疼痛强度、伤口视觉模拟量表评分、自评焦虑量表、自评抑郁量表、生活质量评分以及患者对护理满意度的影响。观察组在AVF穿刺期间经历中度至重度疼痛的患者比例低于对照组，而无疼痛或轻度疼痛的患者比例更高（P = 0.008）。护理后，观察组的伤口视觉模拟量表评分、自评焦虑量表评分和自评抑郁量表评分均显著低于对照组（P < 0.001），生活质量评分显著更高（P < 0.05）。观察组的护理满意度为95.00%，显著高于对照组的65.00%（P = 0.018）。持续质量改进护理模式显著降低了血液透析患者AVF穿刺部位的伤口疼痛，减轻了负面情绪，提高了生活质量，并获得了较高的患者满意度。因此，这是一种在护理实践中非常值得推荐的方法。
