Peng Mingmei, Cai Xiaoyan, Wang Qingqing, Li Zhiying, Cao Rui, Guan Baozhang, Yang Yuli, Xu Shuting, Yang Yi, Yang Shuai, Yan Fengxia
The Blood Purification Center, Department of Nephrology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China.
School of Nursing, Jinan University, Guangzhou, Guangdong, China.
West J Nurs Res. 2025 Feb;47(2):89-99. doi: 10.1177/01939459241306705. Epub 2024 Dec 21.
Patients with end-stage renal disease often require maintenance hemodialysis (MHD). Effective self-management is crucial for the prognosis of patients undergoing MHD; however, their self-management practices remain suboptimal.
This study aimed to explore the effects of visualized health education based on health belief model on self-management, self-efficacy, quality of life, and quality of dialysis in patients undergoing MHD.
A total of 93 patients undergoing MHD from a tertiary hospital in Guangzhou were recruited between December 2021 and June 2022 and divided into control (n = 44) and intervention (n = 49) groups according to their dialysis time. The control group received standard health education, while the intervention group received visualized health education based on the Health Belief Model (3 months, 3 times a week, about 1 hour each time). The Hemodialysis Self-Management Instrument, Self-Efficacy Scale, Hemodialysis Knowledge Questionnaire, and 12-Item Short-Form Health Survey were used before and after intervention. Physiological indices related to hemodialysis (serum potassium, phosphorus, intact parathyroid hormone, albumin, and hemoglobin) were collected.
After intervention, the intervention group showed significantly higher scores in self-management ability (63.0 [57.0, 68.5]), self-management efficacy (29.0 [26.0, 31.0]), hemodialysis knowledge (21.0 [20.0, 22.0]), and quality of life (68.8 [56.3, 79.2]) than the control group ( < .05). More individuals in the intervention group achieved normal ranges for hemoglobin, albumin, serum potassium, and serum phosphorus.
The visualized health education intervention significantly enhanced self-management level, self-efficacy, and quality of life in patients undergoing maintenance hemodialysis. This approach is recommended for broader application.
终末期肾病患者常需维持性血液透析（MHD）。有效的自我管理对接受MHD治疗的患者预后至关重要；然而，他们的自我管理实践仍不尽人意。
本研究旨在探讨基于健康信念模型的可视化健康教育对接受MHD治疗患者的自我管理、自我效能、生活质量和透析质量的影响。
2021年12月至2022年6月，从广州一家三级医院招募了93例接受MHD治疗的患者，根据透析时间分为对照组（n = 44）和干预组（n = 49）。对照组接受标准健康教育，干预组接受基于健康信念模型的可视化健康教育（为期3个月，每周3次，每次约1小时）。在干预前后使用血液透析自我管理工具、自我效能量表、血液透析知识问卷和简明健康状况调查12项量表。收集与血液透析相关的生理指标（血清钾、磷、全段甲状旁腺激素、白蛋白和血红蛋白）。
干预后，干预组在自我管理能力（63.0 [57.0, 68.5]）、自我管理效能（29.0 [26.0, 31.0]）、血液透析知识（21.0 [20.0, 22.0]）和生活质量（68.8 [56.3, 79.2]）方面的得分显著高于对照组（P <.05）。干预组更多患者的血红蛋白、白蛋白、血清钾和血清磷达到正常范围。
可视化健康教育干预显著提高了维持性血液透析患者的自我管理水平、自我效能和生活质量。建议广泛应用这种方法。
