Chen Zhiyu, Ma Jinyan, Ou Hongchun, Pu Li
Department of Nephrology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, China.
Medicine (Baltimore). 2025 Jan 10;104(2):e41050. doi: 10.1097/MD.0000000000041050.
This study investigated the impact of nursing interventions based on the Integrated Theory of Health Behavior Change on hemodialysis patients. A retrospective analysis of 713 hemodialysis patients' electronic medical records from June 2020 to November 2023 was conducted. Patients were divided into an experimental group, receiving nursing interventions based on the theory, and a control group, receiving regular nursing care. After 1 month, dialysis indices and hospitalization rates were compared. Subgroup analyses based on education level were performed. After basic information matching, the spKt/V values of the experimental group and the control group were 1.62 ± 0.27 and 1.41 ± 0.25, with 198 and 176 individuals meeting the standard, respectively. The urea reduction ratio of the experimental group was 78.26 ± 8.72, with 187 individuals meeting the standard. From the 2 indicators, the dialysis indices of the experimental group were significantly better than those of the control group (P < .05). The numbers of readmissions in the 2 groups were 41 and 61, respectively, with a statistically significant difference (P = .024). We also compared the reasons for readmission between the 2 groups and found significant differences in the reasons. Particularly, the numbers of readmissions due to fluid overload were 13 and 32 in the experimental and control groups, respectively, with significantly fewer in the experimental group than in the control group (P = .033). The education level did not affect the readmission rate of patients, with readmission rates of 12 and 11 in the 2 groups, respectively, with P > .05. The dialysis indices spKt/V and urea reduction ratio increased with increasing BMI, and there was a correlation between the 2, with values of 0.61 and 0.51, respectively, which were statistically significant (P < .05). The extremely satisfied rates were 46% in the experimental group and 36% in the control group, with dissatisfaction rates of 2% and 3% in the 2 groups, respectively, showing a significant statistical difference (P < .01). Nursing interventions based on the Integrated Theory of Health Behavior Change improved dialysis outcomes and patient satisfaction, providing insights for chronic disease management.
本研究调查了基于健康行为改变综合理论的护理干预对血液透析患者的影响。对2020年6月至2023年11月期间713例血液透析患者的电子病历进行回顾性分析。将患者分为实验组和对照组，实验组接受基于该理论的护理干预，对照组接受常规护理。1个月后，比较透析指标和住院率。并根据教育水平进行亚组分析。经过基本信息匹配后，实验组和对照组的标准化Kt/V值分别为1.62±0.27和1.41±0.25，达到标准的个体分别为198例和176例。实验组的尿素清除率为78.26±8.72，达到标准的个体有187例。从这两个指标来看，实验组的透析指标明显优于对照组（P<0.05）。两组的再次入院人数分别为41例和61例，差异有统计学意义（P = 0.024）。我们还比较了两组再次入院的原因，发现原因存在显著差异。特别是，实验组和对照组因液体过载导致的再次入院人数分别为13例和32例，实验组明显少于对照组（P = 0.033）。教育水平未影响患者的再次入院率，两组的再次入院率分别为12%和11%，P>0.05。透析指标标准化Kt/V和尿素清除率随体重指数增加而升高，两者之间存在相关性，值分别为0.61和0.51，具有统计学意义（P<0.05）。实验组的极度满意率为46%，对照组为36%，两组的不满意率分别为2%和3%，差异有统计学意义（P<0.01）。基于健康行为改变综合理论的护理干预改善了透析效果和患者满意度，为慢性病管理提供了思路。
