Hu Shimin, Yuan Chunyu, Lu Qingzhu, Yan Xiaoyong, Huang Yan, Chen Minzhu, Liu Yong, Tan Zhouke, Quan Mingtao
Department of Nephropathy, Affiliated Hospital of Zunyi Medical University, Zunyi, China.
Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China.
J Nurs Manag. 2023 Nov 9;2023:4920799. doi: 10.1155/2023/4920799. eCollection 2023.
To explore the effects of a nursing intervention based on a solution-focused approach on improving renal transplant recipients' anxiety, depression, and quality of life.
A total of 75 eligible recipients who underwent renal transplantation were recruited and randomly divided into intervention and control groups. The renal transplantation recipients in the intervention group received nursing intervention based on a solution-focused approach (SFA) developed by the research group. The SFA intervention included the following five stages: describing the problem, developing well-formed goals, exploring for exceptions, end of session feedback, and evaluating progress. Additional methods, such as empowerment, miracle questions, and scale mark questions, were included. The intervention began after informed consent, and baseline data were collected at admission, with each participant receiving five interventions lasting 30-60 minutes. The featured methods and five stages of the SFA could be interspersed and used repeatedly. The follow-up was performed at one, three, and six months postoperation. The control group received the usual care of comparable length and follow-up contact. The anxiety, depression, and quality of life of renal transplant recipients were measured and recorded using the Hospital Anxiety and Depression Scale (HADS) and the Quality of Life Scale for Patients of Renal Transplantation (QOL-RT). A trained research nurse collected all the baseline and follow-up data.
The baseline information of the patients, such as gender, age, BMI, endogenous creatinine clearance, anxiety, and depression, was similar between the two groups ( > 0.05). The total scores of HADS (A), HADS (D), and total HADS in both groups showed a downward trend. The intervention group exhibited significantly lower HADS (A) (4.21 ± 1.85) and total HADS scores (7.81 ± 3.31) one month after surgery than the control group in the same period (5.50 ± 2.44 and 9.85 ± 4.19, respectively; < 0.05). Fewer people in the intervention group had a HADS (A) score ≥8 than those in the control group at one month ( < 0.05). Depression in the intervention group was significantly lower than that in the control group at three and six months ( < 0.05). The total QOL-RT scores of the intervention group at one month (126.54 ± 9.62), three months (137.02 ± 7.69), and six months (144.89 ± 7.53) were higher than those of the control group (119.50 ± 11.58, 128.8 ± 10.80, and 138.61 ± 9.09, respectively; < 0.05). Furthermore, the scores of the physiological function dimensions and treatment dimensions of the QOL-RT in the intervention group were higher than those in the control group at one, three, and six months after the intervention ( < 0.05). The scores of the social function dimension in the intervention group were higher than those in the control group at three and six months after the intervention ( < 0.05).
Nursing intervention based on the SFA improved anxiety and depression among renal transplant recipients, thereby improving their quality of life.
探讨基于聚焦解决方案模式的护理干预对改善肾移植受者焦虑、抑郁及生活质量的效果。
共纳入75例符合条件的肾移植受者，随机分为干预组和对照组。干预组肾移植受者接受基于研究组开发的聚焦解决方案模式（SFA）的护理干预。SFA干预包括以下五个阶段：描述问题、制定良好目标、探索例外情况、 session结束反馈和评估进展。还包括赋权、奇迹问题和量表标记问题等其他方法。在获得知情同意后开始干预，入院时收集基线数据，每位参与者接受5次持续30 - 60分钟的干预。SFA的特色方法和五个阶段可穿插并反复使用。术后1个月、3个月和6个月进行随访。对照组接受长度相当的常规护理及随访联系。采用医院焦虑抑郁量表（HADS）和肾移植患者生活质量量表（QOL-RT）对肾移植受者的焦虑、抑郁及生活质量进行测量和记录。由经过培训的研究护士收集所有基线和随访数据。
两组患者的性别、年龄、BMI、内生肌酐清除率、焦虑和抑郁等基线信息相似（>0.05）。两组HADS（A）、HADS（D）及HADS总分均呈下降趋势。干预组术后1个月的HADS（A）（4.21±1.85）及HADS总分（7.81±3.31）显著低于同期对照组（分别为5.50±2.44和9.85±4.19；<0.05）。干预组术后1个月HADS（A）评分≥8分的人数少于对照组（<0.05）。干预组术后3个月和6个月的抑郁程度显著低于对照组（<0.05）。干预组术后1个月（126.54±9.62）、3个月（137.02±7.69）和6个月（144.89±7.53）的QOL-RT总分高于对照组（分别为119.50±11.58、128.8±10.80和138.61±9.09；<0.05）。此外，干预组术后1个月、3个月和6个月的QOL-RT生理功能维度和治疗维度得分高于对照组（<0.05）。干预组术后3个月和6个月的社会功能维度得分高于对照组（<0.05）。
基于SFA的护理干预改善了肾移植受者焦虑和抑郁状况，从而提高了他们的生活质量。
