行为分阶段转变理论在腹膜透析患者容量控制中的应用

摘要

目的 探索建立在行为分阶段转变理论模型上的容量控制教育,在腹膜透析新患者容量控制上的作用。方法 59例新进入腹膜透析的患者为研究对象。建立在行为改变模型上的容量控制教育作为干预手段。本组随访6个月,分别对患者在透 析后1周、1个月、3个月及6个月的容量状况及营养状况进行了比较。结果 不同时间患者总液体清除的差异有统计学意义(P＜0.05),水肿的发生率显著下降(x2=44.311,P＜0.001),体内多余水(OH值)有明显的下降(P＜0.01)。同时,患者的体重、血压稳定,血清白蛋白升高,营养状况有改善。结论 应用以行为改变分阶段理论模型为基础的容量控制教育,可帮助患者在透析开始的前6个月改善他们的容量状况,腹膜透析医护人员可以使用该模型来教育和帮助患者改善他们的容量状况。%Obective To explore the effect of the Transtheoretical Model and stages of change on volume control in new peritoneal dialysis patients. Methods A pie-post design was adopted in the study. Fifty-nine new peritoneal dialysis patients received an eudcation program based on the Transtheoretical Model of behavior change. The volume control and nutritional status were measured at baseline,one month,three months and six months after dialysis. Results The total volume output,incidence of edema and overhydration value were significantly decreased(P<0.05 or P<0.01). Moreover,patients' body weight and blood pressure remained stable,and the level of serum albumin and nutritional status were improved. Conclusion The education programe based on the Transtheoretical Model and stages of change is helpful for volume control in new peritoneal dialysis patients in the first six months.