The effectiveness of intensive nursing care on seasonal variation of blood pressure in patients on peritoneal dialysis

摘要

Aim. This article is a report of a study to reduce the seasonal variation of blood pressure in patients on peritoneal dialysis through an intensive programme of nursing care. Background. The seasonal variation of blood pressure is a common phenomenon in patients on maintenance dialysis. Whether or not this variation can be reduced through a given intervention is unknown. Methods. The programme of intensive nursing care including education on volume control, home blood pressure monitoring and intensified antihypertensive treatment, was implemented from December 2006. The blood pressure, fluid and sodium removal and defined daily doses of antihypertensive agents were measured at 1-monthly intervals and averagely quarterly for seasonal values for spring, summer, autumn and winter, respectively, before (December 2005-November 2006) and after intervention (December 2006-November 2007). Findings. A total of 76 clinically stable patients on peritoneal dialysis were enrolled and finally analysed. The mean age was 60·6years, and dialysis duration was 23·2months. Before intervention, there were important seasonal variations in systolic and diastolic blood pressure. After intensive nursing care was implemented, the seasonal variation of systolic blood pressure disappeared. The diastolic blood pressure still represented a season pattern, but the discrepancy between winter and summer decreased. There were no seasonal patterns of total fluid and sodium removal before and after intervention. Conclusions. Intensive nursing care reduced the seasonal variation of blood pressure in patients on peritoneal dialysis. These data provided an evidence for implementing nurse-centred interventions in this population.