行为分阶段转变理论在老年糖尿病肾病腹膜透析患者健康教育中的应用

摘要

Objective To explore the effect of transtheoretical model and stages of change (TTM) in health education for diabetic nephropathy patients with peritoneal dialysis. Methods Totally 104 diabetic nephropathy patients with peritoneal dialysis were randomly divided into control group with conventional treatment and health education and observation group with TTM in addition to conventional treatment and health education for a six-month intervention. The assessment of volume load, glucose metabolism indicators and self-care behavior was conducted within one week after adminstration and after the six-month intervention. Results Significant improvement was found in blood pressure, body mass, dialysate ultrafiltration volume, fasting blood glucose(FBG),2-hour postprandial blood glucose(2hPBG) and glycosylated hemoglobin(HbA1c) in observation group, which indicated statistical significance (P<0.05). In terms of self-care behaviour, significant difference was found in dietary behaviors, sport and glucose monitoring, which indicated statistical significance (P<0.05). Conclusion TTM-based nursing is effective for the improvement of volume load and the control of blood glucose and the improvement of patients ’ self-care behavior.%目的：探讨行为分阶段转变理论在老年糖尿病肾病行腹膜透析患者健康教育中的应用。方法选择104例老年糖尿病肾病持续腹膜透析的患者为研究对象，采用随机数字表法分为观察组和对照组，对照组采用常规治疗及传统健康教育，观察组在常规治疗和护理的基础上对患者进行基于行为分阶段转变理论的健康教育，干预时间6个月，在患者入院1周内及实施干预6个月后进行容量负荷、糖代谢指标、自护行为的评估。结果观察组患者血压、体质量、透析液超滤量、空腹血糖、餐后2h血糖、糖化血红蛋白较对照组有明显改善，差异有统计学意义（P<0.05）；观察组自护行为总体饮食、运动、血糖监测3个维度较对照组有明显提高，差异有统计学意义（P<0.05）。结论基于行为分阶段转变理论的护理干预能有效帮助老年糖尿病腹膜透析患者改善容量负荷，控制血糖，提高患者的自护行为。