行为分阶段转变理论在腹膜透析相关性腹膜炎控制中的应用

摘要

Objective: To explore the effect of nursing intervention according to transtheoretical model and stages of change on controlling peritoneal dialysis - related peritonitis. Methods:71 cases of patients with PD in our hospital from January 2010 to December 2011 were chosen as the control group, meanwhile,65 cases from January 2012 to February 2013 were chosen as the experimental group. Intervention according transtheoretical model and stages of change the was applied to the experimental group,and then the nursing compliance,serum albumin (ALB),hemoglobin (Hb),and quality of life were com-pared between the two groups. Results:Compliance scores,ALB,Hb of the experimental group were higher than that of the control group (P < 0. 05) after PD - treatment for 12 weeks,24 weeks. The incidence of peritonitis in the experimental group was lower than that in the control group,the difference was sta-tistically significant (P < 0. 05). Compared with the control group,the scores of experimental group was higher and there was significant difference between the scores of KDTA(P < 0. 05). Similarly,there was significant difference between the scores of SF - 36 ( P < 0. 05). Conclusion:Nursing intervention based on transtheoretical model and stages of change could improve compliance of patients with PD,reduce the incidence of peritonitis.%目的：：探讨行为分阶段转变理论指导护理干预对腹膜透析相关性腹膜炎的控制作用。方法：选择2010年1月~2011年12月在我院置管并行腹膜透析治疗的患者71例作为对照组,将2012年1月~2013年2月在我院置管并行腹膜透析治疗的患者作为试验组。根据行为分阶段转变理论对试验组行5个阶段干预,观察两组患者护理依从性、血清白蛋白(ALB)、血红蛋白(Hb)、腹膜炎发生率及生活质量情况。结果：腹膜透析后第12,24周时,试验组患者护理依从性得分比对照组高( P <0.05)。在12,24周时,试验组的 ALB,Hb 平均浓度较对照组高( P <0.05)。腹膜透析治疗48周内,试验组腹膜炎发生率比对照组低,差异具有统计学意义(P <0.05)；肾脏病相关生存质量(KDTA)评分,试验组较对照组高,差异具有统计学意义(P <0.05)；一般健康相关生存质量(SF -36)评分,试验组较对照组高,差异具有统计学意义(P <0.05)。结论：以行为分阶段转变理论为基础的护理干预能提高腹膜透析患者的依从性,降低腹膜炎发生率。