| Objective:To investigate the current status and influence factors of dialysis adequacy of patients undergoing maintenance hemodialysis.The purpose is to study the effect of Quality Control Circle intervention on dialysis adequacy of patients with maintenance hemodialysis,and determine the effect of Quality Control Circle for hemodialysis patients,providing the basis for carring out Quality Control Circle intervention as a quality management tool in Hemodialysis Center.Methods:This is a quasi-experimental research.Firstly,we investigated patients’ hemodialysis adequacy,general information,hemodialysis-related knowledge and quality of life,so that we can learn about hemodialysis adequacy status and analyze related influence factors of hemodialysis adequacy.Then we apply quality control circle intervention on patients with maintenance hemodialysis from June 2015 to November 2015 in Shen Zhen Sixth People’s Hospital.We adopt convenience sampling method to select 88 cases who were ramdonly divited into experimental group(n=44)and control group(n=44)from Hemodialysis Center as object of the study.While established a QCC team based on the voluntary participation principle in the Hemodialysis Center,then applying QCC intervention to the experimental group for six months.QCC team held regular meetings once a week to collect data,analyze data,and corrective measures etc.Routine nursing care was applied to the control group.Before intervention,the experimental group and the control group were granted demographic form;two groups of patients were granted hemodialysis knowledge questionnaire,Quality of life BREF(WHOQOL-BREF)questionnaire,and tested related laboratory information before and after intervention.Results:1、Before the intervention,an average of urea clearance index(Kt / V)was 1.16± 0.09 in the control group,which was 1.17 ± 0.13 in the intervention group,there was no statistically significant difference between two groups(t = 0.716,p> 0.05);After the intervention,an average of urea clearance index(Kt / V)was 1.18 ± 0.10 in the control group,the intervention group was 1.31 ± 0.16,the difference was statistically significant between two groups(t = 4.463,p <0.05).2、Before the intervention,the total score of hemodialysis knowledge level of the control group was 18.00 ± 1.11,the total score of the intervention group was 17.54 ±1.33,the difference was not statistically significant(t =-1.226,p> 0.05);After the intervention,the total score of hemodialysis knowledge level of the control group was18.23 ± 1.0,the total score of the intervention group was 20.86 ± 1.13,the difference was statistically significant between the two groups(t = 8.141,p <0.05).3、There was no statistically significant difference between the two groups of patients on the scores of each field of hemodialysis knowledge before the intervention(p> 0.05);After the intervention,there was statistically significant difference on the scores of diet and medication field,dialysis treatment field,and anemia field(p<0.05).4、Before the intervention,the total score of quality of life of the control group was 75.14 ± 2.68,the intervention group was 74.23 ± 4.47,the difference between the two groups was not statistically significant(p> 0.05);After the intervention,the total score of quality of life of the control group was 77.50 ± 2.91,the intervention group was 86.50 ± 3.14,the difference was statistically significant(p <0.05).5、There was no statistically significant difference on the scores of each field of quality of life between the two groups of patients before the intervention(p> 0.05);After the intervention,there was statistically significant difference on the scores of physical field,psychological field,social relations field(p <0.05);there was no statistically significant difference on the score of environmental field(p> 0.05).Conclusion:1、The dialysis adequacy for patients with maintenance hemodialysis was at a medium level,and the quality of life was also not high.2、In this study,the main factors affecting dialysis adequacy were as follows:educational level,duration of dialysis,personal income per month,hemodialysisrelated knowledge,which explaining 72.5% of the total variance.2 、 There was a positive correlation beteewn dialysis adequacy and threedimensions of quality of life which included physical function,psychological function and social relations.It indicates that the increase of hemodialysis adequacy can effectively improve physical function,psychological function and social relations,thus to improve the whole quality of life for patients with maintenance hemodlialysis.3 、 QCC intervention can effectively improve the dialysis adequacy of hemodialysis patients,and improve the level of hemodialysis knowledge and the quality of life,reducing the incidence of long-term complications. |
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