| Objective ①To explore the effect of volume management based on multistage change theory on volume-related knowledge and volume management behavior of peritoneal dialysis patients.②To explore the effect of volume management based on multistage change theory on volume load,water and salt intake,incidence of chest tightness and shortness of breath in peritoneal dialysis patients.③To explore the effect of volume management based on multistage change theory on cardiac function in peritoneal dialysis patients.④To explore the effect of volume management based on multistage change theory on improving the nutritional status and dialysis adequacy of peritoneal dialysis patients.Method86 patients with peritoneal dialysis were selected as the research object in the First Affiliated Hospital of Guangxi Medical University.The patients were randomly divided into the control group and the intervention group using the random number table method,with 43 cases in each group.The control group received routine nursing care,and the intervention group received the volume management based on multistage change theory.Using general data questionnaire,volume-related knowledge questionnaire,volume management behavior scale for peritoneal dialysis patients,volume management behavior stage assessment and visual analog scales.Their volume management behavior stage evaluation,volume-related knowledge scale,volume management behavior scale,water and salt intake,volume load index,cardiac function index,nutritional and dialysis adequacy indicators before and after the intervention were compared.Results1.The volume management behavior change phase distribution:before the intervention,there was no statistically significant difference between the two groups in the distribution of patients’ volume management behavior changes(P>0.05).After three months of intervention and after six months of intervention,the number of patients in the action and maintenance stages in the intervention group was higher than that in the control group(P<0.05).2.Volume-related knowledge scale and volume management behavior scale scores:①the scores of the two groups were not statistically significant before the intervention(P>0.05).After three months of intervention and after six months of intervention,the scores of volume-related knowledge scale and volume management behavior scale of patients in the intervention group were increased(P<0.05).②Before and after the intervention,patients’ volume-related knowledge scores and volume-management behavior scores were significantly statistically different in the time effect,intergroup effect and their interaction(P<0.05).3.Patients’ daily fluid intake,daily salt intake and thirst score:①There were no statistically significant differences in daily fluid intake,salt intake and thirst scores between the two groups before intervention(P>0.05).After three months of intervention and after six months of intervention,the daily fluid intake and daily salt intake of the patients in the intervention group were gradually reduced,and the degree of thirst was reduced.The difference between the two groups was statistically significant(P<0.05).②Before and after the intervention,patients’daily fluid intake,salt intake and thirst score were significantly statistically different in the time effect,intergroup effect and their interaction(P<0.05).4.Volume load related indicators:① Before the intervention,there was no significant difference in edema degree between the two groups(P>0.05),after 3 months and 6 months of intervention,the edema degree of patients in the intervention group was gradually reduced(P<0.05).②There were no significant differences in body weight,blood pressure,24h urine volume and 24h ultrafiltration volume between the two groups before intervention(P>0.05).After three months of intervention and after six months of intervention,the weight loss and systolic blood pressure decrease in the intervention group/P<0.05).After 6 months of intervention,the diastolic blood pressure of patients in the intervention group decreased,and the difference was statistically significant compared with the control group(P<0.05).③The differences of body weight and systolic blood pressure before and after intervention,which were statistically significant in time effect,intergroup effect and their interaction(P<0.05).5.Cardiac function indicator:①Before the intervention,the level of pro-brain natriuretic peptide of the two groups were not statistically significant(P>0.05).After six months of intervention,the pro-brain natriuretic peptide of intervention group was decreased(P<0.05).②The two groups were compared before and after intervention,the level of pro-brain natriuretic peptide in the intervention group was lower than that before the intervention(P<0.05).6.Subjective symptoms:There were no statistically significant differences in the incidence of anorexia,fatigue,chest tightness and shortness of breath between the two groups before intervention(P>0.05).After 3 months and 6 months of intervention,the incidence of chest tightness and shortness of breath in the intervention group were significantly lower than that in the control group(P<0.05).The incidence of anorexia in the intervention group decreased after 6 months of intervention(P<0.05).After the intervention,there was no significant change in the fatigue of the two groups(P>0.05).7.Nutrition related indicators level:①Before the intervention,the nutrition related indicators level of the two groups were not statistically significant(P>0.05).after three months of intervention,the difference of serum albumin was statistically significant(P<0.05).After six month,the differences of the serum albumin and pre-albumin level were statistically significant(P<0.05)·②The differences of serum albumin and pre-albumin level before and after intervention were statistically significant in the time effect,intergroup effect and their interaction(P<0.05).8.Dialysis adequacy indicators level:There were no significant differences in serum urea nitrogen,serum creatinine,urea clearance index and creatinine clearance rate between the two groups before and after the intervention(P>0.05).Conclusion1.Volume management based on multistage change theory can promote behavioral change in peritoneal dialysis patients,promoting patients from the lower stages of volume management to the action or maintenance stages.2.Volume management based on multistage change theory can improve patients’ volume-related knowledge level and volume management behavior level,and enhance patients’volume self-management ability.3.Volume management based on multistage change theory can reduce patients’ water and salt intake,reduce patients’ thirst,and reduce patients’volume load.4.Volume management based on multistage change theory can effectively improve the level of cardiac function of patients.5.Volume management based on multistage change theory can promote the reduction of the incidence of anorexia,chest tightness and shortness of breath in patients,and reduce the burden of symptoms in patients.6.Volume management based on multistage change theory has a positive impact on improving patients’ nutritional status.7.Volume management based on multistage change theory has no effect on patients’ dialysis adequacy. |
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