| Research Purpose:In this study,we evaluated the efficacy of the intervention of teach back method on the self-management ability of PD patients by applying it to PD patients health education;To provide new ideas for clinical workers to explore a more suitable way of health education for PD patients from a multi-pathway educational approach.Research Methods:1.This study was a experimental study.From October 2019 to October 2020,102 peritoneal dialysis patients who met the inclusion criteria were selected and were divided into two different groups in the Department of Nephrology of a tertiary hospitals from Hu Zhou.The 102 subjects were entered into the EXCEL form from 1 to 102,and the random number sequence was generated by Excel software.Random number in ascending order,divided into two groups,the first 51 for the intervention group,after 51 for the control group.The 102 envelopes were prepared,No.1 as the intervention group and No.2 as the control group,and were distributed to the patients according to the coding sequence.The control group used traditional education methods to carry out Self-management.The intervention group were given follow-up intervention on the basis of routine health education,the health education was carried out through the Teach-back method questionnaire,which includes pre-intervention assessment,the knowledge transfer through the evaluation,the retelling by patient,evaluation and clarification and correction of patient retelling,ask again to evaluate.2.The intervention time was 3 month after discharge.The data were collected before the intervention and collected with Peritoneal Dialysis theoretical knowledge assessment score,"Self-management Scale for Peritoneal Dialysis Patients" and "Dialysis adequacy assessment Scale",at the same time,the disease-related biochemical indexes were examined before and after discharge to evaluate the effect of Teach-back method on the self-management ability of patients.Research Results:There were 8 cases lost to follow-up,5 cases in the intervention group and 3 cases in the control group.The final study participation in the trial was 94 subjects in both groups,46 cases in the intervention group and 48 cases in the control group.1.Before the intervention,the general demographic data and clinical data of the two groups were comparable.2.Score of theoretical knowledge assessment of peritoneal dialysis for patients in two groups :(1)There was no significant difference in the contrast scores between the two groups before the intervention with peritoneal dialysis theory knowledge(P > 0.05).Statistically significant differences(P < 0.05)were found between the two groups in the scores obtained on the day of discharge with the theoretical knowledge of peritoneal dialysis.(2)There was a statistically significant difference(P < 0.01)between the scores obtained before intervention and on the day of discharge for patients in the invention group with theoretical knowledge of peritoneal dialysis.There was a statistically significant difference(P < 0.01)between the scores obtained before the intervention and on the day of discharge for patients in the control group with theoretical knowledge of peritoneal dialysis.3.Comparison of self-management ability between the two groups :(1).On the day of discharge,there was no significant difference between the two groups in the total score of self-management ability,fluid change operation technology,handling of abnormal conditions in operation,diet management,complication monitoring,emotional management and social return(P>0.05).However,in the third month after discharge,the total score of self-management ability and the scores of each dimension in the intervention group were significantly higher than those in the control group(P<0.05),and the total score of self-management ability and the scores of diet management in the intervention group were significantly higher than those in the control group(P<0.01).(2).The third month after discharge,the total score of self-management ability and the scores of each dimension in the intervention group were significantly higher than those on the day of discharge(P<0.05),especially in the total score of self-management ability and the three dimensions of diet management,complication monitoring,emotional management and social return(P<0.01).There was no significant difference between the control group and the day of discharge(P>0.05),but the score was higher than that of the day of discharge.There were significant differences in complication monitoring,emotion management and social return(P<0.05).4.Comparison of peritoneal dialysis adequacy and related biochemical indexes between the two groups:(1)On the day of discharge,there was no significant difference in the adequacy of peritoneal dialysis between the two groups(P>0.05)At the third month after discharge,compared with the control group,the dialysis adequacy of the intervention group was significantly improved.The number of dialysis patients in the intervention group was more than that in the control group,but there was no significant difference in Kt/v between the two groups(P>0.05),and the other differences were statistically significant(P<0.05);At the third month after discharge,the adequacy of peritoneal dialysis in the intervention group was significantly higher than that on the day of discharge,there was no significant difference in Kt/v level(P>0.05),but there was significant difference in Ccr level(P<0.05);At the third month after discharge,there was no significant difference in Kt/v and Ccr between the third month and the day of discharge in the control group(P > 0.05),but the adequacy of dialysis was improved(P<0.05).(2)On the day of discharge,there was no significant difference in clinical biochemical indexes between the two groups(P>0.05);In the third month after discharge,there were significant differences in hemoglobin(Hb),albumin(Alb),prealbumin(PA),parathyroid hormone(i PTH),blood urea(BUN)and serum creatinine(Scr)between the intervention group and the control group(P<0.05),in which serum creatinine(Scr)increased more significantly(P<0.01);there were not statistically significant(P>0.05)in serum calcium(Ca),phosphorus(P)and potassium(K)between the two groups.In the third month after discharge,the related biochemical indexes of the intervention group were significantly improved compared with those on the day of discharge,and the differences in hemoglobin(Hb),blood phosphorus(P),total parathyroid hormone(i PTH),blood urea(BUN)and serum creatinine(Scr)indexes of the intervention group were statistically significant(P<0.05);the control group was significantly higher than those on the day of discharge only in hemoglobin(Hb)There was no significant difference in other indexes(P>0.05);The biochemical indexes of the intervention group were better than those of the control group.Research Conclusion:In the two different health education methods,the Teach-back health education can improve the overall self-management ability of peritoneal dialysis patients and indirectly improve patient dialysis adequacy and disease-related biochemical parameters better than routine health education,should be more deeply promoted in CKD Education. |
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