Research On The Effect Of Nursing Intervention Based On Chronic Illness Trajectory Model In Non-dialysis Patients With Chronic Renal Failure

Objective:Based on Chronic Illness Trajectory Model(CITM),to describe anxiety,depression,hope level and quality of life(QOL)of life of patients with Chronic Renal Failure(CRF)whose condition has not deteriorated to the degree of dialysis treatment in different stages of the continuous development of the disease.And on this basis,establish specific and effective intervention programs;At the same time,it demonstrates and further improves the impact of relevant schemes on patients,so as to provide a scientific evidence for helping them reduce negative emotions,raise the level of hope and improve the quality of life.Methods:80 non-dialysis patients with CRF who hospitalized in the Department of Nephrology of the First Hospital of Shanxi Medical University from October 2020 to September 2021 were selected for study.Using phenomenological research methods,we understand the feel of illness-related work,biographical work and everyday life work for non-dialysis patients with CRF in the stages of renal function compensation,renal function decompensation,renal failure and uremia.On this basis,we establish specific,scientific and effective intervention programs.Using random allocation method and closed envelopes,the patients were selected with sealed envelopes,and all envelopes were numbered.At the same time,the envelopes numbered odd and even were identified as intervention group and opposite recruitment group respectively.Finally,there were 40 cases in each group.The control group received the routine nephrology nursing and follow-up,while the intervention group received the CITM-based nursing intervention on the basis of routine care.The specific plan is formulated according to the trajectory mode of chronic diseases,and the length of intervention in three months.Before the start of this study,ensure that all participants are aware of all the contents of the control study and sign a specific informed consent form.The specific conditions of the two groups of patients were comprehensively evaluated according to the general situation questionnaire;Similarly,the Hospital Anxiety and Depression Scale(HAD),Herth hope index(HHI),Quality of life instruments for chronic Disease-chronic renal failure(QLICD-CRF 2.0)were also used to compare the two groups of patients,and finally get the specific impact of the intervention scheme on the mental health status,expectation level and actual quality of life of the patients.Results:1.General date and disease date: the number of questionnaires prepared by the author in this study is 86.All questionnaires have been recovered.After careful review,80 questionnaires are confirmed to be valid.There were 40 cases in the intervention group and the control group.There were no statistically difference between the patient age,gender,education,working status,monthly family income,medical payment methods,and protopathy involved in this survey and this study(P> 0.05).The general data and disease date of the two groups of patients were consistent and comparable.2.The score of anxiety and depression of the two groups before intervention was no statistically difference(P> 0.05).After intervention for three months,the intervention group had lower levels of anxiety and depression than the control group,and the difference was statistically significant(P <0.05).3.The score of the hope level of the two groups before intervention was no statistically difference(P> 0.05).After intervention for three months,the intervention group had higher hope level than the control group,and the difference was statistically significant(P <0.05).4.The score of QOL of the two groups before intervention was no statistically difference(P> 0.05).After intervention for three months,the intervention group had higher QOL than the control group,and the difference was statistically significant(P<0.05).Conclusion:1.Nursing intervention based on Chronic Illness Trajectory Model can reduce the level of anxiety and depression in non-dialysis patients with Chronic Renal Failure.2.Nursing intervention based on Chronic Illness Trajectory Model can raise the hope level in non-dialysis patients with Chronic Renal Failure.3.Nursing intervention based on Chronic Illness Trajectory Model can improve the QOL in non-dialysis patients with Chronic Renal Failure.