| Objective:This study is guided by Orem support-education system theory,nursing intervention was carried out in patients with mainenance hemodialysis(MHD),to evaluate its effect on the self-care ability of MHD patients,in the future,it will provide scientific basis for improving the self-care ability of patients with MHD and other chronic diseases.Methods:(1)According to the inclusion criteria and exclusion criteria,66 cases of hemodialysis patients enrolled in the fourth affiliated hospital of Nanchang university from March 2017 to June 2017 were selected as the research objects.In order to facilitate the implementation of the intervention content of this study,patients should be grouped according to their dialysis time,divided into group A on Monday,Wednesday and Friday,and divided into B group on Tuesday,Thursday and Saturday.Using coin tossing method,two groups of A and B were randomly divided into intervention group and control group,33 cases in each group.The final study completed was performed in 63 patients,intervention group(31cases)and control group(32cases).(2)The control group given hemodialysis routine care,the intervention group was given a 12-week Orem support-education system theoretical intervention every 2weeks on the basis of routine hemodialysis care,including knowledge guidance of diseases,training of nursing skills in arteriovenous fistula,basic knowledge of Pilates exercise and exercise guidance and emotional support.Determination by exercise of self-care agency(ESCA),revised Piper fatigue scale(RPFS),hospital anxiety and depression scale(HADS),and related laboratory examination,blood pressure and inter-dialysis weight gain and dry weight ratio(IWGR%)were compared before and after the intervention effect.(3)Statistical methods:SPSS22.0statistical software was used for dataprocessing,measured data were in accordance with normal distribution by means±standard deviation((?)±s),using t-test.Comparison in the group,the data were normally distributed using paired t-test.Comparison between groups,the data were normal distribution using independent sample t-test,otherwise non-parametric statistics Mann-Whitney U test;count data in accordance with the normal distribution using frequency,percentage description,using chi-square test.Results:(1)Comparison between the two groups before and after intervention,the results showed:(1)After intervention,the total score of self-care ability and the score of each dimension in the intervention group were significantly higher than before intervention,and the difference was statistically significant(P<0.05),there was no significant difference in the control group before and after intervention(P>0.05).(2)After intervention,the score of fatigue and its dimensions in the intervention group were significantly lower than before intervention,and the difference was statistically significant(P<0.05),there was no significant difference in the control group before and after intervention(P>0.05).(3)After intervention,the score of anxiety and depression after intervention in the intervention group were significantly lower than before intervention,and the difference was statistically significant(P<0.05),the difference was not obvious in the control group(P<0.05).(4)The biochemical indexes were significantly improved after intervention in the intervention group(P<0.05),the improvement of control group was not obvious before and after intervention(P<0.05).(5)After intervention,blood pressure and IWGR% in the intervention group were lower than before intervention(P<0.05),there was no statistical difference in the control group before and after intervention(P>0.05).(2)Comparison between the two group patients difference before and after the intervention,the results showed:(1)There was significant difference between the total score of the self-care ability and the difference between the scores of each dimension in the intervention group and the control group(P<0.05).(2)There was statistically significant difference between the difference of the fatigue total score and thedifference between the scores of each dimension in the intervention group and the control group(P<0.05).(3)The difference between the anxiety score difference and depression score difference between the intervention group and the control group was statistically significant(P<0.05).(4)In addition to the difference value of albumin in biochemical indexes of the intervention group,the difference between the other biochemical indexes and the control group was statistically significant(P<0.05).(5)There was a statistically significant difference between the difference in blood pressure and IWGR% between the intervention group and the control group(P<0.05).Conclusion:Orem support-educational system theory intervention can enhance the self-care ability of MHD patients,relieve fatigue symptoms,reduce negative emotions such as anxiety and depression,at the same time,it can also increase Hb,blood Ca content;decrease the levels of BUN,Scr,blood K,blood Na and blood P,blood pressure and IWGR%. |
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