The Application Of Continuous Diet Self-management In Patients With Maintenance Hemodialysis And Its Effect Evaluation

Objective:To explore the application effect of continuance diet self-management in maintenance hemodialysis patients,provide data support for the in-depth development and application of continuance diet self-management,and provide theoretical-and clinical trials for the transformation of Yunnan medical care service model.Methods:Patients treated with maintenance hemodialysis were selected from the blood purification room of a third grade a hospital in yunnan province in October 2016-December 2016.Conform to the inclusion criteria and obtain informed consent of patients as the research object,follow the principle of randomized controlled trials,the patients were randomly divided into intervention group(n = 38)and control group(n = 38).The control group was given a regular diet care,including a weekly education for every two weeks,giving the promotional materials,regularly scheduled for the hemodialysis health lecture hall.The intervention group was given a continuous diet self-management intervention on the basis of routine dietary care,lasting for 6 months.Including the establishment of intervention team,team member training and orientation,sensitivity,control and evaluation of 4 intervention stages.Directional phases "one-on-one"tutoring,sensitive stage "one-on-one" coaching and collective education,WeChat public platform and exchange control stage,evaluation stage found deficiencies and timely solve the problems in a timely manner.Subjective evaluation indexes included dietary compliance of maintenance hemodialysis patients,health belief scale of fluid intake,and improved subjective nutrition score of patients.Questionnaires were used to investigate the patients before and after intervention for 6 months.Objective indicators include serum phosphors,dialysis period weight gain,serum albumin.Results:1.Intervention compared with control group,the intervention group patients 6 months after the subjective index score increased significantly,the diet adherence scores higher than that of control group,respectively(53.65±4.68),(44.50± 5.64)points,with significant difference(P<0.01).Intervention group fluid intake health belief subscales score respectively(35.66±3.37?33.61 ±2.59?35.79±2.45)score were higher than the control group(38.42±3.41?30.87±3.23?33.08±+3.79),the difference was statistically significant(P<0.05).The total score of modified subjective nutrition score was higher than that of the control group(13.13±2.72?14.84±3.00),and the difference was statistically significant(P<0.05).2.The intervention group of the objective indicator was obviously lower than the control group(1.84±0.10?1.91±0.15),and the difference was statistically significant(P<0.05).There was a statistically significant difference(P<0.05)between the dialysis period weight gain(2.19±0.23?2.23±0.20).The serum albumin was significantly higher than the control group(40.49±3.33?38.50±2.09),and the difference was statistically significant(P<0.01).Conclusions:1.Continuing diet self-management interventions can improve dietary compliance,improve fluid intake health beliefs,decrease patient's improved subjective nutritional score,serum phosphorus levels,and interdialytic weight gain in maintenance hemodialysis patients,and increase serum albumin Levels,thereby improving the patient's diet,fluid intake and nutritional status,enable the patient to establish and maintain a healthy diet self-management behavior.2.Continuing diet self-management intervention can improve dietary nutritional status of maintenance hemodialysis patients,and provide reference and basis for future clinical health care workers to improve intervention methods to maintain dietary nutrition of hemodialysis patients.