| Research objective: This study combines the trans-theoretical model with the self-management intervention method of patients with chronic kidney disease stage 3-4 to explore its application and effect in the establishment of self-management behavior of patients with chronic kidney disease stage 3-4,and whether it can provide theoretical methods and practical guidance experience for clinical nurses in self-management of patients with CKD stage 3-4.Research methods: In this study,CKD3-4 patients were randomly divided into intervention group and control group by convenient sampling method.The patients were discharged from hospital as the starting point of intervention,and self-management behavior intervention was conducted for 10 months after discharge.The follow-up effect was 6 months after discharge and 10 months after discharge.The control group was given routine nursing measures,including Wechat knowledge push,telephone follow-up and outpatient follow-up.On the basis of routine nursing care,the intervention group implemented nursing intervention measures based on trans-theoretical model.In the intervention process,the behavioral phase change assessment questionnaire,self-management efficacy scale,chronic kidney disease self-management scale,health questionnaire(SF-36)and biochemical indicators were used to evaluate patients’ behavioral transition stage,self-efficacy level,self-management and quality of life.Change and effect.All data were input and analyzed by IBM SPSS24.0 software.Result:(1)There was no significant difference in general conditions(age,sex,marital status,educational level,family income per capita,medical expenses,CKD stages,primary diseases)between the two groups at discharge(P> 0.05).(2)There was no significant difference between the two groups in terms of behavioral change assessment questionnaire,chronic kidney patient self-management scale,chronic disease self-efficacy scale,health questionnaire(SF-36)and laboratory indicators(P> 0.05).(3)Six months after intervention and ten months after intervention,the results of the phase change assessment questionnaire showed that there were significant differences between the two groups(P<0.001);the scores of self-management scale for chronic kidney patients,self-efficacy scale for chronic diseases,and SF-36 were all improved,but the improvement level of the intervention group was higher than that of the control group,the difference was statistically significant.Meaning(P<0.05);hemoglobin and albumin index were increased,uric acid and blood phosphorus index were decreased,the difference between the two groups was statistically significant(P<0.05),creatinine and urea index were decreased,the difference between the two groups was not significant(P>0.05),but the intervention group was significantly lower than the control group.The scores of self-management scale,self-efficacy scale for chronic kidney disease and SF-36 of the two groups increased with time,and the difference was statistically significant(P< 0.05);the indexes of hemoglobin and albumin increased with time,and the indexes of uric acid decreased with time(P<0.05).The levels of blood phosphorus and phosphorus in the intervention group were lower than those in the control group(P< 0.05).Conclusion:(1)Interventions oftrans-theoretical model can promote the development of behavioral stages in patients with CKD3-4.(2)Cognitively,the intervention measures of trans-theoretical model enhanced the self-care awareness and compliance behavior of CKD3-4 patients,improved self-emotion management and disease coping ability,and enhanced self-efficacy.(3)In behavioral aspect,the interventions of trans-theoretical model stimulate the intrinsic motivation of self-management behavior of CKD3-4 patients,help them establish healthy living habits,and play an effective and stable role in guiding and maintaining.(4)Interventions oftrans-theoretical model can improve the quality of life of CKD3-4 patients.(5)Interventions oftrans-theoretical model can improve the laboratory indicators of CKD3-4 patients,delay the progress of disease,and provide theoretical methods and practical basis for clinical nurses. |
