摘要
目的 观察两种健康教育模式对等待尸体肾移植患者心理状况和营养状况的影响，探讨适合患者的健康教育模式。方法 研究对象为2009年9月1日至2010年8月30日在本院肾脏病中心确诊为慢性肾衰竭等待尸体肾移植患者125例，随机分为对照组（62例）和观察组（63例）。对照组采用传统的健康教育，住院期间进行常规术前教育。观察组除常规术前教育外，配备专职护士进行营养评估，建立个人档案，给予个性化饮食指导和移植相关知识教育，并跟踪随访；采用多样化教育形式，为患者提供与手术主管医生见面沟通机会，与肾移植术后患者进行交流等。采用焦虑自评量表（SAS）、抑郁自评量表（SDS）对两组患者教育前后进行心理测评和肱三头肌皮褶厚度（TSF）、上臂肌围（MAMC）的测量和生化指标检验，比较两组患者健康教育前后心理、营养状况。结果 健康教育前两组间SAS、SDS、TSF、MAMC、Hb、白蛋白（Alb）测评无统计学差异（P值均＞0.05），健康教育后SAS、SDS观察组较对照组明显降低（40.02±9.05和47.05±10.32,42.70±10.01比50.83±10.12；P值均＜0.01）。健康教育后两组TSF、Hb均升高（P值均＜0.001或＜0.05），观察组Alb升高[（35.67±6.19） g/L比（37.48±5.09） g/L，P值＜0.01]。结论 对等待肾移植患者开展全面而形式多样的健康教育可明显缓解患者的心理压力，改善患者营养，利于患者积极正确面对疾病，提高生活质量。
Objective To investigate the effects of two health education models on the psychology and nutrition of patients waiting for cadaveric renal transplantation.Methods A total of 125 patients waiting for cadaveric renal transplantations were involved in our study.They were diagnosed with chronic renal failure in our hospital during September 1, 2009 to August 30, 2010.The patients were randomly divided into control group （n = 62） and observational group（n = 63）.Patients in the control group received traditional health education with routine preoperative education during hospitalization.In the observational group, full-time nurses assessed the nutrition status of each patient and monitored the data. The observational patients were followed up and were given dietary guidance and knowledge of transplantation.Various kinds of education formats were adopted in observational group to provide communication opportunities between patients and surgeons in charge as well as patients who underwent transplantation.Psychological testings of patients in both groups were tested by self-rating anxiety scale （SAS） and self-rating depression scale （SDS） before and after the health education.Triceps skinfold thickness （TSF）, mid-arm muscle circumference （MAMC） and biochemistry index were also tested.Psychological and nutritional status of patients in the two groups was compared.Results There were no significant differences in scores of the SAS, SDS, TSF, Hb, and albumin （Alb） between the two groups （all P〉0.05） before health education.After health education, SAS and SDS in observational group were lower than those in the control group （40.02 ±9.05 vs 47.05 ± 10.32,42.70 ± 10.01 vs 50.83 ± 10.12; both P〈0.01）.Both TSF and Hb were elevated after education （P 〈 0.001 or 0.05）.Alb was significantly elevated in the observational group [（35.67 ±6.19）g/L vs （37.48 ±5.09）g/L, P 〈0.01].Conclusion Comprehensive and various health education methods can significantly alleviate mental stress and improve nutrition of the patients waiting for kidney transplantation, which is helpful for patients facing disease positively and having a better quality of life.
出处
《中华内科杂志》
CAS
CSCD
北大核心
2011年第10期845-847,共3页
Chinese Journal of Internal Medicine
基金
浙江省医药卫生科技计划（20088052）
关键词
肾功能衰竭
慢性
肾移植
健康教育
心理学
营养
Kidney failure, chronic
Kidney transplantation
Health education
Psychology
Nutrition
