基于共享决策理念的护理干预方案在慢性肾脏病非透析病人中的应用研究

    Study on the application value of nursing intervention scheme based on shared decision-making concept in non-dialysis patients with chronic kidney disease

    • 摘要: 目的: 探讨基于共享决策理念的护理干预方案在慢性肾脏病(CKD)非透析病人中的应用效果。方法: 采用便利抽样法抽取CKD病人80例, 采用掷币法随机分成2组, 观察组和对照组各有40例, 对照组采用CKD常规护理, 观察组采用基于共享决策理念的护理干预方案, 并在干预前、出院后1个月和3个月时随访收集病人决策准备(PrepDM)、自我管理和恐惧疾病进展(FoPQ-SF)。结果: 在干预后2个时间点观察组PrepDM得分、自我管理各维度及总分均高于对照组(P < 0.05), 观察组PrepDM得分、自我管理各维度及总分均呈现上升趋势(出院后3个月>出院后1个月>干预前)(P < 0.05);干预后观察组FoPQ-SF 2个维度及总分均低于对照组(P < 0.01)和干预前(P < 0.05);对照组自我管理各维度上升趋势较为缓慢(出院后3个月>干预前)(P < 0.05), 生理健康和总分低于干预前(P < 0.01)。干预后观察组FoPQ-SF总分≥34分病人占比低于对照组(P < 0.05)。结论: 通过基于共享决策理念的护理干预方案进行干预后, 各指标提升情况明显高于常规护理干预方案, 病人决策准备、自我管理提升, 恐惧疾病进展下降。

       

      Abstract: Objective: To explore the application effects of nursing intervention scheme based on shared decision-making concept in non-dialysis patients with chronic kidney disease(CKD). Methods: A total of 80 CKD patients were selected by convenience sampling method, and randomly divided into the observation group and control group by coin toss(40 cases in each group).The control group received routine care for CKD, while the observation group received a nursing intervention scheme based on the shared decision-making concept.The patients' preparation decision making (PrepDM), self-management and fear of progression questionnaire-short form (FoPQ-SF) were followed up, and collected before the intervention, at 1 month and 3 months after discharge. Results: At two time points after intervention, the PrepDM score, each dimension and total scores of self-management in the observation group were higher than those in control group(P < 0.05), and the PrepDM score, each dimension and total scores of self-management in the observation group showed an upward trend(3 months after discharge>1 month after discharge>before the intervention) (P < 0.05).After the intervention, two dimensions and total score of FoPQ-SF in the observation group were lower than those in control group(P < 0.01) and before the intervention(P < 0.05).The upward trend of each dimension of self-management in the control group was relatively slow(3 months after discharge>before intervention)(P < 0.05), and the physical health and total score were lower than those before intervention(P < 0.01).After the intervention, the proportion of patients with a total FoPQ-SF score ≥34 points in the observation group was lower than that in control group(P < 0.05).Conclusions: After the nursing intervention scheme based on the shared decision-making concept, the improvement of each indicator is significantly higher than that of the conventional nursing intervention program.Patients' decision-making preparation and self-management improve, and fear of disease progression decreases.

       

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