心理护理干预在尿毒症维持性血液透析患者中应用效果观察.docVIP

心理护理干预在尿毒症维持性血液透析患者中应用效果观察 　　[摘要] 目的 ?^察心理护理干预在尿毒症维持性血液透析患者中的应用效果。 方法 选取本院住院治疗的尿毒症维持性血液透析患者60例，根据护理方法不同随机分为干预组与对照组，每组各30例，对照组采取常规护理，干预组在常规护理的基础上增加心理护理干预，共观察3个月。比较分析两组患者干预前后的心理状态评分、治疗依从性及生活质量评分的变化情况。 结果 护理前两组SAS、SDS评分比较无显著差异；护理后，两组患者的负性心理明显改善，两组患者的SAS、SDS评分分别显著低于护理前（P0.05）；且干预组患者的SAS、SDS评分分别显著低于对照组（P0.05）。护理后，干预组患者的治疗依从性明显提高，干预组患者的治疗依从率达93.33%（28/30），显著高于对照组70.00%（21/30），组间比较存在显著差异（P0.05）。护理后，干预组患者的生活质量明显改善，干预组患者的躯体功能、情绪功能、角色功能和社会功能评分分别显著高于对照组，组间比较存在显著差异（P0.05）。 结论 对尿毒症维持性血液透析患者在治疗中联合心理护理干预，有利于改善患者的负性心理，提高治疗依从性及生活质量，对于延长患者的生存时间和生活质量具有重要作用。 　　[关键词] 尿毒症；维持性血液透析；心理护理干预；生活质量 　　[中图分类号] R473.5 [文献标识码] B [文章编号] 1673-9701（2018）06-0160-04 　　[Abstract] Objective To observe the application effect of psychological nursing intervention in maintenance hemodialysis patients with uremia. Methods 60 uremia patients with maintenance hemodialysis treated in our hospital were randomly divided into intervention group and control group according to different nursing methods， with 30 cases in each group. The control group received routine nursing. The intervention group received psychological nursing intervention based on routine nursing. The patients were observed for 3 months. The changes of psychological status score， treatment compliance and quality of life score between the two groups before and after intervention were compared and analyzed. Results There were no significant differences in scores of SAS and SDS between the two groups before nursing. After nursing， the negative psychology of both groups improved obviously. The SAS and SDS scores of the two groups were significantly lower than those before nursing（P 　　[Key words] Uremia； Maintenance hemodialysis； Psychological nursing intervention； Quality of life 　　尿毒症患者主要通过采取维持性血液透析能够清除体内代谢的废物，排出多余的水分，纠正机体的酸碱和电解质失衡，从而部分或完全恢复患者的肾功能[1]。但血液透析技术操作复杂，专业性较强，其护理操作中的每一个环节对治疗效果可能都会产生影响。另外，由于维持性血液透析病程较长，并发症多，多数患者易出现焦虑、恐惧、抑郁等消极心理，甚至对治疗失去信心，严重影响治疗依从性及患者的生活质量。因此，为提高治疗效果、缓解或改善患者的负性心理，有效地评估患者的心理状态并实施系统有效的心理护理干预措施具有重要意义。本研究旨在探讨心理护理干预在尿毒症维持性血液透