Effect of 321 health education guided by transtheoretical model on symptom groups of hemodialysis patients / 中国实用护理杂志

ABSTRACT

Objective:To explore the intervention effect of 321 health education guided by transtheoretical model on hemodialysis patients.Methods:A total of 107 cases of hemodialysis patients from January to December in 2019 in the Central Hospital of Panzhihua, Sichuan Province, were divided into a control group of 53 cases and a study group of 54 cases by table of random number. Patients in the control group received routine health education, and patients in the study group were intervened by 321 health education guided by transtheoretical model. The level of health literacy, symptoms, quality of life of patients in the two groups were evaluated by chronic disease patients health literacy scale, the Chinese version of Dialysis Frequency Severity and Symptom Burden Index (DFSSBI), and the Chinese version of Kidney Disease Questionnaire (KDQ) before and after the intervention.Results:After the intervention, the total score of the health literacy scale of patients with chronic diseases in the control group and the score of the three dimensions of information acquisition ability, communication and interaction ability, and willingness to be healthy were (89.16±11.04), (32.62±3.51), (31.48±3.61), (16.85±2.57), lower than those of the study group (99.86±11.46),(35.92±3.42),(35.73±3.92),(19.96±2.77), respectively, and the differences were statistically significant ( t values were -21.898--4.925, P<0.01). After the intervention, the total score, physical symptom score and psychological symptom score of the two dimensions of DFSSBI in the control group were (56.39 ± 8.21), (47.27 ± 6.85), (9.12 ± 1.31),higher than those of the control group (49.00 ± 6.31), (41.81 ± 5.35), (7.17 ± 0.95),respectively, and the differences were statistically significant ( t values were 5.226, 4.599, 8.827, P<0.01). After the intervention, the incidence of difficulty in falling asleep, fatigue, dry skin, itching, dry mouth in the study group were 38.89%(21/54), 38.89%(21/54), 27.78%(15/54), 27.78%(15/54), 25.93%(14/54), lower than those in the control group 66.04%(35/53), 62.26%(33/53), 49.06%(26/53), 49.06%(26/53), 45.28%(29/53), respectively, and the differences were statistically significant(χ 2 values were 5.124-9.224, P<0.05 or <0.01). The symptom scores of difficulty in falling asleep, fatigue, dry skin, itching, dry mouth in the control group were (7.44 ± 0.81), (7.34 ± 0.72), (7.42 ± 0.73), (8.62 ± 0.72), (7.82 ± 0.77), higher than those in the study group(6.11 ± 0.65), (6.02 ± 0.59), (6.15 ± 0.61), (7.12 ± 0.65), (5.84 ± 0.51) respectively, and the differences were statistically significant ( t values were 9.376-15.710, P<0.01). After the intervention, the total score of KDQ and the scores of physical symptoms, fatigue and depression in the control group were (106.46 ± 13.39), (23.87 ± 2.40), (22.71 ± 2.67), (22.52 ± 2.93), lower than those in the study group (116.89 ± 14.59), (27.12 ± 2.53), (25.16 ± 2.82), (27.12 ± 3.75), respectively, and the differences were statistically significant ( t values were -7.062--3.851, P<0.01). Conclusions:Intervention of 321 health education guided by transtheoretical model on hemodialysis patients can improve their health literacy and symptoms, reduce their symptom burden score and improve their quality of life.