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中华临床医师杂志(电子版)

中华临床医师杂志(电子版) ›› 2022, Vol. 16 ›› Issue (12) : 1256 -1261. doi: 10.3877/cma.j.issn.1674-0785.2022.12.018

护理园地

基于IKAP理论的护理专案改善腹膜透析患者自我感受与期望水平
金莉1,†(), 刘丽1, 金程1, 郑多娟1, 王娟1   
  1. 1. 237006　安徽六安，安徽省六安市中医院肾病二科
  • 收稿日期:2022-02-17 出版日期:2022-12-15
  • 通信作者: 金莉

Nursing project based on IKAP theory improves self-perceived burden and the Herth hope index in peritoneal dialysis patients

Li Jin1,†(), Li Liu1, Cheng Jin1, Duojuan Zheng1, Juan Wang1   

  1. 1. Second Department of Nephrology, Traditional Chinese Hospital of Lu'an, Lu'an 237006, China
  • Received:2022-02-17 Published:2022-12-15
  • Corresponding author: Li Jin
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金莉, 刘丽, 金程, 郑多娟, 王娟. 基于IKAP理论的护理专案改善腹膜透析患者自我感受与期望水平[J]. 中华临床医师杂志(电子版), 2022, 16(12): 1256-1261.

Li Jin, Li Liu, Cheng Jin, Duojuan Zheng, Juan Wang. Nursing project based on IKAP theory improves self-perceived burden and the Herth hope index in peritoneal dialysis patients[J]. Chinese Journal of Clinicians(Electronic Edition), 2022, 16(12): 1256-1261.

目的

考察基于IKAP理论的护理专案在改善腹膜透析患者自我感受与希望水平的效果。

方法

选取2018年6月~2019年12月在肾病科进行腹膜透析治疗的终末期肾病（end stage renal disease，ESRD）75例作为对照组，2020年1月~2021年7月治疗的患者75例作为试验组。对照组接受常规护理，试验组接受基于IKAP理论的护理专案。比较2组患者护理前后的自我感受与希望水平，比较2组患者护理后的满意度。

结果

2组患者护理前的经济/家庭负担、照护负担、心理/情感负担、心理/情感负担、治疗负担及自我感受总分、对现实与未来的积极态度、采取的积极行动、与他人保持亲密的关系及希望水平总分差异无统计学意义（P＞0.05），护理后，2组患者经济/家庭负担、照护负担、心理/情感负担、心理/情感负担、治疗负担及自我感受总分均明显降低（P＜0.05），对现实与未来的积极态度、采取的积极行动、与他人保持亲密的关系及希望水平总分显著升高（P＜0.05），与对照组比，试验组经济/家庭负担、照护负担、心理/情感负担、心理/情感负担、治疗负担及自我感受总分均明显降低（P＜0.05），对现实与未来的积极态度、采取的积极行动、与他人保持亲密的关系及希望水平总分显著升高（P＜0.05）。与对照组比，试验组的满意度明显增高（P＜0.05）。

结论

基于IKAP理论的护理专案有助于改善腹膜透析患者的自我感受与希望水平，提高患者的治疗满意度，值得临床推广。

关键词: IKAP理论, 护理专案, 腹膜透析, 自我感受, 希望水平
Objective

To investigate the effect of the nursing project based on IKAP theory in improving the self-perceived burden and hope of peritoneal dialysis patients.

Methods

Seventy-five patients who underwent peritoneal dialysis for end stage renal disease at our department from June 2018 to December 2019 were selected as a control group, and 75 patients who were treated from January 2020 to July 2021 were selected as an experimental group. The control group received routine care, and the experimental group received the nursing project based on IKAP theory. The self-perceived burden and hope levels before and after nursing, as well as the patient's satisfaction with the nursing care were compared between the two groups.

Results

Before nursing, the scores of economic/family burden, nursing burden, psychological/emotional burden, psychological/emotional burden, and treatment burden, the total score of self-perceived burden, the scores of positive attitudes toward reality and the future, positive actions taken, and keeping an intimate relationship with others, and the total score of hope had no significant difference between the two groups (P＞0.05). After nursing, the scores of economic/family burden, nursing burden, psychological/emotional burden, psychological/emotional burden, and treatment burden, the total score of self-perceived burden, the scores of positive attitudes toward reality and the future, positive actions taken, and keeping an intimate relationship with others improved significantly in both groups (P＜0.05). Compared with the control group, the scores of economic/family burden, nursing burden, psychological/emotional burden, psychological/emotional burden, and treatment burden and the total score of self-perceived burden in the observation group decreased signficantly (P＜0.05), while the scores of positive attitudes toward reality and the future, positive actions taken, and keeping an intimate relationship with others increased significantly (P＜0.05).

Conclusion

The nursing projects based on IKAP theory can help improve the self-perceived burden and Herth hope inder of peritoneal dialysis patients.

Key words: End stage renal disease, IKAP theory, Nursing project, Peritoneal dialysis, Self-perceived burden, Herth hope index
表1 2组患者的一般情况比较
组别 对照组 试验组 t/χ2值 P值
例数（例） 75 75
男∶女 46∶29 50∶25 0.463 0.496
年龄（岁） 51.24±10.25 50.96±10.36 0.136 0.892
受教育程度（例） 3.889 0.143
≤中 15 10
中专~高中 26 19
≥大专 34 46
体重指数（kg/m2） 22.15±2.45 22.31±2.78 0.374 0.710
婚姻状态（例） 0.030 0.863
已婚 50 49
单身/丧偶/分居 25 26
家庭人均月收入（元/月） 0.367 0.833
＜1000 24 21
1000~3000 39 40
＞3000 12 14
工作状态（例） 0.599 0.741
全职 42 46
部分时间工作 20 19
病休、无业、退休 13 10
医疗费用支付方式（例） 0.126 0.939
自费 10 9
医疗社会保险/商业保险 50 52
公费医疗 15 14
生活自理能力（例） 1.724 0.422
较差 15 20
一般 50 49
较好 10 6
透析龄（年） 2.12±0.52 2.31±0.64 1.629 0.110
每周透析次数（次/周） 0.427 0.514
1~2 35 39
3 40 36
表2 2组患者护理前后的自我感受比较（
xˉ
±s，分）
组别 护理前/后 经济/家庭负担 照护负担 心理/情感负担 治疗负担 自我感受总分
对照组 护理前 28.15±5.69 16.45±4.36 20.11±6.11 15.39±3.96 80.10±5.87
护理后 26.15±4.89 15.01±4.02 18.06±5.89 14.03±3.54 73.25±5.44
t值 2.309 2.103 2.092 2.217 7.412
P值 0.024 0.039 0.040 0.030 ＜0.001
试验组 护理前 27.96±6.01 16.23±4.95 20.64±6.34 15.95±4.01 80.78±5.87
护理后 24.03±4.65a 13.03±4.35a 15.11±5.47a 12.15±3.64a 64.32±5.18a
t值 4.479 4.205 5.719 6.077 18.208
P值 ＜0.001 ＜0.001 ＜0.001 ＜0.001 ＜0.001
表3 2组患者护理前后的希望水平比较（
xˉ
±s，分）
组别 护理前/后 对现实与未来的积极态度 采取的积极行动 与他人保持亲密的关系 希望水平总分
对照组 护理前 8.26±1.69 8.46±1.25 9.12±1.61 25.84±1.53
护理后 9.43±1.71 9.96±1.39 10.25±1.79 29.64±1.64
t值 4.214 6.995 4.065 14.673
P值 ＜0.001 ＜0.001 ＜0.001 ＜0.001
试验组 护理前 8.34±1.75 8.29±1.69 9.24±1.89 25.87±1.64
护理后 10.03±1.78 10.65±1.48 11.19±1.98 31.87±2.16
t值 5.863 9.098 6.170 19.160
P值 ＜0.001 ＜0.001 ＜0.001 ＜0.001
表4 2组患者护理后的满意度比较（
xˉ
±s，%）
组别 非常满意（%） 比较满意（%） 一般（%） 不满意（%） 满意度（%）
对照组 48（64.00） 10（13.33） 5（6.67） 12（16.00） 63（84.00）
试验组 48（64.00） 19（25.33） 6（8.00） 4（5.33） 71（94.67）
χ2值 4.478
P值 0.034
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