标题：菜单式护理对腹膜透析患者营养状况、健康行为和社会支持的影响

      作者：史娟娟，徐飒，王荟苹，李冠华，田瑞杰    史娟娟，徐飒，王荟苹，李冠华，田瑞杰郑州大学第一附属医院肾脏内科，河南 郑州 450000

      卷次： 2023年34卷24期

      【摘要】 目的 探讨菜单式护理在腹膜透析患者中的应用效果。方法 选取2020年1月至2023年1月郑州大学第一附属医院收治的112例腹膜透析患者作为研究对象，按随机数表法分为对照组和观察组各56例。对照组患者采取常规护理，观察组在对照组的护理基础上采取菜单式护理。护理3个月后比较两组患者的遵医率、并发症及护理前后的营养状况、社会影响量表(SIS)评分、健康行为能力量表(SRAHP)评分和社会支持评定量表(SSRS)评分。结果 观察组患者的遵医率为91.07%，明显高于对照组的71.43%，并发症发生率为3.57%，明显低于对照组的16.07%，差异均有统计学意义(P<0.05)；与对照组比较，护理1个月后、3个月后，观察组患者的社会孤立、社会排除、内在羞耻评分降低，SSRS评分升高，差异均有统计学意义(P<0.05)；护理3个月后，观察组患者的NRS2002评分为(2.24±0.33)分，明显低于对照组的(2.71±0.35)分，三头肌皮褶厚度(TSF)为(4.28±0.40) mm，明显高于对照组的(3.81±0.38) mm，上臂肌围(AMC)为(9.12±1.23) mm，明显高于对照组的(8.03±1.05) mm，差异均有统计学意义(P<0.05)；观察组患者护理1个月和3个月后的心理舒适性[(16.33±1.89)分、(18.29±2.24)分]、健康责任[(15.56±2.03)分、(18.96±2.26)分]、运动管理[(14.87±1.86)分、(17.79±2.11)分]等评分明显高于对照组[(14.45±2.16)分、(17.01±2.34)分，(14.49±2.11)分、(17.73±2.18)分，(13.03±1.44)分、(16.12±1.98)分]，差异均有统计学意义(P<0.05)；观察组患者护理 3个月后的营养管理评分为(16.61±1.92)分，明显高于对照组的(14.43±1.56)分，差异有统计学意义(P<0.05)。结论 菜单式护理可帮助腹膜透析患者建立健康行为，减轻病耻感，提高营养状况及社会支持，降低并发症。
      【关键词】 菜单式护理；腹膜透析；社会支持；健康行为；营养状况
      【中图分类号】 R47 【文献标识码】 A 【文章编号】 1003—6350（2023）24—3625—06

Impact of menu nursing on the nutritional status, health behavior, and social support of patients undergoingperitoneal dialysis.
SHI Juan-juan, XU Sa, WANG Hui-ping, LI Guan-hua, TIAN Rui-jie. Department of Nephrology,First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan, CHINA
【Abstract】 Objective To explore the application effect of menu nursing in patients undergoing peritoneal dial-ysis. Methods A total of 112 patients undergoing peritoneal dialysis admitted to the First Affiliated Hospital of Zheng-zhou University from January 2020 to January 2023 were selected as the research subjects and randomly divided into acontrol group and an observation group, each with 56 cases. Patients in the control group received routine care, whilethose in the observation group received menu nursing on the basis of routine care. After 3 months of nursing, the compli-ance rate, complications, and nutritional status before and after nursing were compared between the two groups. Thescores of the Social Impact Scale (SIS), Social Readiness and Health Promotion Assessment (SRAHP), and Social Sup-port Rating Scale (SSRS) were also compared. Results The compliance rate of patients in the observation group was91.07%, significantly higher than 71.43% in the control group, and the incidence of complications was 3.57%, significant-ly lower than 16.07% in the control group, with statistically significant differences (P<0.05). Compared with the controlgroup, after 1 month and 3 months of nursing care, the observation group showed a decrease in social isolation, social ex-clusion, and internal shame scores, while the SSRS score increased, with statistically significant differences (P<0.05). Af-ter 3 months of nursing, the NRS2002 score of the observation group was (2.24±0.33) points, significantly lower than(2.71±0.35) points in the control group; the triceps skinfold thickness (TSF) was (4.28±0.40) mm, significantly higherthan (3.81±0.38) mm in the control group; the upper arm muscle circumference (AMC) was (9.12±1.23) mm, significant-ly higher than (8.03±1.05) mm in the control group; the differences were statistically significant (P<0.05). The scores ofpsychological comfort [(16.33 ± 1.89) points and (18.29 ±2.24) points], health responsibility [(15.56 ± 2.03) points and(18.96±2.26) points], and exercise management [(14.87±1.86) points and (17.79±2.11) points] in the observation groupafter one and three months of nursing were significantly higher than those in the control group [(14.45±2.16) points and(17.01±2.34) points, (14.49±2.11) points and (17.73±2.18) points, (13.03±1.44) points and (16.12±1.98) points], and thedifferences were statistically significant (P<0.05). The score of nutritional management in the observation group afterthree months of nursing was (16.61±1.92) points, which was significantly higher than (14.43±1.56) points in the controlgroup (P<0.05). Conclusion Menu nursing can help patients undergoing peritoneal dialysis establish healthy behavior,reduce stigma, improve nutritional status and social support, and reduce complications.
      【Key words】 Menu nursing; Peritoneal dialysis; Social support; Health behavior; Nutritional status