标题：家庭赋权模式对初次血液透析患者准备度、应对方式及透析管理能力的影响

      作者：陈静，王炎，岳晓红    郑州大学第一附属医院血液净化中心，河南 郑州 450000

      卷次： 2024年35卷14期

      【摘要】 目的 探究家庭赋权模式对初次血液透析患者准备度、应对方式及透析管理能力的影响。方法 选取2022年1月至2023年6月于郑州大学第一附属医院进行初次血液透析的120例患者作为研究对象，根据随机数表法分为对照组和观察组各60例。对照组患者给予常规护理，观察组患者于此基础上给予家庭赋权模式护理。比较两组患者护理干预前后的透析准备度、应对方式[医学应对方式问卷(MCMQ)]、希望水平[Herth希望量表(HHI)]、透析管理能力和并发症发生情况。结果 干预后，观察组患者透析准备度量表中透析知识、个人状况、透析适应能力、预期性支持维度评分分别为(21.32±3.57)分、(12.57±2.13)分、(20.65±3.24)分、(15.47±3.12)分，明显高于对照组的(18.00±2.96)分、(9.43±1.96)分、(15.41±2.75)分、(11.75±2.67)分，差异均有统计学意义(P<0.05)；干预后，观察组患者MCMQ量表中的回避、屈服评分分别为(11.36±2.59)分、(8.41±1.42)分，明显低于对照组的(16.24±3.18)分、(10.06±2.06)分，面对评分(26.35±3.21)分，明显高于对照组的(20.47±4.02)分，差异均有统计学意义(P<0.05)；干预后，观察组患者HHI量表中的现实和未来的积极态度、与他人保持亲密关系、采取积极行动评分分别为(13.54±2.01)分、(14.42±2.86)分、(13.98±2.03)分，明显高于对照组的(11.78±2.12)分、(12.11±3.00)分、(11.46±2.16)分，差异均有统计学意义(P<0.05)；干预后，观察组患者透析管理能力量表中运动锻炼、规范治疗、合理饮食、导管/内瘘维护、日常生活管理评分分别为(17.63±2.15)分、(15.67±3.10)分、(16.24±3.32)分、(18.36±3.63)分、(17.28±2.63)分，明显高于对照组的(12.48±2.36)分、(11.87±2.74)分、(14.00±2.18)分、(12.57±3.11)分、(15.03±3.12)分，差异均有统计学意义(P<0.05)；观察组患者并发症发生率为8.33%，略低于对照组的18.33%，但差异无统计学意义(P>0.05)。结论 家庭赋权模式可提升初次透析患者透析准备度，改变其应对方式，提升希望水平，增强透析管理能力，但是否对降低并发症具有积极作用还需今后增加样本量进一步深入探究。
      【关键词】 家庭赋权模式；准备度；透析；应对方式；初次；透析管理能力(依从性)
      【中图分类号】 R459.5 【文献标识码】 A 【文章编号】 1003—6350（2024）14—2108—06

Impact of family empowerment model on the readiness, coping style, and dialysis management ability of patientsundergoing hemodialysis for the first time.
CHEN Jing, WANG Yan, YUE Xiao-hong. Blood Purification Center, theFirst Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan, CHINA
【Abstract】 Objective To investigate the effects of a family empowerment model on readiness, coping styles,and dialysis management skills of patients undergoing hemodialysis for the first time. Methods A total of 120 patientswho underwent hemodialysis for the first time at the First Affiliated Hospital of Zhengzhou University from January2022 to June 2023 were selected as the study subjects. They were randomly divided into a control group and an observa-tion group, with 60 patients in each group, using a random number table method. Patients in the control group were giv-en routine care, while those in the observation group were given family empowerment mode care on this basis. The dialy-sis readiness, coping strategies [Medical Coping Modes Questionnaire (MCMQ)], hope level [Herth Hope index (HHI)],dialysis management ability, and incidence of complications were compared between the two groups of patients before and af-ter nursing intervention. Results After intervention, the scores of dialysis knowledge, personal status, dialysis adaptability,and anticipatory support in the Dialysis Readiness Scale were (21.32±3.57) points, (12.57±2.13) points, (20.65±3.24) points,and (15.47±3.12) points, respectively, significantly higher than (18.00±2.96) points, (9.43±1.96) points, (15.41±2.75) points,and (11.75±2.67) points in the control group (P<0.05). After intervention, the avoidance and yield scores in MCMQ inthe observation group were (11.36±2.59) points and (8.41±1.42) points, respectively, which were significantly lower than(16.24±3.18) points and (10.06±2.06) points in the control group; the facing score was (26.35±3.21) points, significantlyhigher than (20.47±4.02) points in the control group; the differences were statistically significant (P<0.05). After the in-tervention, the scores of positive attitude towards reality and future, maintaining close relationships with others, and tak-ing positive actions in the HHI scale of the observation group were (13.54±2.01) points, (14.42±2.86) points, and (13.98±2.03) points, respectively, significantly higher than (11.78±2.12) points, (12.11±3.00) points, and (11.46±2.16) points inthe control group (P<0.05). After intervention, the scores of exercise, standardized treatment, reasonable diet, catheter/fistula maintenance, and daily life management in the Dialysis Management Ability Scale in the observation group were(17.63±2.15) points, (15.67±3.10) points, (16.24±3.32) points, (18.36±3.63) points, and (17.28±2.63) points, respective-ly, significantly higher than (12.48±2.36) points, (11.87±2.74) points, (14.00±2.18) points, (12.57±3.11) points, and(15.03±3.12) points in the control group (P<0.05). There was no significant difference in the complication rate betweenthe observation group (8.33%) and the control group (18.33%), P>0.05. Conclusion The family empowerment modelcan improve the dialysis readiness, change the coping style, enhance the hope level, and enhance the ability of dialysismanagement. However, whether it has a positive effect on reducing complications needs to be further explored by in-creasing the sample size in the future.
      【Key words】 Family empowerment model; Readiness; Dialysis; Coping style; The first time; Dialysis manage-ment ability (compliance)