Application Of The Motivational Interviewing On The Self-management Among Patients With Continuous Ambulatory Peritoneal Dialysis

ObjectiveTo explore the intervention effect of motivational interviewing(MI) on self-efficacy,self-management skills, nutritional status, capacity control and dialysis adequacy with continuous ambulatory peritoneal dialysis patients, and to provide reference when nursing staff carry out health education.MethodsEighty-four patients were recruited from a third-grade class-A hospital and were randomly divided into control and experimental groups, each group 42 cases. After the baseline survey, the patients in the control group received routine health education, while the patients in the experimental group received motivational interviewing intervention,and the intervention time were six months. The behavior of the patient’s self-management,and self-efficacy were measured with Dialysis patient self-management behavior questionnaire and Self-efficacy Scale, and the patient’s dialysis adequacy indicator,capacity control indicator, indicators of nutritional status and the status of peritonitis were measured before intervention and six months after intervention, to evaluate and analyze the effect of motivational interviewing.ResultsFinally, 41 patients in the control group and 40 patients completed the study.1. In self-efficacy, compared with the control group, the level of patients’ selfefficacy were significantly higher in the experimental group(P <0.05).2. In self-management, compared with the control group, the patients’ selfmanagement total score were significantly higher in the experimental group(P <0.05).In the five dimensions of self-management behavior questionnaire which excepted medication compliance, scores of four dimensions included dialysis technique, dietary intake, Disease Surveillance and management of complications were significantly increased, and the difference was statistically significant(P <0.05 or <0.01).3. In nutritional status and capacity control, compared with the control group,patients’ blood phosphorus was significantly lower in the experimental group, however,hemoglobin and serum prealbumin was significantly increased and blood pressure and edema situation had improved significantly, and the difference was statistically significant(P <0.05).4. In dialysis adequacy, compared with the control group, patients’ urea nitrogen removal index and creatinine clearance rate increased significantly, the score of clinical index project was significantly higher in the experimental group, the difference was statistically significant(P <0.05).5. In peritonitis, six months after the intervention, nobody had peritonitis in the experimental group, but six people had in the control group, and the difference was statistically significant(Fisher exact test, P <0.05).ConclusionMotivational Interviewing can significantly increase the continuous ambulatory peritoneal dialysis patient’s self-efficacy and self-management skills, and improve the patient’s nutritional and the status of capacity control, enhance the effect of dialysis and reduce the incidence of peritonitis.