The Effects Of Disease Adaptation Intervention Program Among Young And Middle-aged Patients Undergoing Early Stage Of Peritoneal Dialysis

ObjectivesTo explore the effects of Roy adaptation model-guided intervention program on the disease adaptability,medical coping,quality of life,edema,and serum albumin levels of among young and middle-aged patients undergoing early stage of peritoneal dialysis.MethodsThis study is quasi-experimental study designed with repeated measurements.A total of 88 patients who comes from the peritoneal dialysis center of the inpatient ward of Nephrology Department of a tertiary hospital in Zhengzhou City were selected as subjects by convenience sampling.According to the department,88 patients were divided into intervention group(43 cases)and control group(45 cases).The control group received routine care based on dialysis operation specification,health education instruction and telephone follow-up.The intervention group received disease adaptation intervention based on Roy adaptation model on the basis of routine care: organically combining group activities and individualized interventions,and using telephone follow-up and WeChat interactions to perform physiological,psychological,and social aspects of early stage of peritoneal dialysis.The study was used by batch intervention,and each batch of patients was intervened for 6 weeks.The total study duration lasted for 4 months.The effect of disease adaptation intervention based on Roy adaptation model was assessed by Self-Report Psychological Adjustment to Illness Scale(PAIS-SR)score,Medical Coping Modes Questionnaire(MCMQ)score,Short Form of 36 health survey questionnaire(SF-36)score,edema degree and serum albumin index at baseline,1st month intervention period and post-intervention.Data were analyzed with SPSS Statistics 17.0,using the descriptive statistical analysis,chi-square test,T test,Mann-Whitney U rank sum test,repeated measurement of variance analysis,and generalized estimation equation.P<0.05 was considered statistically significant.Results4 of the 92 subjects(4.35%)were lost owing to transfer or kidney transplant,transfer to hemodialysis.Then the final effective samples were 88 cases,including 43 cases in intervention group and 45 cases in the control group.1.Comparison of PAIS-SR scores of patients before and after intervention.(1)The results of repeated measurements of analysis variance indicated that the total scores of PAIS-SR of the two groups were statistically significant before intervention,1st month intervention period and post-intervention,and between group effects,time effect and interaction between the group effect and time effect(P<0.05).(2)The results of generalized estimation equation indicated that the scores of health care,the ability to work,sexuality,and psychological condition of the group effects between two groups were statistically significant at each time point;the scores of PAIS-SR in each dimension have significant differences in time effect and interaction between the group effect and time effect,it is to say that the scores of psychosocial adjustment in each dimension change with time,and the trends are different.2.Comparison of MCMQ scores of patients before and after intervention.(1)The results of repeated measurements of analysis variance indicated that the scores of face dimensions of the group effects and time effects between two groups were statistically significant at each time point;there was a statistically significantdifferent in the total scores of MCMQ,face dimension,and avoidance dimension with interaction between the group effect and time effect.(2)The results of generalized estimation equation indicated that the scores of yield dimensions of the group effects,time effects,and interaction between the group effect and time effect between two groups was statistically significant at each time point.3.Comparison of SF-36 scores of patients before and after intervention.The results of generalized estimation equation indicated that there were statistically significant in the time effects and interaction between the group effect and time effect of the physical health and mental health scores at each time point between the two groups(P<0.05).4.Comparison of outcomes of patients before and after intervention.(1)The results of Mann-Whitney U rank sum test showed that there was no significant difference in edema degree between the two groups before and after intervention(P>0.05).(2)The results of generalized estimation equation indicated that there was no significant difference in the group effects of serum album at each time point between the two groups,and there was a significant difference in time effects and interaction between the group effect and time effect between the two groups(P<0.001).ConclusionBased on Roy adaptation model-guided intervention program are easy to operate.It can effectively improve the disease adaptability among young and middle-aged patients undergoing early stage of peritoneal dialysis,promote the positive transformation of patients’ negative coping;although the improvement in the patients’ quality of life,the edema degree,and the serum albumin index is not significant,it still has a certain positive effect.