Illness Perception Intervention Program For Hemodialysis Patients Based On Self-regulation Model Research

Objective1.To investigate the status of illness perception in hemodialysis patients and analyze the influence factors,2.To explore the effects of self-regulation model interventions on illness perception,coping style and quality of life in hemodialysis patients.MethodsInventory survey: Patients who over 18 years old and having received HD over 3months from December 2017 to April 2018 at a 3A grade hospital in Zhengzhou were selected.Data were collected included demographic characteristics,the brief illness perception questionnaire,medical coping modes questionnaire,herth hope index,then analyzed the influence factors of illness perception.The collected data were analyzed using IBM SPSS Statistics 21.0,and the statistic methods included descriptive statistical analysis,single factor analysis of variance,t-test and muliple linear regression analysis.Intervention study: This study belongs to an experimental study.Based on the first part of the study,82 patients in a blood purification center of a third-grade hospital in Zhengzhou City were selected for long-term hemodialysis treatment andvolunteered to participate in the study.The 42 patients who underwent dialysis on Monday,Wednesday,and Friday were divided into control groups.Forty patients who underwent dialysis on Tuesday,Thursday,and Saturday were divided into intervention groups.Patients in the control group received routine education,and patients in the intervention group received SRM-based illness perception intervention.The intervention lasted for 6 weeks.Before,Immediately after intervention and 3 months after intervention,the illness perception level,medical coping modes,quality of Life,interdialysisl weight gain value were used to test the intervention effect.The data were analyzed by descriptive statistical,t-test analysis,chi-square analysis and repeated measurement variance analysis.Results1.Inventory survey: A total of 176 questionnaires were completed in this study,including 162 valid questionnaires with an effective rate of 92.0%.(1)The score of hemodialysis patients' illness perception is(55.98±4.40),rage38~65,The disease care degree score was the highest(9.24 ± 0.79),and the personal control score was the lowest(5.94 ± 2.05).(2)Screening the influencing factors of illness perception in hemodialysis patients by Pearson correlation analysis,one-way analysis of variance,t-test and other statistical methods.The total score of illness perception in hemodialysis patients was dependent variable,and the patient face,avoidance,yield dimension score,total score of hope,dialysis history,education level,and type of medical insurance were independent variables.The results were analyzed by multiple linear regression.The yield dimension,the level of hope,and the level of education are the influencing factors of illness perception.2.Intervention study: During the intervention,3 hemodialysis patients were lost to follow-up,and 82 patients completed the intervention,40 in the intervention group and 42 in the control group.(1)The patient's illness perception and its generalized estimation equations before and after intervention showed statistically significant differences in BIPQ total scores,outcomes,personal control,symptoms,concern,emotional inter-group effects,time effects and interaction effects(P<0.05).There was no significant difference in duration between groups(P>0.05).There was a statistically significant difference in time effect and interaction(P<0.001).There was no significant difference in disease control and understanding interaction(P>0.05),the inter-group effect and time effect were statistically significant(P<0.001).(2)Comparison of medical coping styles before and after intervention.The results of generalized estimation equations of MCMQ total scores of the two groups showed no statistically significant(P>0.05),and the difference between time and effect was statistically significant(P<0.05).The results of the generalized estimation equations of the avoidance dimension and the yield dimension of the two groups showed statistically significant differences between the group effects,time effects and interaction effects(P<0.05).The results of repeated measures analysis of variance between the two groups of patients with face dimension scores showed that the differences between groups,time effects and interaction effects were statistically significant(P<0.05).(3)The results of repeated measures analysis of variance between the two groups of patients with quality of life showed that the differences between groups,time effects and interaction effects were statistically significant(P<0.05).(4)The results of repeated measures analysis of variance between the two groups of patients with dialysis interval weight gain showed that there were significant differences in the total grouping effect,time effect and interaction between the two groups(P<0.05).Conclusions1.The illness perception of hemodialysis patients in this study was at the upper-middle level.Among them,the highest attention score for disease and the lowest for personal control.2.The illness perception of hemodialysis patients in this study was influenced by the general data,coping style and hope level of the patients.The patient's yielding coping style was positively correlated with illness-perception.The higher the patient's hope level,the more positive the illness-perception,the patients with different dialysisyears,education level and medical insurance type had different illness perceptions.3.Illness perception intervention based on SRM can improve patients' illness perception,promote the transformation of their coping style,improve quality of life,and reduce interdialytic weight increase value.