| Objectives To evaluate the safety of the portable and collapsible cleaning operation box which is used for peritoneal dialysis catheter connection and dialysate exchange(the operation box)in patients with continuous ambulatory peritoneal dialysis(CAPD),and discuss the impacts of the operation box on social regression,psychological state,quality of life and other aspects of CAPD patients.On the premise of ensuring the safe and standard dialysate exchange environment,the operation box should provide a kind of more portable,more practical and cheaper dialysate exchange micro-environment for CAPD patients during they are outside of home,and the operation box should even further replace the room which is specifically used for peritoneal dialysis.The patent on the operation box may provide a solution for clinical staffs to promote social regression,improve negative psychological state and quality of life of CAPD patients.Methods This study belonged to the quasi-experimental study.This study was conducted with the informed consent of the subjects and the approval of the medical ethics committee of one Three Level of First-class Hospital in Shenzhen.According to the inclusion and exclusion criteria,100 CAPD patients who were diagnosed with end-stage renal disease in the peritoneal dialysis center of one Three Level of First-class Hospital in Shenzhen were selected by the convenience sampling method and divided into the intervention group and the control group.The subjects in the intervention group used the operation box which was sterilized by the miniature ozone sterilizer to finish dialysate exchange,while the subjects in the control group finished dialysate exchange in the peritoneal dialysis operation room which was disinfected by ultraviolet sterilizer.At the beginning of the study,the researchers conducted the baseline survey to collect general information,the level of social regression,the scores of depression and the scores of quality of life;after 6 months,the researchers collected information about subjects again,including the incidence of peritoneal dialysis related peritonitis,rehospitalization,withdrawal from peritoneal dialysis and deaths due to peritoneal dialysis related peritonitis,the level of social regression,the scores of depression and the scores of quality of life.The data were processed and analyzed by SPSS 19.0 statistical software,the statistical methods included two-sample t-test,paired t-test,Mann-Whitney U test,Wilcoxon signed-rank test,Wilcoxon rank sum test,Chi-square test,Fisher's exact probability test and so on,all data were tested by two-sided test,the test level of significance ?=0.05,and P<0.05 was considered statistically significant.Results(1)There were no statistically significant differences between the two groups in gender,age,marital status,education level,employment status,the hours of going out,medical insurance status,course of disease,months of peritoneal dialysis,diabetes or not,albumin level and other general information(P>0.05),the two groups were comparable.(2)During the period of the study,there was no case of withdrawal from peritoneal dialysis and even deaths due to peritoneal dialysis related peritonitis in the two groups.There was no case of peritoneal dialysis related peritonitis and rehospitalization in the intervention group,while there was 1 case of peritoneal dialysis related peritonitis(2.00%)and 1 case of rehospitalization(2.00%)due to peritoneal dialysis related peritonitis in the control group.There were no statistically significant differences in the incidence of peritoneal dialysis related peritonitis and rehospitalization between the two groups(P>0.05).(3)At the end of the study,as for the level of social regression of CAPD patients in the intervention group,there were 18 patients(36.00%)in level 3 and 32 patients(64.00%)in level 4,as for the level of social regression of CAPD patients in the control group,there were 6 patients(12.00%)in level 2,20 patients(40.00%)in level 3 and 24 patients(48.00%)in level 4.The social regression of CAPD patients in the intervention group was obviously better than that in the control group,and the difference was statistically significant(P<0.05).At the end of the study,the social regression of CAPD patients in the intervention group was better than that at the beginning of the study,and the difference was statistically significant(P<0.05).(4)At the end of the study,the median scores of depression of CAPD patients in the intervention group was 3.00,and the median scores of depression of CAPD patients in the control group was 6.00,the mental health status of CAPD patients in the intervention group was obviously better than that in the control group,and the difference was statistically significant(P<0.05).Moreover,at the end of the study,the depression status of CAPD patients in the intervention group was obviously better than that at the beginning of the study,and the difference was statistically significant(P<0.05).(5)At the end of the study,the median scores of quality of life of CAPD patients in the intervention group and the control group were 606.84 and 526.17 respectively.The quality of life of CAPD patients in the intervention group was obviously better than that in the control group,and the difference was statistically significant(P<0.05).At the end of the study,the quality of life of CAPD patients in the intervention group was obviously better than that at the beginning of the study,and the difference was statistically significant(P<0.05).At the end of the study,the scores of physical role function,energy,social function,emotional role function and mental health of CAPD patients in the intervention group were all higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusion On the premise of the correct use,the operation box and the miniature ozone sterilizer can replace the traditional dialysate exchange operation room which is sterilized by ultraviolet sterilizer,it can provide safe and standard dialysate exchange micro-environment for CAPD patients,especially while they are engaged in outdoor activities;the use of the operation box can solve the problem that specific room for peritoneal dialysis couldn't be found by CAPD patients due to the limit room in their houses;the use of the operation box for dialysate exchange can reduce the time of sterilization and further improve the treatment compliance of CAPD patients to some extent;the operation box is collapsible and the size of the operation box is appropriate,so it can be carried conveniently by CAPD patients,and the operation box can provide safe dialysate exchange micro-environment for CAPD patients during they are outside of home,especially while they are engaged in work,travel or other outdoor activities,effectively promote social regression of CAPD patients;the use of the operation box can help CAPD patients realize their own value,improve the negative psychological state,such as depression and so on,help them regain confidence in life,and further improve their quality of life. |
PDF Full Text Request