| Objectice1.To investigate the status of fear of falling in elderly hemodialysis patients and analyze its influencing factors;2.Based on the results of the first stage,construct a cognitive-motor intervention program and explore the impact of this program on patients' fear of falling,physical function,and quality of lifejective.Methods1.Inventory survey:Patients who met inclusion and exclusion criteria in blood purification centers of two hospitals in zhengzhou were selected for investigation.The survey included patients' general information,fear of falling,movement and balance function and level of hope,and analyzed the factors influencing fear of falling.SPSS 21.0 software was used to organize and analyze the data.Statistical analysis methods such as descriptive statistics,t-test and multiple linear regression were used to analyze the collected data.2.Intervention phase:90 patients who met the inclusion criteria and voluntarily participated in the intervention were selected for intervention.Because hemodialysis patients have a fixed dialysis time within a week,first divide the patients into A and B groups according to the dialysis time,group A:dialysis on Monday,Wednesday and Friday,and group B:dialysis on Tuesday,Thursday and Saturday.And then group A and B were randomly divided into intervention group and control group by tossing coin.The control group received routine education,and the intervention group received cognitive-motor intervention for four months.Data of patients before,after and 3 months after intervention were collected,including fear of falling,motor function,balance function,grip strength,STS 10 test time,quality of life,and Kt/V value.T-test,chi square test,rank sum test and other methods were used to analyze the collected data.Results1.A total of 245 questionnaires were collected in this study,of which 237 were valid questionnaires,with an effective rate of 96.73%.(1)The score of fear of falling in elderly hemodialysis patients was(65.52 ± 18.83),the score of indoor dimension was(44.35±12.81),and the score of outdoor dimension was(21.16±8.73).(2)Multi-linear regression analysis was performed using the score of patient's fear of falling as the dependent variable,motor function,balance function,hope level,fall history,caregiver type,etc.as the independent variables.The results showed that motor function,balance function,level of hope,comorbidities and education level were the factors affecting the fear of falling.2.During the intervention,3 elderly hemodialysis patients were lost to follow-up.A total of 87 elderly hemodialysis patients completed the intervention,44 in the intervention group and 43 in the control group.(1)There were statistically significant differences in the intergroup effect,time effect and interaction effect of the fear of falling score,motor function scores,balance function scores,STS 10 test time,grip,physical health score and mental health score between the two groups of patients before and after the intervention(P<0.05).(2)The difference in the time effect of Kt/V between the two groups of patients before and after the intervention was statistically significant(P<0.05),and there were no significant differences in the intergroup effects and interaction effects between the groups(P>0.05).Conclusions1.In this study,the motor function,balance function,level of hope,comorbidities,and educational level of elderly hemodialysis patients can affect the degree of their fear of falling.2.Cognitive-motor intervention can alleviate patients' fear of falling,improve their physical function and quality of life.However,the effect of intervention on dialysis adequacy in patients remains to be further explored. |
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