| Objective To understand the self-management behavior of maintenance hemodialysis patients.To explore the relationship among hope level,family function,locus of control and self-management behavior of maintenance hemodialysis patients.To provide theoretical basis for clinical nurses to carry out self-management behavior intervention.Methods By using cross-sectional survey,305 patients with maintenance hemodialysis from January 2018 to January 2019 in one top three hospitals in Hefei City,Anhui Province were selected as the survey objects,striving to be filled in independently by patients.For those who are limited by objective reasons,the researcher used a unified language to ask the offspring for filling in,and the questionnaire was checked,verified and retrieved on the spot.Herth hope scale,family cohesion and Cohesion Scale II(FACESII),multi-dimensional mental health locus of control scale(MHLC)and selfmanagement behavior scale were used to investigate.Epi Data 3.1 was used to build the database,spss19.0 was used for data statistics description and correlation analysis,sequential test was used to test the intermediary effect of locus of control was used to build the structural equation for path analysis.P < 0.05 means the difference is statistically significant.Results1.General situation of maintenance hemodialysis patients: in 305 patients investigated in this study,the age was 21-90 years old,the average age was(58.51 ± 11.34)years old.There were 186 male patients and 119 female patients.The average duration of dialysis was(4.09 ± 0.84)years.2.The total score of self-management behavior of maintenance hemodialysis patients was(57.03 ± 10.22).The score of problem solving was(14.31 ± 3.10).The score of partnership was(11.86 ± 2.64).The score of emotion processing was(10.43 ± 2.68).The score of self-care was(20.43 ± 3.88).The scores of self-management behavior of patients with different education and payment methods were different(P < 0.05).3.There were significant positive correlation between hope,family intimacy,family adaptability,internal control,influential others and self-management(r>0,P<0.05).Opportunity variables only had significant correlation with internal control and influential others,but no significant correlation with other variables(P>0.05).4.In maintenance hemodialysis patients,hope,family intimacy and family adaptability can positively predict self-management(P<0.05).Internal control plays an important role in hope,family intimacy,family adaptability and self-management.The proportion of intermediary effect in total effect was 12.68%,13.05% and 15.96% respectively.The influential others play a part of intermediary among hope,family intimacy,family adaptability and self-management.The proportion of intermediary effect in total effect was 12.42%,12.35% and 12.22% respectively.Conclusion The self-management level of patients with maintenance hemodialysis is in the middle level,and there are differences in the self-management level of patients with different education levels and payment methods of medical expenses.The hope level,locus of control,family intimacy and adaptability of patients have direct effects on their self-management behavior.The internal control of locus of control and the influential others have intermediary effects between hope and self-management behavior,family intimacy,family adaptability and self-management behavior,respectively.It shows that hope,family intimacy and family adaptability of maintenance hemodialysis patients can not only directly affect self-management behavior,but also indirectly affect self-management behavior through psychological control sources.In the clinical nursing work,nurses need to strengthen the internal control intervention of patients’ psychological control sources.Nurses need to improve the control tendency of health authorities to find various ways to improve patients’ self-management ability and improve patients’ quality of life. |
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