The Study Of Development And Application On Specialized Nurse-led Individualized Home Visit For Patients With Peritoneal Dialysis

Objectives1.To describe the home-based supportive care needs of peritoneal dialysis patients;2.To construct a home visits program for peritoneal dialysis patients;3.To confirm the effectiveness of the home visits program.Method1.Firstly,a qualitative study was employed to understand the overview of the home-based supportive care needs of peritoneal dialysis patients;2.The application of literature review and expert meeting method in the construction of a home visits program for peritoneal dialysis patients:?1?To consult and analyze the guidelines related to peritoneal dialysis and to draw up a home visits program for peritoneal dialysis patients.?2?Convened an expert meeting to discuss the basic content of home visits program for peritoneal dialysis patients,combined with experts'opinion to collate and revise,the official text of the home visits program for peritoneal dialysis patients.3.Finally,a randomized controlled trial was conducted to verify the effectiveness of the home visits program.Result1.The result of the qualitative studyThrough analyzing the interview data of 11 peritoneal dialysis patients,this study extracted 5 theme:poor control of disease symptoms;lack of information and knowledge;poor behavior compliance;serious negative psychological emotion;poor social support.2.The construction and development of the home visits programBased on evidence-based medicine as guidance,combined with clinical experience and expert opinion,we developed the home visits program for peritoneal dialysis patients.3.The effectiveness evaluation of the home visits programThe full data collection was completed from totally 61patients,including the intervention group?n=30?and the control group?n=31?.The results showed that no significant differences were observed between the two groups for the baseline measures?P>0.05?.Statistically significant effects were found in KDQOL-36^TM,Self-management Scale,Self-Rating Anxiety Scale and Self-Rating Depression Scale between the two groups?P<0.05?.The SGA,MAC,TSF,Alb,Hb,DEI and DPI in study group were significantly higher than those in the control group?P<0.05?.However,there was no significant difference in BMI?P>0.05?.The Blood pressure in the study group were lower than those in the control group?p<0.05?,but there was no significant difference in urine volume and ultrafiltration volume?p>0.05?.Conclusion1.It is necessary to construct a home visits program for peritoneal dialysis patients.2.The home visits program not only significantly improved patients'quality of life and ability of self-management and alleviated the anxiety and depression,but also improved nutrition and prevented capacity overload.The program can be effectively popularized to the management of the peritoneal dialysis patients in the community health service center.