Study On Fluid Intake Behavior Of Hemodialysis Patients Based On Transtheoretical Model Of Behavior Change And Health Belief Model

Objectives1.To study the status and influencing factors of fluid intake behavior in hemodialysis patients.2.To describe the current state of health beliefs about fluid intake behavior among hemodialysis patients(including barriers and benefits of fluid intake adherence,seriousness and susceptibility to consequences of fluid intake nonadherence,self-efficacy of fluid adherence).3.To disclose the differences in health beliefs of hemodialysis patients at different stages of fluid intake behavior based on the transtheorectial model of behavior change(precontemplation stage,contemplation stage,preparation stage,action Stage,maintenance stage),so as to provide theoretical basis for improving fluid intake adherence of hemodialysis patients and designing interventions to reduce fluid intake.MethodsThis was a cross-sectional descriptive design study.A total of 205 hemodialysis patients who met the inclusion and exclusion criteria and signed informed consent in the Blood Purification Center of a Class A tertiary comprehensive hospital in Jinan were enrolled in this study by convenience sampling.The demographic data and basic disease characteristics data of the subjects were collected using a general information questionnaire;the status of health beliefs about fluid intake behavior of the subjects was investigated using the Health Belief Model Variables;and the stage of fluid intake behavior was assessed by transtheoretical model of behavior change in combination with an the calculation of mean interdialytic weight gain.SPSS 19.0 statistical software was used to enter and analyze the above data.Results1.Among the 205 hemodialysis patients,21(10.2%)patients were at the precontemplation stage,42(20.5%)patients were at the contemplation stage,43(21.0%)patients were at the preparation stage,73(35.6%)patients were at the action stage,and 26(12.7%)patients were at the maintenance stage.2.Among the patients in different stages,significant differences were observed in marital status,degree of education,economic level,duration of dialysis(P<0.05),and interdialytic weight gain(P<0.01).3.Ranking from high to low,the scores of perceived health belief of fluid intake behavior of hemodialysis patients were 3.93 ± 0.90(perceived benefits),3.68 ± 0.92(perceived seriousness),3.12±1.21(perceived self-efficacy),2.85±1.01(perceived barriers),2.74±0.82(perceived susceptibility).4.There were significant differences in the health belief of hemodialysis patients at different stages of fluid intake behavior(P<0.001).Converted into T scores of each stage,the scores of perceived benefits were 39.79±14.32,47.32± 9.93,49.98±8.62,52.21± 7.56,56.53±6.41 respectively;the scores of self-efficacy were 39.04± 6.91,40.10± 5.36,45.89 ± 7.41,57.20 ± 4.57,60.84 ± 3.55;both showed gradual increase with the development of the stages.The scores of perceived barriers(41.51±6.94,53.46± 8.34,56.61 ± 9.08,50.11 ± 8.48,39.62 ± 7.16),seriousness(35.47 ± 9.73,50.72 ± 8.28,53.98 ± 7.82,52.45 ± 8.53,47.07 ± 9.10),susceptibility(43.39 ± 9.73,50.57± 8.99,54.43 ± 10.69,54.43 ± 10.69,51.12 ± 9.14,43.75 ± 7.15)increased in the initial stage.However,with the progress of stage,there were substantial changes in behavior,the scores began to decrease when behavior entered the action stage and continued to decrease when behavior entered the maintenance stage,the scores of perceived barriers and susceptibility in the maintenance stage were similar to those in the precontemplation stage and there was no statistical difference.Conclusions1.The fluid intake behavior of hemodialysis patients is at the action stage;the number of patients in the two extremes of the Transtheoretical model for behavior change(precontemplation stage and maintenance stage)is small.The factors influencing the fluid intake behavior of hemodialysis patients included marital status,degree of education,economic level and interdialytic weight gain.2.Hemodialysis patients have a strong perception of the benefits of fluid intake adherence,but a weak perception of the consequences of fluid intake nonadherence.Therefore,nursing staff should pay attention to improve the patients' susceptibility to the consequences of nonadherence with fluid intake,which can not only arouse the willingness of patients to change behavior,but also keep the vigilance of adherance maintenance?3.When designing intervention schemes to improve fluid intake adherence in hemodialysis patients,it is very important to distinguish different stages of fluid intake behavior and develop targeted interventions according to the health beliefs of hemodialysis patients at different stages,which can help nursing workers take individualized nursing measures.