Effect Of Multidisciplinary Assisted Intervention On Volume Management Of Maintenance Hemodialysis Patients Based On 5E Rehabilitation Model

Objective:To understand the current capacity management status of maintenance hemodialysis patients,and to take multi-disciplinary collaborative intervention based on 5E rehabilitation mode for the hemodialysis patients with poor capacity management,to study the capacity management impact of 5E rehabilitation mode to maintenance hemodialysis patients.Methods:A randomized controlled experimental trial was used to select 108 patients with poor volume management of maintenance hemodialysis who were treated in two blood purification centers of Two Municipal Third Class Hospitals in Hefei from May 2019 to May 2020.There were 54 cases in each group.Patients in the control group were routinely treated according to blood purification.The intervention group adopted the multidisciplinary teamwork intervention based on 5E rehabilitation model on the basis of routine care,which includes five dimensions of "encourage""education""exercise""employment""evaluation".When the two groups’ of patients join into the groups,conducted on general information questionnaire,Questionnaire on self-management behavior of hemodialysis patients,Capacity Management Behavior Scale,Exercise self-efficacy scale to make an evaluation for general condition,self-management behavior of hemodialysis patients,capacity management behavior and exercise self-efficacy retrospectively collected the average weight growth rate,blood pressure and ultrafiltrationvolume of the patients in the week before enrollment as well as the incidence of dialysisrelated complications within one month.After 6 months of intervention,selfmanagement behavior,volume management behavior and exercise self-efficacy of the patients were evaluated again,and the average weight growth rate,premachine blood pressure and ultrafiltration volume of the patients with in one week after intervention and the incidence of dialysis-related complications within one month after intervention were monitored.The collected data were recorded by Epidata 3.1 and analyzed SPSS24.0 software.Results:The study lasted 6 months and 108 patients completed the intervention,Before the intervention,there was no statistical significance in sex,culture,marriage status,residence,primary diseases,the age of dialysis and so on between the two groups（P>0.05）as well as patient volume management behavior,exercise efficacy,blood pressure.After the intervention,the weight growth rate,ultrafiltration volume,mean blood pressure before hemodialysis and the incidence of dialysis-related complications were significantly depressed in the study group,and the self-management behavior,volume management behavior and exercise self-efficacy were significantly higher than those before intervention（P<0.05）.（1）Patient self-management behavior comparison:after intervention,the selfmanagement score of patients in the control group was 64.72±6.76,and the selfmanagement score of patients in the study group was 72.56±6.68.The difference between the two groups was statistically significant（t=6.055,P=0.000）.（2）Comparison of patient volume management behavior and effect:after intervention,the volume management behavior score was 17.43±2.32,An average score of 20.19±2.66,Differences were also statistically significant（t=5.749,P=0.000）.The mean blood pressure（135.96±16.26/77.30±8.94 mmHg）in the study group was significantly lower than that in the control group（142.15±15.82 mmHg/80.85±9.59 mmHg）,t=-2.003,P=0.048/t=-1.994,P=0.049).（2）Comparison of exercise self-efficacy among patients:the exercise selfefficacy score of the control group was 66.50±13.02,the exercise self-efficacy score of the study group was 77.24±13.30,the difference between the two groups has statistical significance（t=3.055,P=0.003）.（3）Patients with dialysis-related complications:28 cases of dialysis-related complications in the study group after intervention were significantly lower than 49 cases in the control group,the study group has a significant improvement than the control group,the difference between both groups has statistical significance.（X2=6.089,P=0.014）.Conclusion:According to the results of this study,multidisciplinary team intervention based on 5 E rehabilitation model can effectively improve the capacity management level and self-management level of maintenance hemodialys is patients,reduce the occurrence of dialysis-related complications and improve the dialysis quality of patients.