| ObjectiveTo explore the effects of solution-focused approach on psychological state and quality of life of young and middle-aged patients with peritoneal dialysis,and to help them adopt positive coping styles so as to improve the quality of life of young and middle-aged patients with peritoneal dialysis.MethodsA total of 128 young and middle-aged peritoneal dialysis patients who were hospitalized in the renal department of a Grade A hospital in Nanjing from March 2022 to September 2022 and regularly followed up in the peritoneal dialysis outpatient department were selected as the study objects.The subjects were divided into control group and experimental group by random number method,with 64 cases in each group.The control group received the routine care of peritoneal dialysis patients,and the experimental group received the focus solution mode nursing intervention on the basis of the control group,once a week,20 to 30 minutes each time,for 5 weeks,follow-up for 3 months.Kidney Disease and Dialysis-related Quality of Life Scale(KDTA),Hospital Anxiety and Depression Scale(HADS)and biochemical indexes were compared in young and middle-aged peritoneal dialysis patients before,after and 3 months after intervention,respectively.Results1.Before intervention,there was no significant difference in hospital anxiety and depression scores between the two groups(P>0.05).After intervention and 3 months after intervention,the scores of anxiety subscale and depression subscale in experimental group were significantly lower than those in control group,the difference was statistically significant(P<0.05).Repeated measurement variance results showed that the time effect,intergroup effect and interaction effect of anxiety subscale and depression subscale scores in the two groups were statistically significant(P<0.05).2.There was no statistical significance in the biochemical indexes of hemoglobin,albumin,prealbumin,blood calcium,blood phosphorus,blood creatinine and urea clearance index between the two groups before intervention(P>0.05).After intervention,there were statistically significant differences in hemoglobin,albumin,creatinine and urea clearance index between the two groups(P<0.05),and the hemoglobin,albumin and urea clearance index of the experimental group was higher than that of the control group,while the creatinine was lower than that of the control group.3 months after intervention,there were statistically significant differences in hemoglobin,albumin,prealbumin,blood phosphorus,blood creatinine and urea clearance index between 2 groups(P<0.05).The results of repeated measurement analysis showed that only considering the time factor,the difference of hemoglobin,albumin,blood calcium,blood phosphorus,blood creatinine and urea clearance index at different time points was statistically significant between the two groups(P<0.05).Only considering the intervention factors,after two different methods of intervention,the two groups of patients in hemoglobin,albumin,blood calcium,blood phosphorus,blood creatinine,urea clearance index,the difference was statistically significant(P<0.05);There was an intergroup and time interaction between hemoglobin,albumin,prealbumin,blood calcium,blood phosphorus,blood creatinine and urea clearance index in 2 groups(P<0.05).3.Before intervention,there was no statistical significance in KDAT scores between the two groups(P>0.05).After intervention,there were statistically significant differences between the two groups in eight dimensions of total KDTA score,disease impact,symptoms and discomfort,cognitive function,social quality,sex life,family support and patient satisfaction(P<0.05),and there were more significant differences in three dimensions of cognitive function,social quality and patient satisfaction(P<0.001).At 3 months after intervention,there were statistically significant differences in 11 dimensions of KDTA score between the two groups(P<0.05),and there were more significant differences in 5 dimensions of total KDTA score,disease burden,cognitive function,social quality and patient satisfaction(P<0.001).The results of repeated measurement analysis showed that only considering the time factor,there were statistically significant differences between the two groups at different time points in the total KDTA score,disease burden,disease impact,symptoms and discomfort,cognitive function,social quality,sleep condition,family support,medical encouragement and patient satisfaction(P<0.05).Considering intervention factors only,after intervention by two different methods,there were statistically significant differences between the two groups in nine dimensions of total KDTA score,disease burden,symptoms and discomfort,cognitive function,social quality,sexual function,family support,medical encouragement and patient satisfaction(P<0.05).In the two groups,eight dimensions of total KDTA score,disease burden,disease impact,symptoms and discomfort,cognitive function,social quality,encouragement of care,and patient satisfaction changed over time There was interaction effect(P<0.05).Conclusion1.Anxiety,depression and other negative emotions are common in young and middle-aged peritoneal dialysis patients,and their quality of life is significantly decreased,so effective clinical nursing intervention measures are urgently needed.2.Compared with conventional psychological nursing measures,focus solving model can excavate the self-potential of young and middle-aged peritoneal dialysis patients can give full play to subjective initiative,effectively relieve anxiety and depression,improve the biochemical indicators of peritoneal dialysis patients,So as to improve its quality of life,it is worth popularizing and applying. |
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