| PurposeTo construct a self-disclosure intervention program for young and middle-aged maintenance hemodialysis patients based on the cultural background and clinical situation in China,and to explore the effects of the program on the sense of disease benefit and disease coping mades of the young and middle-aged maintenance hemodialysis patients.Method1.Construction of the intervention programWe searched the literature on disease benefit perception,coping mades and self-disclosure as an intervention for maintenance hemodialysis patients in Chinese and English databases,analyzed the contents,and structured interviews were conducted with patients,combined with cognitive processing theory and emotion regulation theory,and constructed the first draft of the self-disclosure intervention program for young and middle-aged maintenance hemodialysis patients,and formed the final draft of the intervention program after expert consultation and pre-experimentation.2.Intervention program implementationAccording to the nadir criteria,80 cases of middle-aged and young maintenance hemodialysis patients treated in Zhongshan Hemodialysis Center from March 2022 to August2022 were selected and divided into intervention and control groups using the random number table method,with 40 cases in each group.Patients in the control group implemented routine care in the hemodialysis clinic;the intervention group received self-disclosure intervention in a face-to-face manner on this basis.The intervention was divided into 6 themes: emotional disclosure,analysis of distress,resolution of distress,perception of support,perception of positive change,and prospecting for the future,and was conducted once a week for 30-60 min each time in the form of one-on-one verbal disclosure.General information was collected before the start of the intervention,and the Chinese version of the Distress Disclosure Index(DDI),the Chinese version of the Benefit Finding Scale(BFS)and the Medical Coping Modes Questionnaire(MCMQ)were used before the first intervention and immediately after the sixth intervention.The data were collected using the Chinese version of the Distress Disclosure Index(DDI),the Chinese version of the Benefit Finding Scale(BFS)and the Medical Coping Modes Questionnaire(MCMQ),and statistically analyzed using SPSS 26.0 software to assess the effects of the self-reporting intervention.The count data of the two groups of young and middle-aged MHD patients were described as frequencies and percentages and compared using chi-square test;the measurement data were expressed as mean ± standard deviation;the scores of DDI,BFS and MCMQ of the two groups were compared before and after the intervention,and the scale scores of the two groups were compared within groups using paired-samples t-test or Wilcoxon signed-rank test;independent-samples t-test or Mann-Whitney U rank sum test was used for between-group comparisons.The test criterion was q=0.05,and P<0.05 indicated that the difference was statistically significant.Results1.Comparison of general information of patientsIn the general information of patients in both groups,the mean age of the intervention group was(42.75±9.95)years and the mean age of the control group was(43.11±10.20)years.There was no statistical difference between the two groups in terms of socio-demographic data and kidney disease-related data(P>0.05),and they were comparable.2.Comparison of self-disclosure scores:Before the intervention,patients in the intervention group had a score of(38.97±4.13)and the control group had a score of(37.81±4.75),with no statistically significant difference between the groups(t=1.113,P=0.269),which was comparable;after the intervention,the self-expression level of the intervention group increased significantly(46.53±3.81)and was higher than that of the control group(38.32±5.15),and the difference was statistically significant(t=7.719,P<0.001).3.Comparison of perceived disease benefit scoresBefore the implementation of the self-reporting intervention,the perceived disease benefit score was(42.83±9.63)in the intervention group and(40.38±5.13)in the control group,with no statistically significant difference(t=1.364,P=0.177);after the intervention,the perceived disease benefit score was significantly higher in the intervention group(52.86±8.09)than in the control group(40.47±4.71),with a statistically significant difference statistically significant(t=7.853,P<0.001).4.Comparison of disease coping mades scores(1)Confrontation dimension: Before the intervention,patients in the intervention group received a score of(17.47±2.10)on the confrontation dimension compared with(17.19±2.17)in the control group,with no statistically significant difference between the groups(t=0.565,P=0.574);after the intervention,the score of the intervention group was higher(23.33±2.33)than that of the control group(17.38±2.10),with a statistically significant difference(t=0.565,P=0.574),with a statistically significant difference(t=11.478,P<0.001);the difference was statistically significant in the intervention group before and after the intervention(t=-12.562,P<0.001);the difference was not statistically significant in the control group before and after the intervention(t=-1.744,P=0.09).(2)Avoidance dimension: before intervention began,the score on the avoidance dimension was(16.58±1.73)in the intervention group and(16.95±1.03)in the control group,with no statistically significant difference between the groups(t=-1.093,P=0.278);after the intervention,the score on the avoidance dimension was lower in the intervention group(15.47±1.73)than in the control group(17.19±1.51 score),with a statistically significant difference(t=-4.523,P<0.001);the difference between the intervention group before and after the intervention was statistically significant(t=2.943,P<0.001);the difference between the control group before and after the intervention was not statistically significant(t=-1.158,P=0.255).(3)Submission dimension: before intervention,the submission dimension score was(9.47±1.92)in the intervention group and(10.08±1.64)in the control group,with no statistically significant difference(t=-1.459,P=0.149);after the intervention,the score in the intervention group(7.03±1.18)was significantly lower than that in the control group(9.97±1.38),with a statistically significant difference(t=9.761,P<0.001);the difference between the intervention group before and after the intervention was statistically significant(t=8.240,P<0.001);the difference between the control group before and after the intervention was not statistically significant(t=0.598,P=0.554).ConclusionIn this study,a self-disclosure intervention program for young and middle-aged maintenance hemodialysis patients was constructed and applied to this patient group.By guiding the patients to actively express their experiences and thoughts related to their illness,the patients perceived positive changes in themselves and generated positive emotions,which effectively improved the sense of illness benefit and positive coping level of young and middle-aged maintenance hemodialysis patients,and verified the feasibility and effectiveness of this intervention The intervention was proven to be feasible and effective,and can be further promoted in clinical practice. |
PDF Full Text Request