Study On Effect Of Family Nursing Intervention For Patients With Diabetic Nephropathy And Hemodialysis

Purposes:To investigate the dialysis and living quality of Diabetes-Nephropathy Hemodialysis Patients;To improve the living quality of Diabetes-Nephropathy Hemodialysis Patients and provide references for the nursing of the Diabetes- Nephropathy Hemodialysis Patients in communities.Methods:1.Investigation MethodsParticipants are specialized paramedics from blood-decontaminated center of the First, Second and Third Hospital of Jilin University. The approval of the patients and their families is obtained and the nurses must use unitive instructions to explain the content of the investigation. In addition, available questionnaires are those that patients can comprehend and answer the questions soberly and correctly. Totally, 86 cases are investigated, among which 4 cases are transferred in the process without finishing all the questions, so altogether 82 questionnaires are available. The effective rate is 95.35%.2.Design and Choice of QuestionnaireNormal Complexion Questionnaire, self-designed, includes sex, age, occupation, education, syndrome, fixed number of hemodialysis'year, fixed number of diabetes'year, source of fee-for-service and KDQOL-SF, which is a specialized quantum table used to evaluate the quality of dialysis and kidney patients'living. KDQOL-SF combines the item of living quality of normal health with that of kidney dialysis together and it is designed to evaluate the maintainability of dialysis patients'living quality. In KDQOL-SF, SF-36 includes the relevant content demanded by WHO. Furthermore, it includes KDTA of 12 fields to evaluate the changes on dialyzed patients'living qualities brought about by the treatment of kidney and dialysis. Thus, KDQOL-SF uses SF-36 to evaluate the living quality of patients'normal health and KDTA to evaluate the effects of kidney disease and dialysis on living quality of dialyzed patients. Combing these two, the effects of disease, suffering, economic burden, family support, social recognition and the help and encouragement of doctors and nurses cause by the kidney disease and dialysis, and the spiritual, emotional, physical, physiological and daily-life changes caused by them are taken into consideration. So, its results can fairly reflect the living quality of dialyzed patients reasonably and completely.Understanding of Disease Knowledge Questionnaire, self-designed, includes blood sugar, nursery of internal fistula, diet, exercise, syndrome, etc.3.Personnel training and pre-researchUnified training, standard, and recognition are used to the personnel being investigated in order to the acceptance and feasibility of the survey. Adjust and perfect the problem as soon as it occurs to make sure the reality and reliability of the survey.4.the arrangements of dialysis time and contents about the two groups of patientsThe dialysis time of the two groups are absolutely separated, when the control group is in the dialysis, they will be guided by the trained professionals on the daily life and care, and their variety of health problems will be answered also. When the experimental group is in the dialysis, there will be interventions on their home care provided by the trained professionals, and they will get a telephone follow-up every month.5.statistical methods We use the authorized evaluation software KDQOL-SFTM V1.3 to statistic the data, and the results will be expressed by the median±quartile interval (M±Q). Before and after the intervention group compared with the use of matching symbols rank sum test; intervention group and control group using two-sample rank sum test; count data were compared using X2 test; Level data were compared using CMH- X2 test.Test Results:1. By using the intervention family care, before and after the experimental group and control group there are no significant changes in the kidney, kidney disease burden, work status, sexual function, social support, physical fitness, physical aspects of the impact and pain (P>0.05). Yet there are significant changes on other aspects (P<0.05).2. The experiment group has the great improvement in hemoglobin, total protein, albumen (P<0.05). It has an effect on the decease of the ratio in creatinine and emiction (P<0.05). shrink pressure and diastole pressure are controlled better than pre-intervention (p<0.05). From this we can see, the effect of home care intervention was significantly.3. After the home care intervention, the experimental group is lower than comparison group in the ration of happens in dropsy, the heart failure, unbalance symptom, low blood sugar, low pressure (P<0.05).There is no difference of the infection of fistula and high pressure(p>0.05).4. There is a distinct difference between self-observation of the illness state and experiment group and comparison group of the take notice of the dosage safety medicine in the healthy behavior, such as, to ensure the rest and sleep , the participation in social activities.Conclusion: home care intervention Improved dialysis quality and quality of life of hemodialysis patients; it also improve the health of patients and their attitude towards the disease into the positive aspects; making full use of social and family support system to help patients to improve compliance in patients with the quality of medical and psychological at the same time acts to reduce the burden on the family and society. Therefore, hemodialysis patients with diabetic nephropathy the implementation of hospital, the hospital care outside the family intervention is effective and necessary.