The Effect Of Self-management Education On Self-management Behavior In Patients With Maintenance Hemodialysis

Background : Maintenance hemodialysis (MHD) is an significant renal replacement therapy in the patients with end stage renal disease (ESRD).The lifestyle needs to change once start with hemodialysis,such as dietary adjustments,water and salt control,exercise,etc,which requires the maintenance of good self-management behavior in order to positively change lifestyle,maintain a satisfactory quality of life.With the creasing prevalence rates of end stage renal disease,the number of maintenance dialysis patients also continued to grow,Related studies show that more than 80% of the MHD patients still rely on dialysis treatment to survive in the world.The Chronic kidney disease (CKD),which bring the family and society the heavy economic burden.It is reported that self- management behavior and HRQOL is positive correlated in hemodialysis patients,improve self-management behavior help to improve its HRQOL in hemodialysis patients.Obviously the effectiveness of self-management behavior affects quality of life and survival rate in hemodialysis patients.However,the comprehensive intervention,domestic teaching of illness and the people , comprehensively intervention to promote the quality of life in hemodialysis patients are rarely reported.Nowhere is the common voice of numbers of hemodialysis patients and nurses, as well as an important research topic today.Objective: To study the self-management education on self-management behavior in hemodialysis patients,and to improve their health-related quality of life (HRQOL) by improving self-management behavior.Method:40 cases are choosed from the hemodialysis center,the First Hospital of Jilin University,in 2006 -2008,which random sampling method selection in hemodialysis patients.Hemodialysis patients in the experimental group received nursing intervention , however,control group patients received conventional hemodialysis health education,A questionnaire and short form 36 health survey (SF-36) are used.Two groups'self-management behaviors and HRQOL were tested before and 6 months after the intervention,self-management behaviors and HRQOL were compared using t-test.Result:1.The factors of age,gender,creatinine,blood urea nitrogen,potassium,sodium,hemoglobin,weight,albumin showed no significant difference (P> 0.05) in experimental group and control group,which was balanced with no significant difference,can interfere with research.2.Self-management behaviors and HRQOL showed no significant difference before intervention. 3.Six months after the intervention , the scores of the self-management behavior and HRQOL of hemodialysis patients who receiving self-management education improved(P<0.01, P<0.05 respectively),not only between the intervention group and the control group but before and six months later of the of the intervention group.Conclusion:1.During the inference,The self-management behavior of patients was low,which affect the patients'HRQOL.2.The self-management and HRQOL can be improved by self-management education in maintenance hemodialysis patients.3.Managers,patients,doctors and nurses,the family and society should make effort to improve the self-management behavior of patients,which is the best to maintain the HRQOL.