| Objective(1) Evaluate the effect of the implementation of QCC activities to reduce the incidence of peritoneal dialysis peritonitis in peritoneal dialysis patients in rural areas.(2) Evaluate the effect of the implementation of QCC activities to reduce peritoneal dialysis catheter migration rates in peritoneal dialysis patients in rural areas.(3) Evaluate the effect of the implementation of QCC activities to shorten the average length of hospitalized time in peritoneal dialysis patients in rural areas.(4) Evaluate the effect of the implementation of QCC activities to improve the population awareness rate about health knowledge in peritoneal dialysis patients in rural areas.(5) Evaluate the effect of the implementation of QCC activities to improve satisfaction of peritoneal dialysis patients in rural areas.Methods(1) Design. According to the new document checked at home and abroad and the statistics in2012cases of peritoneal dialysis patients form the operation evaluation form, follow-up table peritoneal dialysis, peritoneal dialysis follow-up cases, we made QCC activities flowchart of peritoneal dialysis patients in rural areas to implement QCC activities.(2) Sample sources. Random sampling method, the experimental group and the control group for the study extracted50cases respectively.(3) The experimental intervention. Selected50rural peritoneal dialysis patients treated in our department from January,2012to December,2012who discharged from hospital as a control group (before the event). There were29males and21females, from26to76years old, mean (41.68±19.94)years of age; primary disease:10cases of obstructive nephropathy,13cases of chronic glomerulonephritis,15cases of hypertension, and12cases of diabetes. Selected50rural peritoneal dialysis patients treated in our department from January,2013to December,2013who discharged from hospital as a experimental group (after the event). There were28males and22females, from22to71years old, mean (41.28±20.25) years of age; primary disease:12cases of obstructive nephropathy,10cases of chronic glomerulonephritis,14cases of hypertension, and14cases of diabetes. All patients were implemented routine care, while the experimental group had QCC activities carried out on this basis. The time for QCC activities is6months, including1st month(selecting topics and laying plans),2nd month(grasping the current situation),3rd month(goal setting, analyzing, drawing up and formulating strategies),4th month(implementing measures),5th month(the recognition of effect and standardization),6th month(reviewing and improving the results published). No intervention in control group.(4) The effect measurement. The effect of the measurement. Self questionnaire used in this study include five parts:peritoneal dialysis patients medical history form, peritoneal dialysis fluid exchange operations evaluation form, peritoneal dialysis patients follow-up table, peritoneal dialysis patients awareness questionnaire, patients satisfaction surveys, effect measurement of rural peritoneal dialysis patients. After the implementation of QCC countermeasures, we collect peritonitis incidence in the experimental group and the control group, the catheter tube floating rates, average length of stay, awareness, patient satisfaction and other indicators of health knowledge to evaluate the effect.(5) Statistical analysis. All data were processed with SPSS17.0statistical software, describe the measurement data using mean±standard deviation, describing count data rate of adoption or proportions. Measurement data between the two groups were compared using two-sample, χ2test was used to compare the count data of the two groups of t test. Two-sided test was adopted, P<0.05was considered statistically significant.Results(1) A total of100cases were studied, the test and control group include50cases respectively, the basic characteristics of the two groups include social features and primary diseases, in which the experimental group include28males, accounting for56.0%,22females, accounting for44.0%; the control group include29males, accounting for58%,21females, accounting for44%;the average age of the experimental group was41.28±20.25years old, the average age of the control group was41.68±19.94years old. Differences in gender, age and culture between the two groups were not statistically different (P>0.05). Primary diseases include chronic nephritis, obstructive nephropathy, hypertension, diabetes, the prevalence of the four diseases in test groups were20.0%,24.0%,28.0%,28.0%respectively, in the control group are26.0%20.0%,30.0%,24.0%respectively. The prevalence of the four diseases in two groups were not statistically different (P>0.05). Experimental group include12cases whose dialysis age<18months,accounting for24.0%)15cases between18-36months, accounting for30.0%,11cases between36-72months, accounting for22.0%,12cases>72months, accounting for24.0%; Control group include11cases whose dialysis age <18months, accounting for22.0%,16cases between18-36months, accounting for32.0%,12cases between36-72months, accounting for24.0%,11cases>72months, accounting for22.0%; two dialysis age distribution showed no significant difference (P>0.05).(2) After the completion of the intervention observation, the experimental group peritonitis incidence was8.0%, lower than the28.0%of the control group. The difference was statistically significant (χ2=6.775, P=0.009), indicating decreased incidence of peritonitis in test group.1、After the completion of the intervention observation, the experimental group peritoneal dialysis catheter migration rates was6.0%, lower than the22.0%of the control group. The difference was statistically significant (χ2=5.316, P=0.021), indicating decreased incidence of peritoneal dialysis catheter migration rates in test group.2、The average length of hospitalized time of the experimental group was11.64±2.01days, shorter than the14.68±2.83of the control group. The difference was statistically significant (t=-6.193, P<0.001), indicating shortened average length of hospitalized time in test group.3、The population awareness rate about health knowledge in the experimental group was90%, higher than the64%of the control group. The difference was statistically significant (t=-6.193, P<0.001), indicating increased population awareness rate about health knowledge in test group.4、The satisfaction of peritoneal dialysis patients in the experimental group was96.0%, higher than the82%of the control group. The difference was statistically significant (χ2=5.005,P=0.025), indicating increased satisfaction of peritoneal dialysis patients in test group.ConclusionCompared with usual care, QCC is more suitably used in self-management of peritoneal dialysis patients in rural areas.(1) The implementation of QCC activities reduces the incidence of peritoneal dialysis peritonitis in peritoneal dialysis patients in rural areas.(2) The implementation of QCC activities reduces peritoneal dialysis catheter migration rates in peritoneal dialysis patients in rural areas.(3) The implementation of QCC activities shortens the average length of hospitalized time in peritoneal dialysis patients in rural areas.(4) The implementation of QCC activities improves the population awareness rate about health knowledge in peritoneal dialysis patients in rural areas.(5) The implementation of QCC activities improves satisfaction of peritoneal dialysis patients in rural areas. |
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