| BackgroundKidney transplant makes more patients with end-stage renal diseases getting rid of Hemodialysis.Although high patient/renal survival rate after Kidney Transplants,we also faced some serious complications,such as infection,diabetes,hypertension,renal allograft dysfunction,urinary fistula and tumor of bladder,etc.The morbidity of diabetes after kidney transplantation(PTDM)was 4% to 25%,it mainly related with such factors as: hypertension,using immunosuppressive drugs,operation stress,pretransplantation blood glucose,corticosteroids,virus infection.The enforcement of the nursing interventions is an important method,which can ameliorate hyperglycosemia,and improve the life quality of renal transplant patients.International researches on this topic are in the primary stage,mostly in health education.The studies,which on the cognitive of PTDM and emotional status of renal transplant recipients were less.and on the impact of comprehensive nursing intervention on PTDM was also less.There was no accurate conclusion that nursing intervention could effectively reduce the morbidity of new-onset diabetes and depress the blood glucose level in patients with the renal transplantation ObjectiveThe randomized controlled trial method was used,we investigated the effect of comprehensive nursing intervention on blood glucose level after kidney transplantion.In addition,we explored whether the intervention can enhance successful rate of renal transplant operation,renal survival rate after Kidney Transplants,and further improve the nursing quality of PTDM patients.Methods1.Research subjects: Using convenient sampling method,we recruited 50 patients with diabetes after renal transplantation from November 2014 to September 2015 in The Seventh People's Hospital of Zhengzhou.With the random number table,we randomly assigned the research subjects into control group(n=25)or intervention group(n=25).2.Intervention methods: All patients received drug therapy of regulating blood glucose level and ameliorating microcirculation.Give routine nursing to patients of control group,the methods were individual health education untimely,including General Introduction,the knowledge of correlation examination and medication,the methods of self-nursing.And the form of intervention was explanation and demonstration face to face untimely.Besides the routine nursing,we give nursing intervention to patients of intervention group.The nursing intervention included health education,family support and relaxation training.And the form of intervention was having special health lectures,giving health education prescription and watching mission video.Each Saturday morning,we gave one intervention about 1 hour.The individual nursing intervention were given Randomly.3.The evaluation method: The blood glucose levels(fasting blood-glucose and 2-h plasma glucose)before operation and 1st day,1st week,2nd week,3rd month,sixth month after intervention of all patients were recorded.We recorded the Body Mass Index(BMI)and glycosylated hemoglobin of two groups before operation and after the intervention at the 3rd month,6th month.We assessed patients with SDS and SAS scores at the 1st week,3rd month,sixth month after tranpalntion,and evaluated the degree of mastering PTDM knowledge of each patient at the sixth month after tranpalntion,frequencies and days of hospitalization of pulmonary infection were collected at the end of the follow-up.The SPSS17.0 statistical software was employed to analyze the data.Results1.The conditions of BMI?FBG and HbA1 c in two groups before operation: When compare with the control group,the intervention group had no significant difference in the conditions of FBG,BMI and HbA1 c before operation P>0.05.2.The condition of FBG with different postoperative time in two group patients: The FBG of intervention group had no significant difference compared with the control group P>0.05.at the first day and first week after operation.While the FBG of intervention group had significant difference compared with the control group P<0.05 at the second week,the third month and the sixth month post operation.3.The condition of 2HPG with different post-operative time in two group patients: The 2HPG of intervention group had no significant difference compared with the control group at the first day and the first week after operation.While the FBG of intervention group had significant difference compared with the control group P<0.05 at the second week,the third month and the sixth month after operation.4.The conditions of BMI and HbA1 c before operation,at the third month and the sixth month after operation in the two groups: The BMI and HbA1 c of the intervention group had no significant difference compared with the control group P>0.05 at the third month post operation.While the BMI and HbA1 c of the intervention group had significant difference compared with the control group P<0.05 at the sixth month post operation.5.The conditions of the knowledge about PTDM in the two groups: The intervention group patients had better understanding about the risk factors,basic knowledge,and damage control of PTDM compared with the control group at the sixth month after operation,P<0.05.6.The conditions of SAS and SDS in the two groups: The SAS and SDS of the intervention group had no significant difference when compared with the control group P>0.05 at the first week post operation.While the SAS and SDS of the intervention group had significant difference when compared with the control group P<0.05 at the third month,sixth month post operation.7.The conditions of pulmonary infection in the two groups: The incidence of pulmonary infection in intervention group had significant difference when compared with the control group(P<0.05).Average hospitalization days after pulmonary infection in the intervention group had significant difference when compared with the control group(P<0.05).ConclusionsUsing the nursing intervention of health education,family support and relaxation training,patients can have a better understanding of PTDM knowledge,lessnegative emotion,and more stable blood glucose levels,and reduce the incidence of complications after kidney transplantation,.increase the patient/renal survival rate. |
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