Effects Of Follow-Up Intervention On Adherence And Dialysis In Rural-Home-Care Patients With Peritoneal Dialysis

ObjectiveTo explore the effect of follow-up intervention on dietary, medication adherence and dialysis adequacy in rural-home-care patients with peritoneal dialysis(PD).Methods1. The study was an experimental study. 106 patients were selected from November 2014 to June 2015 in the first affiliated hospital of Zhengzhou university.The patients were divided by draw method into control group with 53 cases and intervention group with 53 cases. Patients from the control group were given conventional health education in Renal Medicine, the intervention group were given follow-up intervention after discharge. Firstly, the researchers set up a authoritative follow-up team. Secondly, the researchers told patients in the study group about the purpose, significance, methods, and invited them to join in this study before the patients discharged from hospital. Meanwhile, the researchers collected patients' information, such as, telephone and QQ number, We-Chat ID, to establish health files for them. Then, according to the peritoneal dialysis standard operating procedures,combined with the patients' condition and dialysis prescription, the researchers workout a handbook for them. When they discharge from hospital, the researchers use telephone, short messages, QQ group, We-Chat group, and outpatient interventions for the study patients with 6 months of follow-up and guidance.2. Data were collected through Renal Adherence Attitudes Questionnaire(RAAQ), Renal Adherence Behavior Questionnaire(RABQ), Morisky-Green questionnaire, Peritoneal dialysis intelligent evaluation method and biochemical test at the time of discharged date and one month, three months, six months after discharge.3. Statistical analysis was performed using Spss 21.0 software package. Graph was made by GraphPad Prism 5.3 software. Statistical analysis methods include descriptive statistics, T test, analysis of variance of repeated measurement and nonparametric test, etc.Result1. In the survey, the valid sample finally contained 103 patients, 51 patients in intervention group, 52 cases in the control group. There was no significant difference between the two group in general information, the score of drug compliance and dietary adherence(P>0.05).2. The results indicated that the intervention group had shown a better recovery in medication adherence, dietary adherence attitudes and dietary adherence behavior than the control group(P<0.05). There are statistical differences in medication and dietary compliance scores between two groups at one months, three months, six months after discharge from hospital(P<0.05).3. The results indicated that the intervention group had shown a better recovery of well-being, self-care and acceptance(P<0.05), the social restrictions had shown a downward trend(P<0.05), statistical differences in social restrictions well-being,self-care and acceptance scores were identified between the intervention group and control group after discharge at one months, three months, six months(P<0.05).4. The results indicated that the intervention group had shown a better recovery of adherence to fluid restrictions, adherence regarding potassium and phosphaterestrictions, adherence regarding self-care, adherence regarding sodium intake, and adherence in times of particular difficulty than the control group(P<0.05), there are statistical differences in five dimensions between the intervention group and control group at one months, three months, six months respectively(P<0.05).5. The results indicated that there was statistic significance of peritoneal dialysis between the intervention group and control group at one months and six months respectively(P<0.05).6. The results indicated that the intervention group had shown a better recovery of prealbumin and blood urea nitrogen than the control group at one months and six months respectively(P<0.05), there was statistic significance of hemoglobin, albumin,prealbumin, calcium, phosphorus, intact parathyroid hormone, and blood urea nitrogen between the intervention group and control group at one months and six months respectively(P<0.05).ConclusionFollow-up intervention is a safe and effective intervention style. It can improve the compliance of the rural-home-care peritoneal dialysis patients and effect of dialysis. We can promote this intervention style.