| Objectives 1.To develop a low phosphorus diet health belief scale for hemodialysis patients with hyperphosphatemia,and to test the reliability and validity of the scale.2.Evaluation of low phosphorus diet behavior and health beliefs in hemodialysis patients with hyperphosphatemia,To understand the influencing factors,and to provide theoretical basis for the development of nursing interventions.3.To explore the relationship between the health belief model and the multi stage change theory in the diet management of patients with hyperphosphatemia.Methods Based on the theory of health belief model,the initial scale was determined by consulting relevant reference documents,expert consultation and semi-structured interview.From the blood purification Department of the First Affiliated Hospital of Guangxi Medical University 175 patients met the inclusion criteria were conducted a questionnaire survey as the research object,using item analysis,correlation coefficient analysis,exploratory factor analysis to select the item,the formal scale and further validity inspection.Methods 110 patients with hyperphosphatemia were selected as the research object in the blood purification center of the First Affiliated Hospital of Guangxi Medical University.The patients were randomly assigned to the control group(n = 55)and the intervention group(n = 55).Using general data questionnaire,hyperphosphatemia diet and medication knowledge and behavior questionnaire,low phosphorus diet health belief scale,low phosphorus diet behavior stage assessment,social support scale.The control group received routine nursing care of blood purification center.The intervention group received intervention model of health belief model and multi phase change by combining the theory of intervention in twelfth weeks and twenty-fourth weeks again survey of health belief scale,low phosphorus diet behavior evaluation and serum phosphorus,calcium,calcium phosphorus product,serum albumin,albumin and other biochemical indicators.Results 1.The maintenance hemodialysis patients with hyperphosphatemia and low phosphorus diet health belief scale includes 33 items and 5 dimensions,respectively,perceived disease susceptibility,perceived disease severity,perceived benefits,perceived self-efficacy,behavior disorder.The KMO of the exploratory factor analysis was 0.864,P,<0.05,and the cumulative contribution rate of the variance of the 7 factors was 71.736%,and the corresponding factor load was 0.559 to 0.912.The scale and the Cronbach Cronbach,s alpha is 0.778~ 0.938,the split half reliability is 0.710 ~ 0.935,the test-retest reliability was0.754 ~ 0.921.2.Current status of low phosphorus diet in MHD patients with hyperphosphatemia.The investigation of the 110 patients,13 cases(11.8%)in the stage of unconscious patients;17 cases(15.5%)of the patients in the conscious stage;47 cases(42.7%)of the patients in the preparation stage;24cases(21.8%)of the patients in the stage of action;9 cases(8.2%)of the patients in the maintenance stage;3.Relationship between health belief and social support of low phosphorus diet in patients with MHD hyperphosphatemia.4.After 12 and 24 weeks,There was a significant difference between the scores of knowledge of two groups of patients with hyperphosphatemia and behavior(P< 0.05),intervention group related knowledge and behavior scores higher than the control group,there is interaction between group and time was statistically significant differences at different time points;5.After 12 and 24 weeks,The two groups have statistical significance in patients with serum phosphorus,calcium and phosphorus product index difference(P <0.05),intervention group,serum phosphorus,calcium and phosphorus product index is lower than the control group,there is interaction between group and time was statistically significant differences at different time points after the intervention,the difference between the two groups of serum calcium and albumin index statistical significance;6.After 12 and 24 weeks,Two groups of patients with health belief scores,perceived barriers,low phosphorus diet and low phosphorus diet self-efficacy score difference was statistically significant(P < 0.05),there is interaction between group and time(P < 0.05),further analysis of single effect,at a fixed point in time,there was statistical significance different groups of patients with the score differences(P < 0.05).After the intervention,the two groups had no statistical significance with perceived susceptibility,severity of the difference(P > 0.05);two patients were aware of the benefits of low phosphorus diet score has time effect and group by time interaction,conditions at a fixed time,scores of different groups no significant difference(P > 0.05).Conclusions 1.The MHD low phosphorus diet health belief scale language is easy to understand and easy to accept,the scale has good reliability and validity,and is suitable for clinical research and application.2.The current situation of low phosphorus diet behavior of MHD patients with hyperphosphatemia is not ideal,the level of health belief needs to be further improved,and the relationship between the health beliefs of patients with maintenance hemodialysis and the behavior of low phosphorus diet.3.The relationship between health belief and social support of maintenance hemodialysis patients with hyperphosphatemia,Strengthening the social and family support system is an important step to improve the level of low phosphorus health belief in MHD patients with hyperphosphatemia.4.Using the health belief model and the multiple phase change theory of combining the intervention mode of maintenance hemodialysis patients with hyperphosphatemia diet management,can reduce the patients' serum phosphorus and the calcium-phosphorus product;5.Using the health belief model and the multiple phase change theory of combining the intervention model intervention in patients with maintenance hemodialysis hyperphosphatemia,can improve the level of patients with hyperphosphatemia knowledge level and health beliefs. |
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