| BackgroundIn recent years,end-stage renal disease(end-stage renal disease,ESRD)morbidity and hospitalization rates all around the world is increasing,serious threat to human health and life.Epidemiological survey shows doubles every 10 years in the number of patients with ESRD.As living standards improve and change in lifestyle,diabetes prevalence worldwide is gradually on the rise,diabetic patients complicated with renal damage,become a worldwide one of the most important causes of ESRD,the proportion of ESRD in the world of 20%-40%.Kidney disease database of the United States in 2012,the report points out that,in addition to ESRD patients with diabetic nephropathy(diabetic nephropathy,DN)top.In China,the DN has become the second cause of ESRD,about25%,the ratio tended to increase.At present,treatment mainly depends on renal replacement therapy(RRT)for end-stage renal disease(ESRD),including peritoneal dialysis(PD),hemodialysis(HD)and kidney transplantation in three ways.Peritoneal dialysis as a continuity of treatment,closer to a normal physiological process,making it easier for patients return to their families and society,and help improve the quality of life of patients,in line with the current medical model of development.In patients with diabetic nephropathy due to its own vessel conditions,easy bleeding,vascular access for hemodialysis is difficult,and short service life,blood flow is not sufficient reason,inappropriate choice of hemodialysis treatment.Peritoneal dialysis is no need vascular access,so the PD is the preferred mode of renal replacement therapy in patients with diabetic nephropathy.Although is preferred in patients with diabetic nephropathy undergoing peritoneal dialysis in renal replacement therapy,and peritoneal dialysis technology has improved inrecent years,but crowds in the proportion of patients with diabetic nephropathy undergoing peritoneal dialysis is not high.Yu Yu sheng 2011 survey shows DN per cent of total number of peritoneal dialysis in patients with 11.8%,associated with the characteristics of diabetic nephropathy uremia,apart from its own complications of uremia,a itself as an independent risk factor in diabetic patients,its complications in peritoneal dialysis,poor quality of life,to quit and a high mortality rate,therefore make it difficult for replacement therapy for peritoneal dialysis in patients with DN.Several studies have shown that diabetic nephropathy is a chronic lifelong disease,peritoneal dialysis is a means of home treatment,self-management in patients with low capacity will directly affect the outcomes and quality of life,and effective self management helps to improve the treatment,reduce medical costs and improve quality of life.Self-management in patients with diabetic nephropathy undergoing peritoneal dialysis plays an extremely important role.ObjectiveInvestigation of diabetic nephropathy in patients with PD and self-management ability to analyze factors of diabetic nephropathy in patients with PD self management,identifying weaknesses in patient self-management and influencing factors for health guidance focused on diabetic nephropathy in patients with PD provide clinical evidence.Result(1)Present situation of self-management in patients with diabetic nephropathy undergoing peritoneal dialysis at home1)Home peritoneal dialysis patient self-management of the question naire containing four dimensions of 35 items: peritoneal dialysis fundamentals dimensions(10 entries),peritoneal dialysis dimensions(11 entries),behavioral and cognitive dimensions of peritoneal dialysis(7 entries)and peritoneal dialysis compliance dimensions(7 entries).2)Present situation of self-management in patients with diabetic nephropathy undergoing peritoneal dialysis at home self-management in patients with diabetic nephropathy undergoing peritoneal dialysis at home overall average score(124.36 ?9.496),with a total 175 points;according to each dimension item average score ranked from high to low is: behavioral and cognitive dimensions of peritoneal dialysis(3.687)dimensions,peritoneal dialysis(3.597),peritoneal dialysis fundamentals dimensions(3.569)compliance dimensions,peritoneal dialysis(3.323).(2)In patients with diabetic nephropathy under going peritoneal dialysis at home theself management of the factors univariate analysis showed that patient gender,age,education,marital status,age,occupation,dialysis,health education the number of exports and infection can affect self-management in patients with diabetic nephropathy undergoing peritoneal dialysis at home,and the related outcome variables included hemoglobin and blood glucose,blood pressure,serum potassium,calcium,triglyceride.The above factors in multiple regression,the results show that age,educational level,exports infection and peritonitis on self-management in patients with great effects,effects of age and duration of diabetes are the most important factors,and age was negatively correlated with patient self-management,diabetes was positively correlated with patient self management.Conclusion(1)Self-management in patients with diabetic nephropathy undergoing peritoneal dialysis at home lack,and its level of self-management below Lingling Guo non-diabetic nephropathy undergoing peritoneal dialysis patient self-management research results.Patients on peritoneal dialysis for fluid operation and daily concerns have better knowledge of;disease-control attitude more positive,but not enough attention to events that affect people's daily lives;to master basic knowledge of peritoneal dialysis in patients with poor;patient compliance,the compliance behavior is worst,needs more attention and improve in the future.(2)Self-management in patients with diabetic nephropathy under going peritoneal dialysis at home by demographic factors and effect of multiple factors in disease-related factors which influence of age on patients.Among them,the age was negatively correlated with self-management,diabetes was positively correlated with self-management. |
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