The Clinical Study On The Effects Of Empowerment For Improving The Nutritional Status Of Maintenance Hemodialysis Patients

Objective To investigate the nutritional status of MHD patients and analysis the effects of empowerment for improving the diet self-management ability and the nutritional status of MHD patients,which will provide the nurses a scientific evidence on MHD patients nutrition management,and then improve the life quality of MHD patients.Methods We took 2 stages to finish this subject study.In the 1st stage,a convenience sample of 200 MHD patients from the hemodialysis center of the Affiliated Hospital of Guangxi Medical University from Nov.2011 to Dec.2012 was investigated using the nutrition Subjective Global Assessment(SGA).In The 2nd stage,90 MHD patients were selected randomly basing on the 1st stage investigation,and randomly divided into two groups.One was the empowerment group and the other was the contrast group.The contrast group was given routine diet nursing care,and the empowerment group was given empowerment education.We evaluated the effects of dietary self-management by Empowerment Scale(ES),General Self-Efficacy Scale(GSES),Diet Self-Management Scale before and after empowerment of 4 weeks,12 weeks,24 weeks and evaluated the nutritional status of MHD patients with nutrition Subjective-Global Assessment(SGA)and the objective nutrition index in the 12th week,24th week.The data was analyzed by SPSS 13.0 statistical software.The attribute data was expressed as a percentage,and the variable data was expressed as x±s and used t-test or repeated measures analysis of variance(ANOVA).The attribute data was analyzed with ?2 test,and P<0.05 denotes the difference had statistically significant.Result ?SGA shows that 103(51/5%)MHD patients' nutrition was normal,and 97(48.5%)MHD patients was abnormal.As for these 97 poor nutrition MHD patients,96 is mild and/or middle,and 1 is seriously poor nutrition.?The empowerment of the empowerment group is significantly improved(P<0.05).The repeated measures ANOVA showed that there was a significant difference in statistics compared with the contrast group from the 12th week·?The general self-efficacy of empowerment group is significantly improved(P<0.05)The repeated measures ANOVA showed that there was a significant difference in statistics compared with the contrast group from the 12th week.?The diet self-management of empowerment group was significantly improved.There was a significant difference in statistics compared with the contrast group from the 12th week.?The nutrition status of empowerment group was significantly improved in the 24th week.There was a significant statistics difference between the empowerment group and contrast group on the objectives nutrition index,such as BMI,albumin,hemoglobin.Conclusion ?The greater incidence of MHD patients with different degree of malnutrition,worthy of clinical attention?The empowerment education can improve the MHD patients' empowerment which for better decision-making,management.? Empowerment education can enhance MHD patients' general self-efficacy which for self-confidence and ability to achieve self-management.?Empowerment education can change MHD patients diet self-management behavior so that patients have better diet habit.?Empowerrnent education can improve malnutrition of MHD patients,and then improve quality of life.So it was worthy of clinical popularization and application.