Effect Of Well-being Aperm Model On Health-Related Hardiness And Post-Traumatic Growth Of Maintenance Hemodialysis Patients

ObjectiveTo investigate the current status and influencing factors of health-related hardiness and post-traumatic growth level in patients with maintenance hemodialysis;To analyze the correlation between health-related hardiness and post-traumatic growth level;To explore the effect of nursing intervention based on well-being PERMA model on health-related hardiness and post-traumatic growth level of the maintenance hemodialysis patients and to provide a reference to do personalized care for maintenance hemodialysis patients for medical staff working in hemodialysis area.Methods(1)A convenient sampling method was used to select two grade-three general hospitals in Hengyang City,Hunan Province,and then randomly selected 301 maintenance hemodialysis patients who met the inclusion criteria,the research tools including the general information questionnaire,Health-Related Hardiness Scale and Post-Traumatic Growth Scale.The scale is used as a research tool to conduct a questionnaire survey to investigated the current situation of health-related hardiness and post-traumatic growth level in patients with maintenance hemodialysis,and then analyze the influential factors and their correlations.(2)A hospital was selected from the surveyed hospitals by the lottery method,80 maintenance hemodialysis patients were selected from the identified hospitals as the research object,and then randomly divided into the intervention group(40 people)and the control group(40 people)by the lottery method.Patients in the control group were given routine nursing measures,and patients in the intervention group were given an well-being PERMA nursing intervention on the basis of routine nursing measures.The general information questionnaire,the Health-Related Hardiness Scale and Post-Traumatic Growth Scale were used to compare the scores of the health-related hardiness level and post-traumatic growth level of the two groups of patients before intervention,at the end of the intervention and at 3months after the end of the intervention.(3)Use Epdata3.1 software to establish a database and implement double entry.SPSS 24.0 software was used for data statistics.The frequency,composition ratios,means,and standard deviations were used for statistical descriptions,analysis of variance,multivariate linear regression analysis,t-test,chi-square(?~2)test,approximate F-test Welch(W)method,non-parametric test,Pearson correlation Statistical and repeated measurement anova for statistical analysis.The level of significance was set at 0.05(two-tailed).Results(1)The total score of the health-related hardiness level of maintenance hemodialysis patients was(132.93±10.10)and the score range was(110-159),the scores of three dimensions in the health-related hardiness level were:control(52.50±3.75),commitment(27.57±3.50),challenge(52.88±4.87).The family monthly income,number of chronic diseases combined,age,education,family relationships,primary caregivers,gender are important factors influencing the total score of the level of health-related hardiness of maintenance hemodialysis patients.The above variables explain the health-related hardiness was 31.1%(?R~2=0.311).(2)The total score of the post-traumatic growth level of maintenance hemodialysis patients was(56.92±8.18)and the score range was(38-83)points,the scores of each dimension were:life perception was(18.07±3.48),self-change(9.98±3.00),relationship(9.85±1.98),personal power(9.70±1.91),new possibility(9.37±2.43).The family monthly income,family relationships,education,primary caregivers,number of chronic diseases combined,disease awareness are important factors affecting the post-traumatic growth of maintenance hemodialysis patients.The above variables explain the post-traumatic growth was 29.9%(?R~2=0.299).(3)Pearson correlation analysis was used to analyze the correlation between health-related hardiness and post-traumatic growth in patients with maintenance hemodialysis,as a result,there was a positive correlation between the level of health-related hardiness and post-traumatic growth(r=0.795,P<0.01).Control,commitment and challenge are effective predictors of post-traumatic growth levels.(4)Before the intervention,there was no statistically significant difference between the two groups in general information,the health-related hardiness,post-traumatic growth and scores in each dimension(P>0.05).(5)At the end of the intervention,the two groups of patients had statistically significant differences in the health-related hardiness's control dimension,commitment dimension and the post-traumatic growth's life perception dimension,new possibility dimension,relationship with others dimension(P<0.05);At 3 months after the end of the intervention,the two groups of patients had statistically significant differences in the health-related hardiness's control dimension,commitment dimension and the post-traumatic growth's life perception dimension,self-transformation dimension,new possibility dimension,relationship with others dimension(P<0.05).(6)The scores of the health-related hardiness and post-traumatic growth in both groups had main effects of time and interactive effects(P<0.05),and there were main effects of intervention(P<0.05)in the dimensions of commitment,life perception and new possibility.(7)At the end of the intervention,the scores of the health-related hardiness and post-traumatic growth of the intervention group were statistically significant compared with those before the intervention(P<0.05).;At 3 months after the end of the intervention,except for the individual strength dimension,the health-related hardiness and post-traumatic growth scores of the patients in the two groups were statistically significant compared with those in the pre-intervention group(P<0.05);At 3 months after the end of the intervention,there was a statistically significant difference between the intervention group's the health-related hardiness's commitment dimension and post-traumatic growth's life perception dimension,personal strength dimension,and relationship with others dimension at the end of the intervention(P<0.05).Conclusion(1)The level of health-related hardiness of maintenance hemodialysis patients is at the middle level.The family monthly income,number of chronic diseases combined,age,education,family relationships,primary caregivers,gender are the main influencing factors.(2)The level of post-traumatic growth of patients with maintenance hemodialysis is at a moderate level.The family monthly income,family relationships,education,disease awareness,primary caregivers,age,number of chronic diseases combined are the main influencing factors.(3)Health-related hardiness in maintenance hemodialysis patients is positively correlated with post-traumatic growth.The higher the level of health-related hardiness in maintenance hemodialysis patients,the higher the level of post-traumatic growth.(4)Well-being PERMA nursing interventions can improve maintenance hemodialysis patient's health-related hardiness and post-traumatic growth.