| Objective:1.To analyze the score of home peritoneal dialysis patients' disease knowledge,disease attitude,self-efficacy and self-management ability,and to understand the information motivation and behavior skill level of home peritoneal dialysis patients.2.To explore the effects of IMB mode based extended service on home peritoneal dialysis patients' disease knowledge,disease attitude,self-efficacy,self-management ability and behavioral compliance.3.To explore the effect of IMB model based extended service on home peritoneal dialysis patients' clinical status,incidence of dialysis-associated peritonitis,utilization of medical services and consumption of medical expenses,to provides reference for clinical practice.Method:A total of 90 home peritoneal dialysis patients who were followed up at the peritoneal dialysis outpatient department of The First Affiliated Hospital of Guangxi Medical University from February 2017 to May 2018 were selected.The patients were randomly divided into the control group and the intervention group using the random number table method,with 45 cases in each group.Routine follow-up and health education were conducted in the control group,while the intervention group was given extended service based on IMB model.To analyze the score of disease knowledge,disease attitude,self-efficacy and self-management ability of home peritoneal dialysis patients before intervention,and to compare the differences in disease knowledge,disease attitude,self-efficacy,self-management ability,behavioral compliance,and clinical status between the two groups before and 3months and 6 months after intervention,as well as the differences in the incidence of dialysis-associated peritonitis,medical service utilization and medical expense consumption between the two groups 6 months after intervention.Results:1.Home peritoneal dialysis patients' disease knowledge score was 16.94±2.49,attitude score was 3 8.05±6.04,self-efficacy score was 6.30±1.63,self-management ability score was 57.99±9.73.2.Comparison of disease knowledge,disease attitude,self-efficacy and self-management ability:There were no statistically significant differences in knowledge,attitude,self-efficacy and self-management ability between the two groups before intervention(P>0.05).After 3 months and 6 months of intervention,patients in the intervention group had higher scores of disease knowledge,disease attitude,self-efficacy and self-management ability than those in the control group,and the difference was statistically significant(P<0.05).3.Comparison of patients' behavioral compliance:before the intervention,there were no statistically significant differences between the two groups in medication compliance,diet compliance and operation standard compliance(P>0.05).The scores of medication compliance and diet compliance in the intervention group were higher than those in the control group at 3 months and 6 months after intervention,and the difference was statistically significant(P<0.05).After 6 months of intervention,the compliance score of operation standard in the intervention group was higher than that in the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in outpatient follow-up compliance between the two groups at 6 months after intervention(P>0.05).4.Comparison of nutritional status:before the intervention,there were no statistically significant differences in hemoglobin,serum albumin between the two groups(P>0.05).The serum albumin level in the intervention group was higher than that in the control group at 3 months and 6 months after intervention,and the difference was statistically significant(P<0.05).The hemoglobin in the intervention group was higher than that in the control group at 6 months after intervention,and the difference was statistically significant(P<0.05).5.Comparison of volume status:before the intervention,there were no statistically significant differences in patients' systolic blood pressure,diastolic blood pressure,24-hour urine volume,24-hour ultrafiltration volume and edema degree between the two groups(P>0.05).Systolic blood pressure in the intervention group was lower than that in the control group at 3 months and 6 months after intervention,and the difference was statistically significant(P<0.05).After 6 months of intervention,diastolic blood pressure in the intervention group was lower than that in the control group,and the difference was statistically significant(P<0.05).After 6 months of intervention,the edema level in the intervention group was improved compared with that in the control group,and the difference was statistically significant(P<0.05).But there was no statistically significant difference in 24-hour urine volume and 24-hour ultrafiltration volume between the two groups(P>0.05).6.Comparison of calcium and phosphorus metabolism:there was no statistically significant difference in serum calcium and serum phosphorus between the two groups before and after the intervention(P>0.05).7.Comparison of dialysis adequacy:there was no statistically significant difference in urea clearance index and creatinine clearance rate between the two groups before and after the intervention(P>0.05).8.Comparison of the incidence of peritonitis:there was no statistically significant difference in the incidence of peritonitis between the two groups before and after the intervention(P>0.05).9.Comparison of medical service utilization and medical cost consumption:after 6 months of intervention,the difference of average hospitalization days between groups was statistically significant(P<0.05).And no statistically significant difference was found in other comparisons(P>0.05).Conclusion:1.Home peritoneal dialysis patients' disease knowledge,disease attitude,self-efficacy and self-management ability have not yet reached the perfect state,information,motivation and behavioral skills should be supported.2.Extended service based on IMB model can improve home peritoneal dialysis patients' disease knowledge,disease attitude,self-efficacy and self-management ability.3.Extended service based on IMB model can improve home peritoneal patient medication compliance,dietary behavior compliance,and operation standard compliance.4.Extended service based on IMB model can improve the nutritional status and capacity status of patients.5.Extended service based on IMB model can effectively shorten the average hospitalization days of patients. |
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