| ObjectiveAccording to the timing theory,in order to provide better nursing intervention plan and improve patient's capacity management behavior,self-care ability and prognosis to reduce depression and complications for different periods of hemodialysis patients,we built a "Internet +" transitional nursing intervention program and discussed its clinical application effect.Methods(1)Purpose sampling method is used to select a certain level of first-class hospital in hengyang on July 1,2018-August 15,2018,included in the standard of 51 cases of hemodialysis patients as the research object,using the method of literature review,expert consultation method,semi-structured interviews,expert meeting build based on the theory of time "Internet +" transitional nursing intervention in patients receiving hemodialysis.(2)A total of 122 hemodialysis patients who met the inclusion criteria on October 1,2018 and February 28,2019 in a first-class tertiary hospital in hengyang city were selected by convenient cluster sampling method as the study objects.The patients were randomly divided into two groups: experimental group(61 cases)and control group(61 cases).The patients in the control group were given routine nursing,while the patientsin the experimental group were given the "Internet +" transitional care based on the timing theory for hemodialysis patients.The capacity management behavior,self-care ability,depression,hemoglobin,serum albumin,serum potassium ion,serum creatinine(SCR),blood urea nitrogen(BUN),readmission rate and complications were compared between the two groups.All data were analyzed by SPSS 18.0.The general data of the two groups were tested by chi square/z test,and the scores of volume management behavior,self-care ability measurement and depression self-assessment were tested by paired t test.The haematological test indexes in the five stages were Greenhouse-Geisser correction test.The rates of readmission,acute left heart failure and vascular complications of the two groups were tested by Fisher's test,P < 0.05 was statistically significant.Results(1)Qualitative research results: according to the timing theory,five themes about the self-experience and needs of hemodialysis patients at different stages were extracted,which were as follows:(1)Diagnostic phase:denial and helplessness;(2)Stable period: economic difficulties and insufficient information support;(3)Preparation period: worried about poor response;(4)Implementation period: lack of knowledge;(5)Adaptation period: lack of knowledge,isolated life and depressed.(2)Before intervention,mild depression was common in the two groups of hemodialysis patients,and the total scores of patients' capacity management behavior ability and self-care ability were generally low.After analysis,there was no statistical difference between the two groups(P>0.05).After 6 months of intervention,the total scores of volume management behavior ability and self-care ability of patients in the experimental group were significantly higher than those in the controlgroup,while the scores of depression self-evaluation were significantly lower than those in the control group,with statistically significant differences between the two groups(P<0.05).We had a conclusion that the "Internet +" transitional nursing intervention for hemodialysis patients based on the timing theory can improve patients' capacity management behavior ability,self-care ability,and reduce depression.(3)After intervention,the value of hemoglobin and serum albumin in the experimental group was significantly higher than that in the control group,while the value of serum potassium was significantly lower than that in the control group,with statistically significant difference(P<0.05),and there was no statistically significant difference in BUN and SCr between the two groups(P>0.05).With the extension of intervention time,the hemoglobin and serum albumin values of patients in the experimental group showed a gradual increase trend,while the serum potassium ion value,SCr and BUN values showed a gradual decrease trend,and the changes of hemoglobin,serum albumin,serum potassium ion value and SCr values in the five different stages were statistically different(P<0.05).Control group in patients with hemoglobin values in the first four stages showed a trend of gradually increased,while the rise in the fifth stage is not obvious,serum albumin values in the first four stages showed a trend of gradually increased,declines in the fifth stage,serum potassium ion in the first three phase decline gradually,in the two stage instead rise obviously,BUN,SCr value decline gradually in the first three stages,in the two stage increased,hemoglobin,serum albumin,serum potassium values,the tendency of the SCr values were statistically significant(P <0.05).We had a conclusion that the "Internet +" transitional nursing intervention based on the timing theory can improve the serum albumin level of hemodialysis patients,improve anemia status and reduce the occurrence of hyperkalemia,and the longer the intervention time,thebetter the effect.(4)After intervention,Rehospitalization rate,incidence of acute left heart failure and vascular access complications(jams and infection)of hemodialysis patients in experimental group were lower than those in control group(P<0.05).We had a conclusion that the "Internet +" transitional nursing intervention could reduce rehospitalization rate and those complications mentioned above.Conclusion(1)Hemodialysis patients in the diagnosis period,stable period,preparation period,implementation period,adaptation period have a huge need for disease cognition and psychosocial support,and different stages of its needs are different,nursing staff should be different stages of hemodialysis patients to take different nursing measures.(2)The "Internet +" transitional nursing intervention program based on the timing theory could provide better nursing intervention for hemodialysis patients in different periods,improve the capacity management behavior and self-care ability of patients,and relieve the depression of patients;Meanwhile,it could also improve the level of serum white protein,the state of anemia,reduce hyperkalemia,readmission rate,and incidence of acute left heart failure and vascular access complications. |
PDF Full Text Request