Application Of The Health Belief Model In Dietary Management Of Home-based Peritoneal Dialysis Patients

Objective:1.Through qualitative interview,we deeply understand the dietary health beliefs of peritoneal dialysis patients at home.2.To develop a diet education program for peritoneal dialysis patients at home based on health belief model,and to verify the application effect of this program in dietary management of peritoneal dialysis patients at home.Methods:Part Ⅰ:Qualitative research.The purpose sampling method was used to select 11 patients with peritoneal dialysis from May 2020 to June 2020 in the outpatient department of a tertiary class A general hospital in Nanchang for semi-structured interviews,and the data were analyzed by using targeted content analysis method.Part Ⅱ:Clinical intervention.A total of 86 patients with home peritoneal dialysis were selected from the outpatient department of a Grade A general hospital in Nanchang from July 2020 to December 2020.The patients were divided into control group and intervention group by random number method.The control group was given routine care,and the intervention group was given diet education based on health belief model on the basis of the control group.Results:Part Ⅰ:A qualitative study of dietary health beliefs of patients on peritoneal dialysis at homeThe dietary health beliefs of home peritoneal dialysis patients can be summarized into seven themes: perception of the disease susceptibility of dietary noncompliance,perception of the disease severity of dietary noncompliance,perception of the benefits of dietary compliance,dietary adherence barriers(pay attention to food taste,care about the feelings of family cooks,produce burnout psychology),factors that enhance self-efficacy(abnormal biochemical indexes,reduce food intake or consequences of dietary incompliance,cherish life,diet knowledge(master correct knowledge of diet,existence knowledge to forget or erroneous area)and social support(health care staff,family,patients).Part Ⅱ:Application effect of diet education based on health belief model in home-based peritoneal dialysis patients1.Before intervention,there were no significant differences in baseline datas,such as general informations,dietary knowledge,dietary compliance attitude and dietary compliance behavior,between the two groups(P>0.05).2.After the intervention2.1 Intra-group comparison(1)The scores of diet knowledge in the control group before and after intervention were(13.29±3.19)points and(14.05±3.06)points,respectively,and the difference was statistically significant(P<0.05).The scores of diet knowledge in the intervention group before and after intervention were(12.95±3.65)points and(16.44±2.93)points,respectively,the difference was statistically significant(P<0.05).(2)The average scores of total items in the diet compliance attitude scale in the control group before and after intervention were(3.40±0.38)points and(3.51±0.46)points,respectively,and the difference was statistically significant(P<0.05).The average scores of total items in the diet attitude scale in the intervention group before and after intervention were(3.49±0.35)points and(3.78±0.28)points,respectively,and the difference was statistically significant(P<0.05).(3)The average scores of total items of the diet compliance behavior scale in the control group before and after intervention were(3.82±0.41)points and(3.93±0.31)points,respectively,with statistical significance(P<0.05).The average scores of total items of the eating behavior scale in the intervention group before and after intervention were(3.85±0.44)points and(4.14±0.28)points,respectively,and the difference was statistically significant(P<0.05).2.2 Comparison between groups(1)The scores of diet knowledge in control group and intervention group were(14.05±3.06)points and(16.44±2.93)points,respectively,and the difference was statistically significant(P<0.05).(2)The average score of total items in the diet compliance attitude scale of patients in the control group and the intervention group was(3.51±0.46)and(3.78±0.28)points,respectively,and the difference was statistically significant(P<0.05).(3)The average scores of total items in the diet compliance behavior scale in control group and intervention group were(3.93±0.31)and(4.14±0.28),respectively,and the difference was statistically significant(P<0.05).Conclusion:1.The contributing factors of dietary health beliefs in peritoneal dialysis patients included: perception of the disease susceptibility and severity of dietary noncompliance,perception of the benefits of dietary compliance,reduce food intake,abnormal biochemical indexes,consequences of dietary incompliance,cherish life,correct knowledge of diet,and social support.The barries included: pay attention to the feeling of family cooks,pay attention to food taste,produce burnout psychology,existence knowledge to forget or erroneous area.2.Diet education based on health belief model can effectively improve dietary knowledge level,form good dietary compliance attitude and promote dietary compliance behavior.of home peritoneal dialysis patients.