Application Of Interaction Modle Of Client Health Behavior In The Maintenance Of Arteriovenous Fistula In Patients With Maintenance Hemodialysis

Objective:To understand the current situation of self-management of arteriovenous fistula in maintenance hemodialysis patients,and to analyze the influencing factors of self-management of arteriovenous fistula.Based on the health behavior interaction model theory,formulate the intervention measures for the maintenance of arteriovenous fistula,and explore the effect of the intervention program based on the health behavior interaction pattern on the maintenance of arteriovenous fistula in patients.Mehthods:1.Investigation and research: This study is a cross-sectional survey.Using the convenient sampling method,165 patients who underwent dialysis treatment in the hemodialysis center of a class III class a hospital in nanchang city from June 2021 to August 2021 were selected as the research objects.The general information questionnaire,maintenance hemodialysis patients’ arteriovenous fistula self-management scale,chronic disease self-efficacy scale and hospital anxiety and depression scale were used for questionnaire survey,to analyze the current situation and influencing factors of self-management of patients with arteriovenous fistula.2.An intervention program based on the interactive mode of health behavior was constructed,and 80 patients undergoing dialysis in the hemodialysis center of a tertiary hospital in Nanchang from October 2021 to December 2021 were selected as the research subjects.According to the weekly dialysis time of patients,they were divided into control group and intervention group,with 40 cases in each group.The control group implemented routine nursing,and the intervention group implemented the intervention scheme of healthy behavior interaction mode on the basis of routine nursing.Before and 3 months after the intervention,in addition to the dosage table used in the investigation and study,the treatment compliance scale of maintenance hemodialysis patients and nursing job satisfaction questionnaire were used to collect data,and the number of complications of arteriovenous fistula in the two groups was counted to compare the intervention effect of the two groups.Results:1.The results of cross-sectional survey showed that the self-management score of arteriovenous fistula in maintenance hemodialysis patients was(55.12±3.46),which was at the medium level;The self-efficacy score of hemodialysis patients was(5.69±0.39),which was at a low level;The anxiety score was(6.31±2.40)and the depression score was(6.89±2.22).Education level,family monthly income,complications,service life of internal fistula,self-efficacy,anxiety and depression are the influencing factors of arteriovenous self-management in maintenance hemodialysis patients.2.The results of intervention study showed that there was no significant difference between the two groups in demographic data,arteriovenous fistula self-management score,self-efficacy score,anxiety and depression score before intervention(P > 0.05).After the intervention,the scores of self-management and self-efficacy of arteriovenous fistula in the two groups were significantly higher than those before the intervention(P < 0.05);The scores of anxiety and depression were lower than those before intervention,and the difference was statistically significant(P < 0.05).The patients in the intervention group and the control group were compared.There were significant differences between the two groups in terms of arteriovenous fistula self-management score,self-efficacy score,anxiety,depression score,treatment compliance score and nursing satisfaction score(P < 0.05).There was no significant difference in the incidence of complications of arteriovenous fistula between the two groups(P > 0.05).Conclusions:1.The self-management ability of arteriovenous fistula in maintenance hemodialysis patients is at a medium level.The influencing factors of self-management of arteriovenous fistula include: educational level,family per capita monthly income,complications,service life of internal fistula,self-efficacy,anxiety and depression.2.The nursing intervention of health behavior interaction model can not only improve the self-management ability,self-efficacy,treatment compliance and nursing service satisfaction of patients with arteriovenous fistula in maintenance hemodialysis,but also improve the anxiety and depression of patients and reduce the incidence of arteriovenous fistula complications.