基于微信公众平台+问卷星的延续护理对腹膜透析患者换液操作的影响

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目的:探讨基于微信公众平台+问卷星的延续护理模式对腹膜透析患者换液操作的相关知识、操作能力、操作依从性及自我管理行为能力的影响。方法:采用便利抽样法,选取2019年1—6月于广州市番禺区中心医院行腹膜透析治疗的患者210例为研究对象,采用随机数字表法分为试验组和对照组各105例。对照组予腹膜透析常规延续性护理如门诊随访、电话随访、家访等,并予口头宣教。试验组在此基础上让患者关注微信公众平台,实行网络化健康教育配合问卷星做即时测试,多维度与患者沟通等新型延续护理模式。比较2组患者干预前及干预后3、6个月对腹膜透析换液操作相关知识、换液操作考核得分、导管出口处换药考核得分、换液操作管理得分及依从性情况,并比较2组患者干预前后腹膜透析换液操作相关并发症发生率。结果:干预3个月试验组腹膜透析换液操作相关知识、换液操作考核得分、换液操作管理的异常情况处理得分为(55.88 ± 8.97)、92(89,96)、12(11,12)分,高于对照组的(51.88 ± 10.24)、91(86,94)、12(9,12)分,差异有统计学意义(n t值为3.00、n Z值为-2.483、-2.308,n P<0.05)。干预6个月试验组腹膜透析换液操作相关知识、换液操作考核得分、导管出口处换药考核得分及换液操作管理得分(常规换液操作、异常情况处理)为(57.52 ± 9.41)、93(90,96)、90(87,94)、18(17,18)、12(11,12)分,均高于对照组(53.61 ± 10.29)、90(86,94)、90(87,92)、17(15,17)、12(9,12)分,差异有统计学意义(n t值为2.87、n Z值为-7.181~-2.646,均n P<0.01)。组间差异有统计学意义(n χ2值为4.020~7.517,均n P<0.05);时间差异有统计学意义(n χ2值为11.805~164.950,均n P<0.05)。干预6个月试验组并发导管感染、腹膜炎、引流不畅例数为9例占8.91%、5例占4.95%、5例占4.95%,明显低于对照组的21例占20.39%、14例占13.59%、15例占14.56%,差异有统计学意义(n χ2值为5.36、4.51、5.33,均n P<0.05)。n 结论:运用微信公众平台+问卷星的延续性护理,对腹膜透析患者换液操作的相关知识、操作能力、依从性及自我管理行为能力的提高具有明显的促进作用,并能有效降低因腹膜透析操作引起的相关并发症的发生。“,”Objective:To explore the effect of continuing care based on the WeChat public platform questionnaire star on the fluid replacement operation of peritoneal dialysis patients.Methods:Convenience sampling method was used to select 210 patients undergoing peritoneal dialysis in the Panyu Central Hospital, Guangzhou from January to June 2019. They were divided into a experimental group and a control group by random number table method, each with 105 cases. The patients of the control group were given routine continuous care for peritoneal dialysis, such as outpatient follow-up, telephone follow-up, home visit, etc., and oral education. On this basis, in the experimental group, the patients first joined the WeChat public platform, implementing network-based health education and questionnaire stars for real-time testing, and multi-dimensional communication with patients. The knowledge of the peritoneal dialysis fluid replacement operation, the fluid replacement operation evaluation score, the catheter outlet replacement drug evaluation score, the fluid replacement operation self-management score and compliance were compared before and after intervention in the two groups. And the incidence of complications related to the peritoneal dialysis fluid exchange operation of the two groups were compared before and after intervention.Results:The experimental group′s knowledge of peritoneal dialysis fluid exchange operation, examination score of fluid exchange operation, and abnormal situation management score of fluid exchange operation management were 55.88±8.97, 92(89, 96), 12(11, 12) after three-month intervention, and higher than the control group [51.88±10.24, 91 (86, 94), 12 (9, 12)], with statistically significant difference (n t value was 3.00, n Z value was -2.483, -2.308, n P<0.05). After six-month intervention, the relevant knowledge of peritoneal dialysis fluid replacement operation, fluid replacement operation evaluation score, catheter outlet replacement drug evaluation score and fluid replacement operation management score (routine fluid replacement operation, abnormal situation handling) of the experimental group were 57.52±9.41, 93 (90,96), 90 (87,94), 18 (17,18), 12 (11,12), which were higher than the control group [53.61±10.29, 90 (86,94), 90 (87,92), 17 (15,17), 12 (9,12)], with statistically significant difference (n t value was 2.87, n Z value was from -7.181 to -2.664, n P<0.01). The difference between the groups was statistically significant (n χ2 value was 4.21-7.517, all n P<0.05); and the difference between the intervention time points was statistically significant (n χ2 value was 11.805-164.95, all n P<0.05). After six-month intervention, the complications of catheter infection, peritonitis, and poor drainage were 9 (8.91%), 5 (4.95%), and 5 (4.95%) in the experimental group, which were significantly lower than those in the control group [21 (20.39%), 14 (13.59%), 15 (14.56%)], with statistically significant differences (n χ2 value was 5.36, 4.51, 5.33, both n P<0.05).n Conclusions:The continuous care of the WeChat public platform questionnaire star has a significant promotion effect on the improvement of the knowledge, operation ability, compliance and self-management behavior of the peritoneal dialysis patients, and can effectively reduce the complications caused by the peritoneal dialysis operation.
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