IMB引导营养评估与护理对维持性血液透析患者营养状况的影响

目的 探讨信息-行为-动机技巧模型(IMB)引导营养评估与护理对维持性血液透析患者营养状况的影响,为患者提供指导。方法 选取2017年11月～2018年11月来我院进行维持性血液透析的患者100例作为研究对象。按照随机数表法分为对照组与观察组,各50例。对照组患者采取常规健康护理的措施,观察组患者采取IMB引导营养评估与护理的措施。护理6个月后,比较两组患者对营养知识的掌握情况和护理满意度,采用血液生化指标和全面营养评估法(SGA)评估患者营养状况。结果 护理后,两组患者对膳食方案和运动方案的掌握情况得分均明显升高,且观察组明显高于对照组,差异有统计学意义(P0.05)。观察组患者血红蛋白、总蛋白和白蛋白明显高于护理前,差异有统计学意义(P0.05)。护理后,两组SGA评分明显降低,观察组患者明显低于对照组,差异均有统计学意义(P0.05)。观察组患者的护理满意度(92.00%)明显高于对照组(76.00%),差异有统计学意义(P0.05)。结论 IMB引导营养评估与护理可以提高维持性血液透析患者对营养知识的掌握和护理满意度,最终改善患者营养状况,值得临床推广。

Effect of IMB-guided nutrition assessment and nursing on nutritional status of maintenance hemodialysis patients

Objective To explore the effect of information-motivation-behavioral skills model(IMB) guided nutrition assessment and nursing on nutritional status of maintenance hemodialysis patients and to provide guidance to patients.Methods 100 patients who came to our hospital for maintenance hemodialysis from November 2017 to November 2018 were selected as subjects. The subjects were divided into a control group and an observation group according to the random number table method, with 50 patients in each group. The control group was given routine health care measures, while the observation group was given IMB-guided nutrition assessment and nursing. After 6 months of nursing,patients in the two groups were compared in their mastery of nutrition knowledge and nursing satisfaction. Blood bio chemical indexes and subjective global assessment(SGA) were used to evaluate the nutritional status of patients. Results After nursing, the scores of the two groups on the mastery of dietary program and exercise program were significantly increased, and the scores of the observation group were significantly higher than those of the control group, both with statistically significant differences(P<0.05). The levels of hemoglobin, total protein and albumin in the observation group after nursing were significantly higher than those before nursing, and the difference was statistically significant(P<0.05). After nursing,the SGA scores of the two groups were both significantly lowered compared with those before nursing, with statistically significant differences(P<0.05). The SGA score of the observation group was significantly lower than that of the control group after nursing, with statistically significant differences(P<0.05). The satisfaction with nursing of the observation group(92.00%) was significantly higher than that of the control group(76.00%), and the difference was statistically significant(P<0.05). Conclusion IMB-guided nutrition assessment and nursing can improve maintenance hemodialysis patients'' mastery of nutrition knowledge and nursing satisfaction, and eventually improve patients'' nutritional status, which is worthy of clinical promotion.