以自我管理模式为指导的护理干预对肾移植患者自我管理行为及生活质量的影响

目的：探讨以自我管理模式为指导的护理干预对肾移植患者自我管理行为及生活质量的影响。方法签署知情同意书后随机将192例受试者分为研究组99例和对照组93例，研究组在采取常规护理措施和一般随访治疗的基础上，以自我管理模式为指导，实施护理干预，包括集体教育、小组讨论、个别指导及发放宣传资料等方式来实现有效的自我管理。对照组采取常规护理措施和一般随访治疗。于干预前和干预后3个月采用肾移植患者自我管理行为量表及肾移植患者生活质量量表测量两组患者自我管理行为和生活质量情况。结果干预前两组患者自我管理行为和生活质量得分比较差异均无统计学意义（ P＞0．05）；干预后两组患者自我管理行为和生活质量得分比较差异有统计学意义（ t值分别为9．25，-6．65；P＜0．05）。研究组干预前及干预后的自我管理行为得分分别为（93．22±3．28），（100．44±4．44）分，生活质量得分分别为（12．16±1．46），（10．92±0．92）分，干预前后比较差异均有统计学意义（t值分别为-9．11，5．01；P＜0．05）。结论以自我管理模式为指导的护理干预能提高肾移植患者的自我管理水平及生活质量，对于预防排异反应、提高患者的生存率有临床意义。

Effect of nursing intervention guided with self-management on self-management behavior and quality of life of kidney-transplant patients

Objective To investigate the effect of nursing intervention guided with self-management on self-management behavior and quality of life of kidney-transplant patients .Methods 192 eligible subjects were randomly divided into the experimental group （ n =99 ） and the control group （ n =93 ） .The control group received conventional nursing and follow-up visits while the experimental group adopted nursing intervention guided with self-management in addition , including collective education , group discussion , individual guidance and information.Self-management scale and quality of life scale were used to assess patients ’ self-management behavior and quality of life before and 3 months after intervention .Results There was no statistically significant difference of self-management behavior and quality of life between two groups before intervention （P〉0.05）. But after intervention , there was statistically significant difference of self-management behavior and quality of life between two groups （t=9.25,-6.65, respectively;P〈0.05）.In the experimental group, the score of self-management scale before and after intervention was respectively （93.22 ±3.28） and（100.44 ±4.44）, the score of quality of life was （12.16 ±1.46）and（10.92 ±0.92）, and the differences were statistically significant （t=-9.11,5.01, respectively; P〈0.05）.Conclusions Nursing intervention guided with self-management can improve the self-management level and quality of life of kidney transplant patients and has clinical significance for preventing rejection and increasing survival rate .