王芳,季维辉,闻红梅.金山区居家腹膜透析患者的护理问题现状与延续性护理需求研究[J].上海护理,2020,20(7):
金山区居家腹膜透析患者的护理问题现状与延续性护理需求研究
The study on the current situation of nursing problems and continuous nursing needs of home peritoneal dialysis patients in JinShan district.
DOI:
中文关键词:  居家腹膜透析  社区  延续护理  服务需求  奥马哈系统
英文关键词:Home Peritoneal Dialysis  Community  Continuous Nursing  Service demand  Omaha system
基金项目:2018年度上海市中西医结合学会社区医学和健康管理科研课题(2018SQ004)
作者单位E-mail
王芳 上海市金山区漕泾镇社区卫生服务中心 上海 694311499@qq.com 
季维辉 上海市金山区漕泾镇社区卫生服务中心 上海  
闻红梅* 上海市金山区张堰镇社区卫生服务中心 上海 694311499@qq.com 
摘要点击次数: 1803
全文下载次数: 0
中文摘要:
      目的:明确居家腹膜透析患者的护理问题现状和护理服务需求,以指导社区卫生服务中心明确腹膜透析延续护理服务内容,以供同行参考和推广。方法:选取上海市金山区下辖11个社区的居家腹膜透析患者,开展全样本问卷调查。调查工具以奥马哈系统(OS)为理论模型依据,包含基本情况、护理问题评分、护理需求评分三个部分。由11名护理人员于2018年12月~2019年4月期间,针对各自辖区内的居家腹膜透析患者开展问卷调查,问卷当场发放和回收。共发放问卷91份,回收问卷91份,有效问卷91份,有效回收率为100.0%。结果:本次调查的91例金山区居家腹膜透析患者,男性39例(占42.9%),女性52例(占57.1%),居家腹膜透析5.21±2.7年。存在21个护理问题和42种症状体征,59.88%护理问题属于生理领域。生理护理问题2.23±0.82分,心理护理问题2.95±0.45分,认知护理问题1.87±0.67分,健康行为护理问题1.84±0.51分。不同性别患者的生理护理问题评分差异有统计学意义(p=0.028,U=742);不同街道患者的生理护理问题(p=0.002,H=27.559)、心理社会护理问题(p=0.049,H=18.341)评分差异有统计学意义。建档与随访管理需求4.14±0.69分,健康教育需求4.02±0.93分,个体化指导需求3.95±0.91分,专科护理需求3.84±1.01分。不同街道患者的专科护理需求(p<0.001,H=67.757)、建档随访需求(p<0.001,H=48.191)、健康教育需求(p<0.001,H=67.401)、个体化指导需求(p<0.001,H=65.000)评分差异有统计学意义。生理护理问题与建档随访管理需求之间呈现正相关关系(p=0.042,rs=0.214),与个体化指导需求之间呈现正相关关系(p=0.029,rs=0.229)。结论:现阶段上海市金山区居家腹膜透析患者,其护理问题集中在生理和心理方面,其护理需求集中在建档随访管理和个体化指导方面,不同居住街道的患者在护理问题和护理需求方面都存在一定差异。社区在提供相关延续护理服务时,可以将护理重点首先放在为患者建立长期随访档案、根据生理健康情况给予针对性宣教和心理疏导。
英文摘要:
      Objective: To clarify the current situation of nursing problems and nursing service needs of home peritoneal dialysis patients, so as to guide community health service centers to clarify the content of continuous nursing service of peritoneal dialysis for reference and promotion. Methods: A full sample questionnaire survey was conducted among home peritoneal dialysis patients in 11 communities in Jinshan District, Shanghai. The investigation tool is based on the theoretical model of Omaha system (OS), including three parts: basic situation, nursing problem score and nursing demand score. A questionnaire survey was conducted among 11 nurses from December 2018 to April 2019 for home peritoneal dialysis patients in their respective areas. The questionnaires were distributed and collected on the spot. A total of 91 questionnaires were sent out, 91 questionnaires were collected and 91 questionnaires were valid, with an effective recovery rate of 100.0%. Results: among the 91 patients with home peritoneal dialysis in Jinshan District, there were 39 males (42.9%) and 52 females (57.1%). The patients underwent peritoneal dialysis at home for 5.21±2.7 years. There were 21 nursing problems and 42 symptoms and signs, and 59.88% of the nursing problems belonged to the field of physiology. The scores of physiological nursing, psychological nursing, cognitive nursing and health behavior nursing were 2.23 ±0.82, 2.95 ±0.45, 1.87 ±0.67 and 1.84 ±0.51, respectively. There were significant differences in the scores of physiological nursing problems among patients of different genders (p=0.028, U=742), physiological nursing problems of patients in different streets (p=0.002, H=27.559) and psychosocial nursing problems (p=0.049, H=18.341). The needs of filing and follow-up management, health education, individual guidance and specialist nursing were 4.14 ±0.69, 4.02 ±0.93, 3.95 ±0.91 and 3.84 ±1.01, respectively. There were significant differences in specialist nursing needs (p<0.001, H= 67.757), file follow-up needs (p<0.001, H=48.191), health education needs (p < 0.001, H= 67.401) and individualized guidance needs (p<0.001, H=65.000) among different street patients. There was a positive correlation between physiological nursing problems and the needs of document follow-up management (p=0.042, r=0.214), and a positive correlation between physiological nursing problems and individual guidance needs (p=0.029, r=0.229). Conclusion: At present, the nursing problems of home peritoneal dialysis patients in Jinshan District, Shanghai are focused on physiological and psychological aspects, and their nursing needs are focused on file follow-up management and individual guidance. There are some differences in nursing problems and nursing needs among patients living in different streets. When providing relevant continuous nursing services, the community can first focus on the establishment of long-term follow-up files for patients, targeted education and psychological counseling according to physical health.
  查看/发表评论  下载PDF阅读器 全文HTML
关闭