摘要
目的：通过行动研究实践，制订切实可行的护理宣教方案，提高维持性血液透析患者对带涤纶套中心静脉导管自我管理的依从性，降低血液透析患者导管功能不良率。方法对2014年3～10月在湖州市中心医院血透中心血透的17例新置带涤纶套的中心静脉导管患者进行透析导管日常维护行为指导，根据Lewin 提出的行动研究理论，以计划、行动、考察、反思4个步骤进行螺旋式循环，通过询问法评估患者导管自我维护依从性及统计12个月内导管功能不良率，评价宣教方案的可行性和有效性。结果行动研究实践8周，共完成3轮循环，经过完善宣教小组管理方法，改进宣教方法，调整宣教时间，细化护理程序，家庭支持系统，多学科协作等，使患者对透析导管自我维护认知程度得到提高，活动的依从性提高，导管功能不良率明显下降。结论该研究制订的透析导管护理宣教方案经过行动研究实践的修改及完善，能够提高血液透析患者导管自我管理的依从性，有效降低血液透析患者导管功能不良率。
Objective To formulate a practical nursing education project,improving hemodialysis patients＇self -maintenance compliance for central venous catheter with dacron cuff and reducing patients＇catheter dysfunction rate.Methods 17 patients with hemodialysis who newly had the central venous catheter with dacron cuff from March 2014 to October 2014 in our hospital,were selected and carried out a guidance of daily maintenance according to Lewin＇s action research theory.Four steps including plan,action,study and reflection were done spirally.The feasibility and validity of the nursing education project were evaluated by assessing the patients＇catheter self maintenance com-pliance,and counted up the catheter dysfunction rate within 12 months.Results The action research practice was conducted for 8 weeks,and included 3 rounds circulation.According to the nursing education team＇s management method,with the improved education method and adjusted education schedule,refined nursing process,family support system and multi -disciplinary coordination,the knowledge of self -maintenance of the hemodialysis patients were improved,and increased the compliance,reduced the dysfunction rate.Conclusion The dialysis catheter nursing education project of this study has been modified and perfected according to the practice of action research,which could improve patients＇self maintenance compliance and effectively reduce catheter dysfunction rate.
出处
《中国基层医药》
CAS
2016年第13期1955-1959,共5页
Chinese Journal of Primary Medicine and Pharmacy
基金
浙江省医药卫生科技计划项目（2016ZHA005）
