“帮助关系”对促进慢性肾脏疾病患者坚持健康生活方式的有效性

2021-12-07 小文子 MedSci原创

研究证明帮助关系促进慢性肾脏疾病患者坚持健康生活方式的有效性。

健康行为可以减缓慢性肾脏疾病的进展。专业医务人员提供教育、运动锻炼、动机咨询和阶段性策略来改善健康行为,但干预的有效性没有一致性结果。基于跨理论模型的来自重要他人的帮助关系已被证明有利于促进和实践健康促进行为。International Journal of Nursing Studies杂志的一项研究调查了来自重要他人的帮助关系的干预策略促进患者改善运动和饮食行为,促进健康生活方式的效果。

2015年9月至2016年9月,纳入台湾南部的两家肾病门诊诊所的20岁以上慢性肾脏疾病成人患者,有“重要他人”,包括成年子女、配偶、医务人员、父母和朋友。患者随机分配到干预组(n=60)和对照组(n=60),对照组患者参加了终末期肾病前期的教育计划,并进行一年的阶段性干预,以促进运动和饮食行为;干预组除接受教育计划和阶段性干预,同时接受12个月重要他人的帮助关系干预策略。在基线和干预后3、6、9和12个月时评估运动和饮食行为的变化阶段以及健康促进生活方式。

结果发现,与对照组相比,干预组进展到运动行动阶段或维持阶段的比例更高。12个月后,干预组人数进展到运动行动阶段或维持阶段从基线时40.0%(n=24)增加到54.9%(n=28),对照组从基线时43.3%(n=26)降低至16.3%(n=8)。干预组进展到运动行动阶段或维持阶段的人数,6个月时干预组在运动改变阶段的行动或维持阶段的参与者人数显著高于对照组(调整后OR为0.13;95%CI,0.04-0.48;p=0.002),9个月时(调整后OR为0.17;95%CI,0.05-0.54;p=0.003)和12个月(调整后OR为0.16;95%CI,0.05-0.55;p=0.003)。饮食变化的行动/维持阶段也观察到类似的趋势。成年子女和配偶是帮助患者实施健康行为的最常见的重要他人。而之前研究中,专业医务人员是重要他人。

研究证明帮助关系促进慢性肾脏疾病患者坚持健康生活方式的有效性。重要他人的可靠性、可信性和积极性使患者表达其想法和困难时,激励患者参与促进健康的生活方式。专业医务人员、成年子女和配偶可以积极地与患者合作,为患者提供干预措施,以实现更好的健康状况。

原文出处:

Shu-Mei Chao, Miaofen Yen, et al, Effects of helping relationships on health-promoting lifestyles among patients with chronic kidney disease: A randomized controlled trial, International Journal of Nursing Studies(2021), https://doi.org/10.1016/j.ijnurstu.2021.104137.

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