基于行动研究的维持性血液透析患者居家有氧运动干预

发布时间：2018-05-31 23:40

本文选题：行动研究 + 维持性血液透析　；参考：《宁夏医科大学》2017年硕士论文

【摘要】：目的调查、分析维持性血液透析患者运动现状、运动认知、自我管理能力和疾病症状发生程度的现状,探讨基于行动研究的居家有氧运动干预对患者运动认知、自我管理能力、疾病症状发生程度及体能水平的影响效果。方法在武警宁夏总队医院血液透析中心门诊,通过便利抽样法抽取142例维持性血液透析患者进行基线调查,在此基础上随机选取符合纳入排除标准的患者80例作为研究对象,并将其分为对照组和干预组,对照组患者给予常规运动干预,干预组患者在常规干预基础上进行为期9个月的基于行动研究的居家有氧运动干预。干预前后,分别比较两组患者运动认知、自我管理能力、疾病相关症状和体能水平的变化及评估患者的运动依从性,分析基于行动研究的居家有氧运动干预效果。结果1.基线调查结果(1)本研究共对142例维持性血液透析患者进行了基线调查,纳入的80例研究对象中实际完成全干预过程的共72例,干预组和对照组各36例;男性43例,女性29例;年龄在26~65岁,平均为(45.82±11.075)岁。(2)142例维持性血液透析患者中,69.0%偶尔运动锻炼;47.2%有规律运动行为。76.8%的患者对运动相关知识了解较少,89.4%的患者有运动知识相关需求。(3)维持性血液透析患者运动认知状况最高得分为80分,最低为27分,平均得分(55.91±8.62)分,患者对于运动益处和运动障碍的认知均较差。(4)维持性血液透析患者自我管理能力总分在24分到80分之间,平均为(54.42±10.51)分,自我管理能力处于中低水平者占108例(76.1%),其中执行自我护理维度得分最高,情绪处理维度得分最低。(5)维持性血液透析患者的疾病症状中,发生率排名前五的症状依次为乏力(92.3%)、瘙痒(86.6%)、皮肤干燥(85.9%)、入睡困难(85.2%)、口干(84.5%),而严重程度(≥3分)排名前五的症状依次为乏力(30.3%)、入睡困难(27.5%)、易惊醒(27.5%)、性功能障碍(27.5%)、瘙痒(25.4%)等。(6)干预前,两组维持性血液透析患者的基本资料、运动认知、自我管理能力、疾病症状发生程度及体能水平组间比较,差异无统计学意义(P0.05),组间可比。2.干预结果(1)基于行动研究的居家有氧运动干预后,干预组患者运动益处及运动障碍认知得分及总分均显著高于对照组(P0.05)。(2)基于行动研究的居家有氧运动干预后,干预组患者自我管理能力各维度得分及总分均显著高于对照组(P0.05)。(3)基于行动研究的居家有氧运动干预后,干预组患者疾病症状发生程度总分均显著高于对照组(P0.05)。(4)基于行动研究的居家有氧运动干预后,干预组患者较对照组患者握力无显著改善(P0.05),步行速度、10次坐立试验等体能指标均显著高于对照组(P0.05)。结论:1.维持性血液透析患者运动现状欠佳,自我管理能力处于中等偏低水平,疾病症状复杂多发。2.基于行动研究的居家有氧运动干预可提高维持性血液透析患者运动认知及依从行为、改善患者自我管理能力和疾病相关症状、增强患者的体能水平。
[Abstract]:Objective to investigate the status of sports status, exercise cognition, self management ability and the degree of disease symptoms in maintenance hemodialysis patients, and to explore the effect of the intervention on movement cognition, self-management ability, the degree of disease symptoms and physical level of patients with action research in Ningxia. In the outpatient department of hemodialysis center in a team hospital, 142 cases of maintenance hemodialysis patients were selected through the convenient sampling method. On this basis, 80 patients were randomly selected to be included in the exclusion criteria and divided into the control group and the intervention group. The patients in the control group were given routine exercise intervention, and the patients in the intervention group were routine. On the basis of intervention, 9 months of action research based home-based aerobic exercise intervention was conducted. Before and after intervention, the two groups of patients' exercise cognition, self-management ability, disease related symptoms and physical level changes and assessment of the patient's exercise compliance were compared, and the effect of home-based aerobic exercise intervention based on action research was analyzed. The results were 1. basis. The result of the line survey (1) a total of 142 patients with maintenance hemodialysis were investigated in this study, and 72 cases were completed in 80 cases, 36 cases in the intervention group and the control group, 43 in males and 29 in women; the average age was 26~65 years, the average was (45.82 + 11.075) years old. (2) 142 cases of maintenance hemodialysis patients, 69.. 0% exercised occasionally; 47.2% patients with regular exercise.76.8% had less knowledge of exercise related knowledge and 89.4% of the patients had sports knowledge related needs. (3) the highest score of sports cognition in maintenance hemodialysis patients was 80, the lowest was 27, the average score (55.91 + 8.62), and the patients' cognition of sports benefits and dyskinesia. (4) the total score of self management ability in maintenance hemodialysis patients was from 24 to 80 points, the average was (54.42 + 10.51), and the self-management ability was in the middle and low level, 108 cases (76.1%), among which the self nursing dimension was the highest and the emotional processing dimension was lowest. (5) the symptoms of maintenance hemodialysis patients occurred. The first five symptoms were fatigue (92.3%), pruritus (86.6%), dry skin (85.9%), difficulty in falling asleep (85.2%), and dry mouth (84.5%), and the severity (3) in the top five were weak (30.3%), difficulty falling asleep (27.5%), prone to awake (27.5%), sexual dysfunction (27.5%), itching (25.4%), etc. The basic data of the patients, exercise cognition, self management ability, the degree of disease symptoms and the level of physical level were not statistically significant (P0.05). The results were compared with the results of.2. intervention (1) the prognosis of home aerobic exercise based on action research, and the score and total score of exercise benefits and dyskinesia in the intervention group were significantly higher than those in the intervention group. The control group (P0.05). (2) the score and total score of the self-management ability of the intervention group were significantly higher than that in the control group (P0.05). (3) the total score of the incidence of disease syndrome in the intervention group was significantly higher than that in the control group (P0.05) based on the action research (P0.05). (4) the patients in the intervention group were significantly higher than the control group. Compared with the control group, there was no significant improvement in the grip strength between the intervention group and the control group (P0.05), the walking speed and the 10 sitting test were significantly higher than those of the control group (P0.05). Conclusion: the exercise status of the 1. maintenance hemodialysis patients is not good, since my management ability is in the middle and low level, the symptoms of the disease are complex and many Home-based aerobic exercise intervention based on action research can improve the exercise cognition and compliance in maintenance hemodialysis patients, improve the patient's self management ability and disease related symptoms, and enhance the physical ability of the patients with.2..
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.5

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