The effect of multidisciplinary collaborative intervention in chronic disease locus model on psychological status and complications in maintenance hemodialysis patients
摘要: 目的 本研究采用主客观指标，从两个维度来探究慢性疾病轨迹模式的多学科协作干预对维持性血液透析（Maintenance Hemodialysis,MHD）患者个人生活掌控感、负性情绪及并发症的影响。方法 以200例MHD患者为研究对象，随机化分组，分为试验组和对照组，每组各100例，对照组给予一般护理干预，试验组给予慢病轨迹模式的多学科协作干预，使用主观指标：个人掌控量表（Personal Mastery Scale，PMS）、医院焦虑抑郁量表（Hospital Anxiety and Depression Scale，HADS）和客观指标并发症来评价干预前后两组患者干预效果。结果 最终试验组和对照组纳入的MHD患者分别为：98例、99例。干预后，两组患者PMS评分均高于干预前，且试验组明显高于对照组，差异有统计学意义（P＜0.05）。干预后，两组患者HADS评分较干预前均有所降低，且试验组降低幅度大于对照组，差异有统计学意义（P＜0.05）。 在为期5个月的干预期间，对照组的并发症发生率为35.35%，是试验组的2.474倍，差异有统计学意义（P＜0.05）。结论 慢性疾病轨迹模式的多学科协作干预可提高 MHD患者个人生活掌控感，降低其负性情绪，减少其中远期并发症的发生，有助于其疾病的恢复和生命生活质量的提高。
Abstract: Objective In this study, subjective and objective indicators were used to explore the effects of multidisciplinary collaborative nursing of chronic disease trajectory mode on the sense of control over life, negative emotions and complications of maintenance hemodialysis patients from three dimensions.Methods A total of 200 patients with maintenance hemodialysis who were treated in the dialysis room of our hospital from January 2020 to January 2022 and were randomly divided into experimental group and control group, with 100 cases in each group. The control group was given clinical psychological nursing, and the experimental group was given multidisciplinary collaborative nursing intervention in the mode of slow disease trajectory. Subjective indicators were used: Personal Mastery Scale (PMS), Hospital Anxiety and Depression Scale (HADS) and objective indicators complications were evaluated before and after the intervention.Results After intervention, PMS scores in 2 groups were higher than before intervention, and the test group was significantly higher than the control group, the difference was statistically significant (P < 0.05). After intervention, the HADS score of both groups was decreased compared with that before intervention, and the reduction of experimental group was greater than that of control group, the difference was statistically significant (P < 0.05). During the 5-month intervention period, the complication rate of the control group was 35.35%, 2.47times that of the experimental group, and the difference was statistically significant (P < 0.05).Conclusion The multi-disciplinary collaborative nursing of chronic disease trajectory can improve the sense of control over life of MHD patients, reduce their negative emotions, reduce the occurrence of long-term complications, and contribute to the recovery of the disease and the improvement of life quality.