團體衛教合併行為修正對血液透析病患體重控制知識、體重及血壓之成效

Effects of Combined Group Education and Behavior Modification on Knowledge Related to Body Weight Control, Interdialytic Weight Gain and Blood Pressure in Hemodialysis Patients

胡潔瑩(Chieh-Ying Hu) ； 邱啓潤(Chii-Jun Chiou) ； 陳鴻鈞(Hung-Chun Chen) ； 林秋菊(Chiu-Chu Lin)

《實證護理》 1卷4期 (2005/12) Pp. 302-311

https://doi.org/10.6225/JEBN.1.4.302

摘要

本研究旨在探討團體衛教合併行為修正對血液透析病患體重控制知識、兩次透析間體重增加(Interdialytic Weight Gain, IDWG)，以及透析前平均動脈壓之成效。採前、後測及對照組之類實驗研究設計。實驗組於透析日之透析前或透析後1小時，進行每週1次，每次約30-40分鐘，為期四週之團體衛教，期間又併用自我監控、建立新目標、刺激控制及行為增強之方法，期使能達成適當的乾體重。實驗組在進行四週的團體衛教合併行為修正措施，隨後兩組於研究的第五週執行第一次後測，第九週執行第二次後測。研究結果顯示，實驗組病患在體重控制知識、IDWG，以及透析前平均動脈壓方面，均呈現顯著差異，然控制組在上述三個變項均未呈現顯著差異。本研究結果可供發展腎臟照護課程的參考依據，並可將本研究所發展的措施方案整合入病患照護活動中，以提升照護品質。

關鍵字

血液透析 ； 團體衛教 ； 行為修正 ； 兩次透析間體重增加

並列摘要

The purpose of this study was to examine the effects of a combination of group education and behavior modification on knowledge related body weight control, interdialytic weight gain (IDWG) and blood pressure in hemodialysis patients. The study used a quasi-experimental pre-post control group design, with two follow-up tests administered at the fifth week (post-test Ⅰ) and the ninth week (post- test Ⅱ) after the program. Interventions expected to achieve an appropriate dry weight included group education, self-monitoring, goal setting, stimulus control, positive reinforcement and feedback. The experimental group attended a 30-40 minute group education session once per week, one hour prior to or following dialysis therapy. The control group received routine care. In the experimental group, a statistically significant difference was found between pre- and post tests on knowledge related body weight control, IDWG, and predialysis mean arterial blood pressure, while the control group showed no significant score changes in above three outcome measures. The findings of this study may be useful as a reference in developing teaching courses on nephrology nursing. Also, the combined program of group education and behavior modification for hemodialysis patients may be integrated into clinical practice to enhance quality of care.

並列關鍵字

hemodialysis ； group education ； behavior modification ； Interdialytic Weight Gain IDWG