Abstract:

Objective

To explore the intervention effect of the standardized home management in patients with maintenance hemodialysis.

Methods

The department director, head nurse, hemodialysis doctor, and charge nurse made questionnaire for patients through analysis of problems existing in the process of maintenance hemodialysis in 151 patients. According to the questionnaire results in combination with patients needs, the standardized management at home was carried out among 151 patients with maintenance hemodialysis on the basis of regular hemodialysis nursing, mainly including intervention in emotions care,diet management, aerobic exercise, medication guide, self-monitoring, and self-maintenance of arteriovenous fistula, etc. After 1.5 years of the home management, comparisons were made in clinical and lab examinations, as well as in education compliance, complication occurrence, hospitalization, and quality of care, and so on. For comparison between samples, t test was applied, and the difference was considered statistically significant when P value was less than 0. 05.

Results

After the implementation of home management in the patients, the diastolic blood pressure and a number of laboratory indexes were significantly improved (P ＜0.05), treatment compliance was significantly increased, self-management of disease was enhanced (disease knowledge understanding, χ² = 18. 639, P ＜ 0. 001; internal fistula maintenance, χ² = 11.916, P=0.003), incidence of complications was significantly lowered (P ＜0.05),hospitalization frequency in a year was reduced (101 vs 74; t =11.77, P ＜0.001), and the number of patients who had part-time jobs and shared housework was obviously increased (χ² =79.040, P ＜0.001;χ² = 4.211, P=0.04). The relationship between patients and medical workers was more harmonious, and the nursing quality was also improved (P ＜0.05).

Conclusions

The implementation of standardized home management in patients with maintenance hemodialysis improved the quality of dialysis, effectively prevented and reduced the occurrence of complications, reduced the frequency of hospitalization, and improved both survival quality and quality of nursing.

Key words: Hemodialysis, Management at home