الملخص
Objective:To investigate application evaluation of acceptance and commitment therapy among patients undergoing early stage of peritoneal dialysis.Methods:A total of 100 patients who undergoing early stage of peritoneal dialysis from March 2018 to January 2020 in Nephrology of Shanghai Tongji Hospital were assigned to the experimental groupand control group according to the random number table method with 50 cases in each group. The control group received routine nursing care, while the experimental group implemented 6-week acceptance and commitment therapy. The effect was assessed by Self-report Psychosocial Adjustment to Illness Scale (PAIS-SR) and Self-perceived Burden Scale (SPBS).Results:After intervention, the scores of health care, working ability, family relationship, communication, entertainment and psychological status dimensionand total PAIS-SR were (7.93 ± 1.50), (9.11 ± 1.38), (6.61 ± 1.73), (6.82 ± 1.42), (6.82 ± 1.66), (8.18 ± 1.79), (50.91 ± 4.24) points in the experimental group, which were lower than those in the control group (9.63 ± 1.22), (10.78 ± 1.64), (7.50 ± 2.07), (7.57 ± 2.05), (7.50 ± 1.07), (9.43 ± 1.92), (58.02 ± 4.13) points, the differences were statistically significant between the two groups( t values were 2.02-8.07, all P<0.05). After intervention, the scores of physical burden, emotional burden dimension and total SPBS were (9.68 ± 1.75), (14.54 ± 1.76), (30.89 ± 2.99) points in the experimental group, which were lower than those in the control group (10.80 ± 1.82), (16.11 ± 2.04), (33.65 ± 3.19) points, the differences were statistically significant ( t=2.98, 3.89, 4.24, all P<0.05). Conclusions:Acceptance and commitment therapy can improve the ability of disease adaptability and decrease self-perceived burden in patients undergoing early stage of peritoneal dialysis.
الملخص
Objective:To explore the effects of stepped-care intervention on disease adaptation and medical coping among young and middle-aged patients undergoing early stage of peritoneal dialysis.Methods:Totally, 72 young and middle-aged patients undergoing early stage of peritoneal dialysis from January 2018 to December 2019 in the Affiliated Hospital of Guilin Medical College were divided into experimental group and control group according to drawing lots methods, each group contained 36 cases. The control group received routine nursing, while patients in the experimental group were given stepped-care intervention for 6 times. Before and after intervention, the effects was assessed by Self-report Pychosocial Adjustment to Illness Scale (PAIS-SR) and Medical Coping Modes Questionnaire (MCMQ), respectively.Results:After intervention, the health care scores, ability to work scores, family relationship scores, communication scores, entertainment scores, psychological condition scores and total PAIS-SR scores were 7.88±1.53, 9.12±1.30, 6.62±1.10, 6.74±1.31, 6.44±1.80, 8.29±1.83, 50.35±4.26 in the experimental group, significantly lower than those in the control group 8.70±1.33, 10.06±1.90, 7.61±1.66, 7.73±1.86, 7.48±2.15, 9.45±1.60, 56.58±5.04 ( t values were 2.317-5.464, P<0.01 or 0.05). the MCMQ scores in facing were 12.97±2.44 in the experimental group, significantly higher than that in the control group 11.58±2.33; the avoidance and yielding scores were 16.41±1.46, 13.44±1.83 in the experimental group, significantly lower than those in the control group (17.76±1.52, 14.73±2.36), the differences were statistically significant ( t values were 2.389, 3.696, 2.496, P<0.05). Conclusions:Stepped-care intervention can improve the ability of disease adaptation and promote the positive transformation of young and middle-aged patients undergoing early stage of peritoneal dialysis.
الملخص
Objective To explore the effects of disease adaptation intervention in young and middle-aged patients undergoing early stage of peritoneal dialysis.Methods Using convenience sampling method,a total of 88 patients undergoing early stage of peritoneal dialysis were assigned into the experimental group and the control group from the inpatient ward of Nephrology Department of a tertiary hospital in Zhengzhou City.The experimental group received the comprehensive adaptation intervention and routine care,and the control group only received routine care.Before and after the intervention,the Psychosocial Adjustment to Illness Scale(PAIS-SR) and Short Form of 36 health survey questionnaire (SF-36) were used to assess the disease adaptability and quality of life of two groups,and the degree of edema and serum albumin index of two groups were recorded.Results Before and after the intervention,there were significant differences in the scores of psychosocial adaptation and each dimension,the scores of physical health and mental health in the experimental group,and the differences were statistically significant (P＜ 0.05);there were significant differences in the scores of psychosocial adaptation and each dimension in control group,and the differences were statistically significant(P＜0.05),but the differences of the scores of physical health and mental health were not statistically significant(P＞0.05).After the intervention,there were significant differences in the scores of psychosocial adaptation and each dimension,the scores of physical health and mental health between the two groups(P＜0.05);but the differences of serum albumin and edema index of two groups were not statistically significant(P＞0.05).Conclusion Comprehensive adaptation intervention can improve the ability of disease adaptation and the quality of life in young and middle-aged patients undergoing early stage of peritoneal dialysis.
الملخص
Introducción: es de vital importancia promover la adaptación en las personas que padecen una cardiopatía congénita con el fin de contrarrestar el deterioro de la calidad de vida. Objetivo: aplicar el proceso de atención de enfermería a un adulto con cardiopatía congénita basado en el modelo de adaptación de Callista Roy. Material y métodos: estudio de caso con enfoque cualitativo, bajo directrices del proceso de atención de enfermería y el modelo de Callista Roy, aplicado a persona con cardiopatía congénita compleja que reingresó por trombosis de vena yugular y cava superior, a una institución de alta especialidad. Los datos se obtuvieron mediante entrevista semiestructurada, analizada en su contenido para la construcción de categorías, enriquecida con la exploración física y los registros clínicos. Formulación de diagnósticos basados en la NANDA Internacional (NANDA-I); se plantearon metas conforme a la Clasificación de Resultados de Enfermería; y la Clasificación de Intervenciones de Enfermería. Resultados: en el autoconcepto y el desempeño del rol se identificaron conductas ineficaces de adaptación con las etiquetas de: temor, trastorno de la imagen corporal, disposición para mejorar el afrontamiento. En la evaluación de las intervenciones se observó que la persona disminuyó el miedo al asimilar la necesidad de los procesos invasivos; así como ausencia de manifestaciones físicas de ansiedad y la mejora de su autoestima. Conclusiones: el modelo de adaptación de Callista Roy resulta ser útil y aplicable en la práctica de enfermería, al permitir brindar un cuidado holístico que modifica las respuestas ineficaces de afrontamiento ante los estímulos del ambiente para la adaptación.
Introduction: it is vitally important to promote the adaptation in people with congenital heart disease with the purpose of counteract the deterioration of the quality of life. Objective: apply the nursing care process to an adult with congenital heart disease based on the model of adaptation from Callista Roy. Material and methods: case study with qualitative approach, under guidelines of the nursing care prcess and model of Callista Roy, applied to people with complex congenital heart disease, who was readmitted for thrombosis in the jugular vein and superior vena cava to a highly specialized institution. The data was obtained through semi-structured interviews, analyzed in its content for the construction of categories, enriched with physical examination and clinical records. Formulation of diagnosis based in NANDA International (NANDA-I). Goals have been raised according to the Nursing Outcomes Classification; and Nursing Interventions Classification. Results: in self-concept and role performance, ineffective adaptive behaviors were identified with the labels of: fear, body image disorder and willingness to face the disease. In the evaluation of interventions was observed that the person decreased the fear by assimilating the need for invasive procedures as well as lack of physical manifestations of anxiety and improving his self-esteem. Conclusions: the model of adaptation from Callista Roy found to be useful and applicable in nursing practice because it allows to provide holistic care that modifies the ineffective responses of facing the environmental stimuli for the adaptation.