摘要
目的 ：调查慢性肾脏病（Chronic Kidney Disease,CKD）3-5期患者营养门诊复诊依从性,分析其影响因素,以改进护理工作质量,更好地发挥饮食营养治疗在CKD患者康复中的作用。方法 ：回顾分析2007年1月至2012年12月我院肾病营养门诊建档患者（468例）资料,总结其结局及复诊情况。用Logistic回归探索患者建档时的人口学资料、家庭支持、基础肾功能情况以及血清白蛋白水平对复诊依从性的影响;并对依从性差者的主观原因进行分析。结果 ：468例CKD3-5期患者中,仍在接受随访的213例患者资料纳入统计分析,年龄（47.16±13.79）岁,随访时间为（26.85±22.37）个月。其中复诊依从性好者64例,占30.05%。Logistic回归显示,家庭支持（OR=2.448,P〈0.001）、建档时的e GFR（OR=0.638,P=0.038）和Alb（OR=0.932,P=0.043）纳入方程,家庭支持越高者,复诊依从性越好;e GFR和Alb与家庭支持呈负相关,建档时肾小球滤过率及血清白蛋白情况越差的患者,随访依从性相对越好。通过与依从性差者的沟通,得到8个影响复诊依从性的主题,可见依从性差的CKD患者缺乏饮食营养监测及长期管理意识。结论 ：CKD3-5期患者饮食营养门诊复诊依从性有待提高。护理工作中应加强家属教育,着重提高患者及家属的饮食管理和营养监测意识和家庭支持力度,并结合患者的肾功能和营养情况,分级分层管理,加强肾病饮食营养门诊在CKD患者管理中的作用,有效预防营养不良的发生。
Objective： To evaluate follow-up compliance of patients with CKD stage 3-5 in the nutrition clinic, and explore its related factors. Methods： The data of 468 patients with CKD stage 3-5 who got nutrition files created from January 2007 to December 2012 were retrospectively analyzed. Logistic regression was used to analyze the influencing factors of follow-up compliance. Patients＇ demographic data, family support, baseline renal function and serum albumin level were all included in the analysis. At the same time, the subjective reasons of poor adherence were explored. Results： There were 213 cases that still got follow-up at present. Their data were included in this analysis. Their average follow-up time was（26.85±22.37） months, average age（47.16±13.79）, 64 cases（30.05%） had regular follow-up. The Logistic regression analysis showed that family support（OR=2.448, P〈0.001）, e GFR（OR=0.638, P=0.038）, Alb（OR=0.932, P=0.043） were influencing factors of follow-up compliance. Family support had positive correlation with the follow-up compliance. While e GFR and Alb level had negative correlation with the compliance. Eight themes were obtained after interviewing with the patients with poor compliance, and it was found that those patients had not recognized the importance of long-term nutrition management yet. Conclusion： The follow-up compliances of patients with CKD stage 3-5 in the nutrition clinic need to be improved. Nursing education of patient＇s family should be strengthened to increase their consciousness of the diet nutrition monitoring and management. Hierarchical management according to patients＇ kidney function and nutrition level should be implemented to prevent malnutrition effectively.
出处
《中国护理管理》
CSCD
2015年第7期857-860,共4页
Chinese Nursing Management
基金
杭州市科技发展计划项目(2005633Q07)
关键词
慢性肾脏病
营养门诊
依从性
Chronic Kidney Disease
nutrition clinic
compliance
