赵小培

【摘 要】 目的：观察改良式情景模拟宣教对首次透析患者抑郁状态的影响。方法：选择2017年7月至2018年7月在江苏省连云港市第二人民医院血液净化中心行首次血液透析的患者作为研究对象，随机分为观察组和对照组，对照组采用常规血液透析护理宣教方式进行护理，观察组采用改良式情景模拟宣教方式進行护理。在护理宣教前和首次透析结束后，分别对两组患者的抑郁状态进行评价。结果：护理宣教前，两组患者抑郁评分比较，差异没有统计学意义（P>0.05）;首次透析结束后，观察组患者抑郁评分较对照组患者抑郁评分降低明显，差异具有统计学意义（P<0.05）。结论：通过改变护理宣教时机和宣教方式，改良式情景模拟宣教改善首次透析患者抑郁效果确定，明显优于常规护理宣教模式。

【关键词】 改良式情景模拟宣教;首次透析;抑郁

[Abstract] Objective：Observe the effect of improved scenario simulation on the depression status of the first dialysis patients. Methods： The patients who underwent the first hemodialysis in the Blood Purification Center of the Second People's Hospital of Lianyungang City， Jiangsu Province from July 2017 to July 2018 were randomly divided into the observation group and the control group， and the control group used the routine hemodialysis nursing method. For the nursing， the observation group used the improved scenario simulation teaching method for nursing. The depression status of the two groups was evaluated before the nursing mission and after the first dialysis. Results： Before the nursing education， the depression scores of the two groups were not statistically significant （P>0.05）. After the first dialysis， the depression score of the observation group was significantly lower than that of the control group， which was statistically significant （P<0.05）.Conclusion： By changing the timing of nursing education and the way of teaching， the improved scenario simulation mission improved the depression effect of the first dialysis patients， which was significantly better than the conventional nursing education mode.

[Key words]Modified scenario simulation education; First dialysis; Depression

慢性肾脏病是全球面临的严峻公共卫生问题[1]，根据CNRDS系统的统计数据显示，2017年度全国有血液透析患者510101人，较2016年度增加72405人。新入血液透析患者由于恐惧透析、对血液透析知识的缺乏、对治疗手段的陌生，在首次透析时，会出现生理、心理上的双重压力，容易出现抑郁等心理疾病[2-3]。Hedayati等[4]研究发现，透析前患者的抑郁状态与其首次透析是否能够顺利进行及后续是否平稳过渡到规律性透析密切相关。而血液透析的顺利进行亦可清除患者体内某些有害代谢物质，改善患者的抑郁状况[5]。目前，大部分血液透析中心常规护理宣教方式为透析患者进入血液透析中心后启动护理宣教，宣教方法通常为口头宣教，不能起到提前干预、改善透析患者抑郁状态的作用。连云……