摘 要：
血液透析期患者容易出现抑郁、焦虑的心理压力和阻力，影响临床治疗效果。有效的心理干预对提高患者的心理压力和患者的依从性起着非常重要的作用。本研究旨在探讨心理干预对尿毒症性血液透析患者的护理效果。从2021年8月至2022年10月，该医院共收治尿毒症性血液透析患者118例。将患者随机分为常规护理组（n = 59）和心理干预组（n = 59）。常规护理组对尿毒症性血液透析患者进行常规护理。心理干预组对尿毒症性血液透析患者实施心理干预。比较两组患者护理前后的治疗依从性、自评焦虑量表、自评抑郁量表和SF-36量表（评价生活质量），比较两组患者的并发症发生率及护理满意度。结果是心理干预组血液透析尿毒症患者的治疗依从率和护理满意度均显著高于常规护理组；心理干预组血液透析尿毒症患者的自评焦虑量表、自评抑郁量表均显著低于常规护理组，SF-36量表均显著高于常规护理组。尿毒症性血液透析患者的主要并发症为低血压、高钾血症、内瘘闭塞和感染。与常规护理组相比，心理干预组的并发症发生率明显降低。尿毒症血液透析患者实施心理护理干预对降低并发症发生率、提高焦虑、抑郁、治疗依从性、生活质量和护理满意度有显著作用。
关键字：尿毒症；血液透析；心理干预
Abstract：
Patients during hemodialysis are prone to depression and anxiety, which affect the clinical treatment effect. Effective psychological intervention plays a very important role in improving the psychological pressure of patients and the compliance of patients. To investigate the effects of psychological interventions for the care of patients with uremic haemodialysis. From August 2021 to October 2022, the hospital admitted a total of 118 uremia hemodialysis patients. Patients were randomized to usual care (n = 59) and psychological intervention (n = 59). The usual care group provides routine care to patients on uremic hemodialysis. The psychological intervention group provided psychological intervention to patients with uremic hemodialysis. Treatment adherence, self-rated anxiety scale, self-rated depression scale and SF-36 scale (assessing quality of life) before and after nursing were compared between the two groups, and the complication rate and nursing satisfaction of the two groups were compared. The results were that the treatment compliance rate and nursing satisfaction of patients with hemodialysis uremia in the psychological intervention group were significantly higher than those in the usual care group. The self-rated anxiety scale and self-rated depression scale of hemodialysis patients in the psychological intervention group were significantly lower than those in the usual nursing group, and the SF-36 scale was significantly higher than that in the usual nursing group. The main complications in patients with uremic hemodialysis are hypotension, hyperkalemia, fistula occlusion, and infection. The complication rate was significantly lower in the psychological intervention group compared with the usual care group. Psychological nursing interventions in patients with uremic hemodialysis had a significant effect on reducing morbidity, improving anxiety, depression, treatment adherence, quality of life, and nursing satisfaction.
Keywords: Uremia; Hemodialysis; Psychological interventions
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