在资源匮乏的环境中,患者对持续性非卧床腹膜透析治疗的依从性:一项干预研究

M. S. S. Yapa, J. L. P. Chaminda, T. H. N. G. Amaraweera
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摘要

背景:连续不卧床腹膜透析(CAPD)是一种在低资源环境下经济实惠的家庭治疗方法。目前,斯里兰卡正在扩大低资源环境中的 CAPD 设施。患者和护理人员不坚持治疗是一个主要问题:评估目前在低资源环境中坚持 CAPD 治疗的情况和结果,设计一种干预措施以减少目前的不足之处,并评估干预措施对提高患者坚持治疗的效果:这是一项针对接受 CAPD 患者的干预性研究项目。方法:这是一项以接受 CAPD 的患者为对象的干预性研究项目,在干预前和干预后阶段采用访谈者发放的调查问卷和关键信息提供者访谈来评估患者的依从性。在分析干预前的结果后发现的不足之处被用于设计干预措施。举办了三期 "为期一天 "的讲习班,以提高坚持率。新系统投入使用并持续了五个月,之后对干预后的情况进行了评估。采用 McNemar 检验和配对 t 检验来衡量统计学意义:大多数参与者为男性,年龄在 50 至 59 岁之间。结果表明,干预对改善对当前健康状况的总体感受有效(P=0.004)。干预后,患者住院天数减少(p=0.001)。干预对整体个人卫生习惯有积极影响(p=0.000)。此外,干预还对记录保存产生了积极影响(p=0.096):干预对改善患者的依从性和护理人员的知识水平有很大的帮助。应针对有问题的患者实施持续评估、培训计划和家访,以提高患者对 CAPD 的依从性和持续性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Patient adherence to Continuous Ambulatory Peritoneal Dialysis treatment in a low-resource setting: An interventional study
Background: Continuous Ambulatory Peritoneal Dialysis (CAPD) is an affordable home-based treatment method for low-resource settings. Currently, CAPD facilities in low-resource settings are expanding in Sri Lanka. Non-adherence of patients and caregivers to the treatment is a major problem.Objective: To assess the current adherence and outcome of CAPD in low-resource settings, design an intervention to reduce the current shortcomings and evaluate the results of the intervention for improving patient adherence.Methods: This was an interventional research project with patients undergoing CAPD. Interviewer-administered questionnaires and key informant interviews during the pre and post-intervention stages were used to assess adherence. Gaps identified after analysing the results of pre-intervention were used to design the intervention. Three “one-day” workshops were conducted to improve adherence. The new system was introduced and continued for five months, after which post-intervention was assessed. McNemar’s and paired t-tests were used to measure the statistical significance.Results: Most of the participants were males, aged 50 to 59 years. Results showed that intervention proved to be effective in improving overall feelings about current health conditions (p=0.004). The number of days a patient stayed in a hospital decreased after the intervention (p=0.001). It showed a positive effect on overall personal hygiene practices (p=0.000). Further, intervention positively impacted record keeping (p=0.096).Conclusion: The intervention significantly contributed to improving patient adherence and caregivers' knowledge. Continuous assessment, training programs, and home visits for problematic patients should be implemented to improve adherence and sustainability of the CAPD.
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