血液透析患者饮食行为依从性影响因素的质性研究

金玮艺; 张园; 冯春燕; 苏春燕

doi:10.16766/j.cnki.issn.1674-4152.003437

血液透析患者饮食行为依从性影响因素的质性研究

doi: 10.16766/j.cnki.issn.1674-4152.003437

北京大学第三医院肾内科，北京 100191

基金项目:

北京市卫生健康科技成果和适宜技术推广项目 BHTPP202058

详细信息

通讯作者:
苏春燕，E-mail：scybmu@126.com

中图分类号: R459.5 R692
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- 文章访问数: 127
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- 被引次数: 0
出版历程
- 收稿日期: 2023-06-22
- 网络出版日期: 2024-05-27

Influencing factors of hemodialysis patients' dietary behavior adherence: a qualitative study

Nephrology Department, Peking University Third Hospital, Beijing 100191, China

摘要

摘要: 目的血液透析患者的容量超负荷、高血压、电解质紊乱、骨矿物质代谢紊乱和营养不良等相关并发症的发生均与其饮食摄入息息相关，因此，做好透析患者的饮食和营养管理十分重要。本研究运用现象学研究方法从主观角度探讨基于健康信念模式下透析患者对饮食调整的经历和看法，通过质性研究揭示影响透析患者饮食依从性的本质原因，以期为具体化个性化地提高血液透析患者饮食依从性提供指导。方法采用目的抽样法抽取2021年11—12月在北京大学第三医院血液透析室接受治疗的28例患者作为访谈对象。采用现象学研究方法访谈收集资料，并采用定向内容分析法分析资料，提炼主题。结果共提炼出4个主题，分别为感知威胁、感知障碍、自我效能及成功经验和外部因素。感知威胁影响透析患者饮食行为依从性，尤其是感知严重性。感知障碍因素包括主观障碍和客观障碍，主观障碍与饮食建议、饮食习惯和观念、患者体验等有关，共病情况、社交和外出聚餐场合等是透析患者饮食依从性的客观障碍。自我效能及成功经验包括树立信念、自我饮食调整、饮食控制习惯养成和坚持运动。外部因素包括社会支持和其他社会因素。结论血透患者对饮食调整行为的感受和认知是十分复杂的，其饮食行为依从性受多因素影响。提高患者的感知威胁、减少障碍因素、提高自我效能和社会支持将有利于提高透析患者的饮食行为依从性。
- 血液透析 /
- 饮食行为 /
- 质性研究
Abstract: Objective Related complications such as volume overload, hypertension, electrolyte disturbances, bone mineral metabolism disorders and malnutrition in dialysis patients are closely related to their dietary intake. Therefore, it is very important to manage the diet and nutrition of dialysis patients. In this study, the phenomenological research method was used to explore the experiences and views of dialysis patients on dietary adjustment based on the health belief model from a subjective point of view, and to identify the essential reasons that affect dialysis patients' dietary compliance through qualitative research. in order to provide guidance for specific and personalized improvement of dietary compliance of haemodialysis (HD) patients. Methods From November to December 2021, 28 HD patients in Peking University Third Hospital were selected by convenience sampling method. Phenomenological research method was applied to the interview and the data were analyzed using targeted content analysis to extract themes. Results Four themes were extracted, and named as perceived threat, perceived barriers, self-efficacy & successful experience, and external factors respectively. Perceived threat affected the adherence of dialysis patients, especially the perceived severity. Perceived barriers included subjective and objective barriers, and subjective barriers were related to dietary recommendations, eating habits and concepts, and patient experience, etc. Comorbidity, social activities and eating out were objective barriers to dietary compliance in dialysis patients. Self-efficacy and success experiences included belief building, self-dietary modification, dietary control habits, and exercise. External factors included social support and other social factors. Conclusion The perception and cognition of dietary behavior change in HD patients was complicated. Their dietary adherence was influenced by many factors. Improving patients' perceived threat, reducing barriers, improving self-efficacy and social support will help to improve dietary adherence in HD patients.
- Hemodialysis /
- Dietary behavior /
- Qualitative study

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参考文献(22)

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