山东省血液透析室护士对患者透析中运动的知信行现状调查

doi:10.3761/j.issn.0254-1769.2024.24.004

摘要/Abstract

摘要：

目的了解山东省血液透析室护士对维持性血液透析患者透析中运动的知信行现状并分析其影响因素。方法采用便利抽样法，于2024年3月采用自行编制的血液透析室护士对维持性血液透析患者透析中运动知信行问卷对山东省81所医院的血液透析室护士进行问卷调查，问卷包含知识、态度、行为3个维度，共38个条目。采用多元线性回归及广义线性模型分析血液透析室护士对维持性血液透析患者透析中运动知信行水平的影响因素。结果最终纳入478名血液透析室护士，知识、态度、行为维度得分分别为（8.09±3.74）、[41.00（40.00，49.00）]、（26.58±10.62）分。多因素分析结果显示，性别、是否参与过透析中运动相关培训是血液透析室护士对患者透析中运动知识的影响因素；医院级别、护士职务、是否参与过透析中运动相关培训是血液透析室护士对患者透析中运动态度的影响因素；护士关于患者透析中运动的知识和态度、是否参与过透析中运动相关培训、所在血液透析室是否开展过透析中运动、所在血液透析室是否配备运动器材是血液透析室护士关于维持性血液透析患者透析中运动行为的影响因素。结论山东省血液透析室护士对透析中运动的态度较积极，但知识、行为方面有待提高。血液透析室管理者应加强护士透析中运动的相关培训，积极尝试在血液透析室对患者开展透析中运动，在开展过程中不断完善流程和运动设施，持续质量改进，加速透析中运动在血液透析室中的推广。

关键词: 血液透析, 运动, 护士, 知识, 态度, 行为, 问卷调查

Abstract:

Objective To understand the current status of the knowledge，attitude and practice of hemodialysis nurses in Shandong Province on intradialysis exercise for maintenance hemodialysis patients，and to analyze its influencing factors. Methods A convenience sampling method was used to conduct a questionnaire survey on the knowledge，attitude and practice of maintenance hemodialysis nurses in 81 hospitals in Shandong Province in March 2024 by a self-compiled questionnaire on the knowledge，attitude and practice of hemodialysis nurses. The questionnaire included 3 dimensions，namely knowledge，attitude and practice，with a total of 38 items. Multiple linear regression and generalized linear model were used to analyze the influencing factors of exercise knowledge，attitude，and practice levels of hemodialysis nurses on maintenance hemodialysis patients during dialysis. Results A total of 555 questionnaires were collected，of which 478 were valid，with an effective recovery rate of 86.13%. The scores of knowledge，attitude and practice were（8.09±3.74），41.00（40.00，49.00） and（26.58±10.62） scores，respectively. The results of multivariate analysis showed that gender and whether or not they had participated in dialysis exercise-related training were influencing factors of hemodialysis nurses on knowledge. Hospital level，nurse position，and whether or not they had participated in dialysis exercise-related training were influencing factors of hemodialysis nurses on attitude. Nurses’ cognition and nurses’ attitude towards intradialysis exercise for maintenance hemodialysis patients，whether or not they had participated in dialysis exercise-related training，whether or not intradialysis exercise had been carried out in the hemodialysis room，and whether or not the hemodialysis room was equipped with exercise equipment were influencing factors of hemodialysis nurses on practice. Conclusion Hemodialysis nurses in Shandong Province have a positive attitude towards intradialysis exercise，but their knowledge and practice need to be improved. Hemodialysis room managers should strengthen the relevant training of nurses on intradialysis exercise，try to carry out intradialysis exercise in hemodialysis rooms，continuously improve the process and exercise facilities during the implementation process，continuously improve quality，and accelerate the promotion of intradialysis exercise.

Key words: Hemodialysis, Exercise, Nurses, Knowledge, Attitude, Practice, Questionnaire

范晓波, 姜艳萍, 刘慧, 李宁宁, 高朗朗, 崔莉. 山东省血液透析室护士对患者透析中运动的知信行现状调查[J]. 中华护理杂志, 2024, 59(24): 2973-2979.

FAN Xiaobo, JIANG Yanping, LIU Hui, LI Ningning, GAO Langlang, CUI Li. Survey on the current status of knowledge，attitude and practice on exercise in maintenance hemodialysis patients by nurses in hemodialysis rooms of Shandong Province[J]. Chinese Journal of Nursing, 2024, 59(24): 2973-2979.

图/表 4

表1 血液透析室护士的一般资料及对维持性血液透析患者透析中运动知信行的单因素分析（n=478）

Table 1 General information of hemodialysis room nurses and the results of univariate analysis on the scores of exercise knowledge， attitude， and practice questionnaire in MHD patients during dialysis（n=478）

续表1 血液透析室护士的一般资料及对维持性血液透析患者透析中运动知信行的单因素分析（n=478）

Table 1(continued) General information of hemodialysis room nurses and the results of univariate analysis on the scores of exercise knowledge， attitude， and practice questionnaire in MHD patients during dialysis（n=478）

表2 血液透析室护士对维持性血液透析患者透析中运动知信行问卷各维度得分排名后3位的条目（n=478）

Table 2 The bottom 3 items in the questionnaire on exercise knowledge， attitude， and practice of MHD patients during dialysis by nurses in the hemodialysis rooms（n=478）

表3 血液透析室护士对维持性血液透析患者透析中运动知信行多因素分析结果

Table 3 Multivariate analysis of exercise knowledge， attitude， and practice among hemodialysis room nurses in MHD patients during dialysis

参考文献 17

[1]	马迎春. 慢性肾脏病患者的功能障碍及康复策略[M]. 北京: 科学出版社, 2018.
	Ma YC. Dysfunction and rehabilitation strategies for patients with chronic kidney disease[M]. Beijing: Science Press, 2018.
[2]	程艳娇, 韩玮, 宋桂芸, 等. 透析中的卧位体操对维持性血液透析患者的影响[J]. 中华肾脏病杂志, 2015, 31(8):583-588. DOI
	Cheng YJ, Han W, Song GY, et al. Effect of intradialytic exercise in maintenance hemodialysis patients[J]. Chin J Nephrology, 2015, 31(8):583-588.
[3]	陈管洁, 张海林, 尹丽霞, 等. 维持性血液透析合并肌少症患者运动干预方案的构建及应用[J]. 中华护理杂志, 2022, 57(7):798-806. DOI
	Chen GJ, Zhang HL, Yin LX, et al. Construction and application of intradialytic exercise intervention program in maintenance hemodialysis patients with sarcopenia[J]. Chin J Nurs, 2022, 57(7):798-806. DOI
[4]	Zelle DM, Klaassen G, van Adrichem E, et al. Physical inactivity:a risk factor and target for intervention in renal care[J]. Nat Rev Nephrol, 2017, 13(3):152-168.
[5]	Parker K, Zhang X, Lewin A, et al. The association between intradialytic exercise and hospital usage among hemodialysis patients[J]. Appl Physiol Nutr Metab, 2015, 40(4):371-378. DOI PMID
[6]	罗细菊, 邓思妍, 陈静, 等. 9种运动方式对提高血液透析患者透析充分性效果的网状Meta分析[J]. 中华护理杂志, 2022, 57(23):2921-2929. DOI
	Luo XJ, Deng SY, Chen J, et al. The effect of 9 types of exercise in improving the dialysis adequacy on patients undergoing hemodialysis:a network meta-analysis[J]. Chin J Nurs, 2022, 57(23):2921-2929.
[7]	Martínez-Olmos FJ, de Borja Pérez-Domínguez F, et al. Comparison of intradialytic versus home-based exercise programs on physical functioning,physical activity level,adherence,and health-related quality of life:pilot study[J]. Sci Rep, 2020, 10(1):8302.
[8]	Ashby D, Borman N, Burton J, et al. Renal association clinical practice guideline on haemodialysis[J]. BMC Nephrol, 2019, 20(1):379. DOI PMID
[9]	王欣欣, 吝泽华, 王颖, 等. 血液透析中心运动康复实施障碍的横断面调查[J]. 中国血液净化, 2019, 18(1):30-34.
	Wang XX, Lin ZH, Wang Y, et al. Barriers to exercise rehabilitation in hemodialysis centers:a cross-sectional survey[J]. Chin J Blood Purif, 2019, 18(1):30-34.
[10]	Morgan AM, King AC, Viana J, et al. Exercise in dialysis:ready for prime time?[J]. Blood Purif, 2022, 25:1-5.
[11]	Nobahar M. Exploring experiences of the quality of nursing care among patients,nurses,caregivers and physicians in a haemodialysis department[J]. J Ren Care, 2017, 43(1):50-59.
[12]	中国康复医学会肾脏病康复专业委员会, 中关村肾病血液净化联盟肾康复专业委员会, 中国医师协会康复医师分会肾康复治疗专业委员会. 我国成人血液透析患者康复治疗的专家共识[J]. 中国血液净化, 2021, 20(11):721-727.
	The Kidney Rehabilitation Professional Committee of the Chinese Rehabilitation Medicine Association,the Kidney Rehabilitation Professional Committee of the Zhongguancun Kidney Blood Purification Alliance,the Kidney Rehabilitation Treatment Professional Committee of the Rehabilitation Physician Branch of the Chinese Medical Association. Expert consensus on rehabilitation treatment of adult hemodialysis patients in China[J]. Chin J Blood Purif, 2021, 20(11):721-727.
[13]	中国医师协会康复医师分会肾康复专业委员会, 马迎春. 我国成人慢性肾脏病患者运动康复的专家共识[J]. 中华肾脏病杂志, 2019, 35(7):537-543. DOI
	Chinese Medical Doctor Association,Rehabilitation Physicians Branch,Kidney Rehabilitation Committee, Ma YC. Expert consensus on exercise rehabilitation for Chinese adults with chronic kidney disease[J]. Chin J Nephrol, 2019, 35(7):537-543. DOI
[14]	孙佳佳, 顾勤, 薛冬群, 等. 维持性血液透析患者透析中运动锻炼的最佳证据总结[J]. 护理学杂志, 2022, 37(13):9-12.
	Sun JJ, Gu Q, Xue DQ, et al. Evidence summaries:intradialytic exercise for maintenance hemodialysis patients[J]. J Nurs Sci, 2022, 37(13):9-12.
[15]	崔培荣, 周莹霞, 张明霞, 等. 护士胰岛素注射知信行临床实践与指南差距的调查研究[J]. 中华护理杂志, 2023, 58(10):1178-1185. DOI
	Cui PR, Zhou YX, Zhang MX, et al. Investigation and research of the gap between clinical practice and guidelines of nurse knowledge,attitude and practice on insulin injection[J]. Chin J Nurs, 2023, 58(10):1178-1185.
[16]	Wodskou PM, Reinhardt SM, Andersen MB, et al. Motivation,barriers,and suggestions for intradialytic exercise-a qualitative study among patients and nurses[J]. Int J Environ Res Public Health, 2021, 18(19):10494.
[17]	Jhamb M, McNulty ML, Ingalsbe G, et al. Knowledge,barriers and facilitators of exercise in dialysis patients:a qualitative study of patients,staff and nephrologists[J]. BMC Nephrol, 2016, 17(1):192.