目的 探讨基于血管通路核心的干预模式对血液净化患者自我效能的影响。方法 选择2020-06至2023-06解放军总医院第七医学中心收治的血液净化患者98例,随机分为两组,每组49例。对照组采用常规方法干预,观察组联合基于血管通路核心的干预模式,两组均完成6个月干预。比较两组医学应对方式、自我效能水平、血管通路并发症发生率及满意度。结果 干预后两组医学应对方式均得到改善,观察组面对得分高于对照组[(25.38±3.73)vs.(20.21±3.16)],屈服及回避得分低于对照组[(8.32±1.62)vs.(10.29±1.96)][(10.13±1.42)vs.(13.27±1.85)],差异有统计学意义(P<0.05)。干预后两组自我效能水平均提高,观察组事件应对、个体解决问题及目标达成评分均高于对照组[(12.63±2.17)vs.(10.29±1.86)][(10.85±1.32)vs.(8.92±1.17)][(11.52±1.42)vs.(8.47±1.17)],差异有统计学意义(P<0.05)。两组血管通路并发症发生率比较差异无统计学意义。观察组患者满意度高于对照组,差异有统计学意义(P<0.05)。结论 基于血管通路核心的干预模式用于血液净化患者效果显著,可改善患者医学应对方式、提升自我效能水平,提高患者满意度,6 个月观察期内对血管通路并发症发生率无显著降低作用,但整体仍具有临床推广价值。

Objective To investigate the influence of an intervention model based on vascular access core on the self-efficacy of patients undergoing blood purification. Methods A total of 98 patients undergoing blood purification at the Seventh Medical Center of PLA General Hospital from June 2020 to June 2023 were selected and divided into two groups, with 49 patients in each group. The control group received conventional intervention, while the observation group was additionally given an intervention mode based on vascular access core. Both groups were intervened for 6 months. Medical coping style, self-efficacy level, incidence of vascular access complications, and satisfaction were compared between the two groups. Results Medical coping styles improved in both groups after intervention. The scores of confrontation of the observation group were higher than those of the control group [(25.38±3.73) vs. (20.21±3.16)], while the scores of resignation and avoidance were lower than those of the control group [(8.32±1.62) vs. (10.29±1.96) (10.13±1.42) vs. (13.27±1.85)], and the differences were statistically significant (P<0.05). The self-efficacy was elevated in both groups after intervention; the scores of event coping, problem-solving, and goal achievement in the observation group were higher than those in the control group [(12.63±2.17) vs. (10.29±1.86) (10.85±1.32) vs. (8.92±1.17) (11.52±1.42) vs. (8.47±1.17)], and the differences were statistically significant (P<0.05). No statistically significant difference was found in the incidence of vascular access complications between the two groups. The satisfaction of the observation group was higher than that of the control group, and the difference was statistically significant (P<0.05). Conclusions The intervention mode based on vascular access core is effective for blood purification patients, which can improve their medical coping styles, enhance their self-efficacy, and increase their satisfaction. It shows no significant effect on the reduction of vascular access complications within the 6-month observation period, but it still has clinical promotion value overall.