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ENGLISH ABSTRACT
PACE模式对老年维持性血液透析患者疾病不确定感及自我感知负担的影响
陈巧毅
胡丽燕
徐艳
作者及单位信息
·
DOI： 10.3760/cma.j.cn341190-20240620-00777
Effects of PACE model on disease uncertainty and self-perceived burden in older adult patients undergoing maintenance hemodialysis
Chen Qiaoyi
Hu Liyan
Xu Yan
Authors Info & Affiliations
Chen Qiaoyi
Blood Purification Center, Lishui Central Hospital, Lishui 323000, Zhejiang Province, China
Hu Liyan
Blood Purification Center, Lishui Central Hospital, Lishui 323000, Zhejiang Province, China
Xu Yan
Blood Purification Center, Lishui Central Hospital, Lishui 323000, Zhejiang Province, China
·
DOI： 10.3760/cma.j.cn341190-20240620-00777
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摘要

目的探究老年人全面照护服务（PACE）模式对老年维持性血液透析（MHD）患者疾病不确定感及自我感知负担的影响。

方法本研究为前瞻性研究，选取2020年4月至2022年4月丽水市中心医院接受MHD治疗的老年终末期肾病（ESRD）患者80例，入院编号后遵照单双号法将其分为常规组（单号）与PACE组（双号），各40例。常规组实施常规护理干预，PACE组实施PACE护理模式。比较干预前后两组患者疾病不确定感评分（MUIS）、自我感知负担评分（SPBS）、疲乏状况评分（FSS）、生活质量及护理满意度。

结果干预后，两组MUIS总分［（78.43±12.99）分比（66.34±11.43）分］、SPBS总分为［（54.05±6.82）分比（32.12±4.72）分］、FSS总分为［（32.04±5.41）分比（21.91±4.94）］分均较干预前显著下降（ P < 0.05），且PACE组干预后各项目评分均显著低于常规组，差异均有统计学意义（ t=4.42，16.72，8.75，均 P < 0.001）；干预后，两组生理功能、角色功能以及情绪健康评分均显著上升，且PACE组干预后各项评分均显著高于常规组，差异均有统计学意义（ t=3.11、3.25、2.98，均 P < 0.05）；PACE组护理满意度高于常规组，差异有统计学意义（ χ 2=4.02， P=0.045）。

结论PACE模式可以有效降低老年维持性血液透析患者的疾病不确定感及自我感知负担，改善患者疲乏状况，提高患者生活质量及护理满意度，具有推广价值。

肾透析;患病代价;护理;老年人;患者舒适度;生活质量;病人满意度
引用本文

陈巧毅,胡丽燕,徐艳. PACE模式对老年维持性血液透析患者疾病不确定感及自我感知负担的影响[J]. 中国基层医药,2025,32(03)：471-475.

DOI:10.3760/cma.j.cn341190-20240620-00777

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近十年我国终末期肾病发病及病死率均呈现逐年升高趋势，严重危害人类健康，已成为重大公共卫生问题 ［ 1 ］ 。维持性血液透析（maintenance hemodialysis，MHD）是治疗终末期肾病的常用方案，能够帮助患者有效代谢体内毒素，纠正水、电解质紊乱，维持机体稳态平衡，保障患者的生命健康安全 ［ 2 ］ 。MHD是终末期肾病患者肾脏代疗法，需长期、定期实施透析治疗，保证生命安全，然老年MHD患者随年龄增长，多出现不同程度生理、认知功能下降，加之MHD相关并发症较多，故老年MHD患者护理问题较多，对相应护理管理提出一定需求 ［ 3 , 4 ］ 。老年人全面照护服务（program of all-inclusive care for the elderly，PACE）模式是美国提出的针对老年医疗护理救助项目 ［ 5 ］ ，它旨在让老年患者能够在医院得到医疗性服务、康复性服务和社会维持性服务等各项医疗护理服务，将老年人的短期医疗和长期护理结合在一起，让高龄患者在社区、医院能够得到相应的护理救助支持，从而提高患者的生活质量与归属感 ［ 6 ］ 。目前，PACE模式在老年MHD患者中的应用报道较少。基于此，本文旨在探究PACE模式对老年维持性血液透析患者疾病不确定感及自我感知负担的影响，展开了如下研究，现报告如下。
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备注信息
A
陈巧毅，Email： mocdef.qabq875762033
B

陈巧毅：酝酿和设计实验、实施研究、起草文章；胡丽燕：采集数据、分析、解释数据；徐艳：实施研究、对文章的知识性内容作批评性审阅

C
陈巧毅, 胡丽燕, 徐艳. PACE模式对老年维持性血液透析患者疾病不确定感及自我感知负担的影响[J]. 中国基层医药,2025,32(3):471-475. DOI:10.3760/cma.j.cn341190-20240620-00777.
D
所有作者声明不存在利益冲突
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浙江省医药卫生科技计划 (2022ZH021)
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