互联网+“情景模式”视频对腹膜透析患者营养状态的影响研究

A Study on the Impact of Internet-Based “Scenario-Based” Video Education on the Nutritional Status of Peritoneal Dialysis Patients

摘要: 目的：探讨互联网+“情景模式”视频教育对居家维持性腹膜透析患者营养状态的影响；方法：选取在福建中医药大学附属第二人民医院肾病科接受新置管治疗的维持性腹透病人为研究对象，时间为2022~2023年1月，共60例。采用随机数位表法，将病人分成观察组及对照组，每组30例，两组病人对照一般资料，如性别、年龄、基本疾病等，并无统计学意义(P > 0.05)之差异，可作比较。对照组病人采取常规的传统健康教育模式，具体内容有入院时口头健康辅导，发放纸质健康手册，出院前常规护理宣教等；观察组在常规健康教育的基础上对对照组患者及其家属实施互联网+“情景模式”视频健康宣教干预，通过网上答疑、视频随访等形式，引导其及其家属定期观看学习，强化其健康宣教的效果。两组病人均连续干预3个月，相关指标的检测和评估分别在干预前1个月、1个月和3个月后进行。结果：观察组病人营养风险筛查表(NRS2002)在介入后3个月的评分均明显低于对照组，且差异有统计学意义(P < 0.05)；同时，观察组病人的三头肌皮褶厚(TSF)和上臂肌围(AMC)整体优于对照组，且差异有统计学意义(P < 0.05)，且观察病人的腹膜炎发生率、导管出口感染率和电解质紊乱相关并发症的发生率均低于对照组。差异具有统计学意义(P < 0.05)。结论：互联网+“情景模式”的视频健康教育，可以有效改善维持性腹透病人的营养状况，说明这种新型的健康教育模式可以减少维持性腹膜透析病人并发症发生的危险，对增强病人治疗的安全性有积极的意义。

Abstract: Objective: To explore the impact of internet-based “scenario-based” video education on the nutritional status of home-based maintenance peritoneal dialysis patients. Methods: Sixty maintenance peritoneal dialysis patients who underwent new catheter placement at the Department of Nephrology, Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine, from January 2022 to January 2023 were selected as research subjects. Using a random number table method, the patients were divided into an observation group and a control group, with 30 patients in each group. There were no statistically significant differences in general data such as gender, age, and underlying diseases between the two groups (P > 0.05), making them comparable. The control group received conventional traditional health education, including oral health guidance upon admission, distribution of paper health manuals, and routine nursing education before discharge. The observation group received internet-based “scenario-based” video health education intervention in addition to conventional health education for patients and their families. This included online Q&A and video follow-up to guide patients and their families to watch and learn regularly, reinforcing the effect of health education. Both groups received continuous intervention for 3 months. Relevant indicators were measured and assessed one month before, one month after, and three months after the intervention. Results: The Nutritional Risk Screening (NRS2002) scores of the observation group were significantly lower than those of the control group at 3 months after the intervention, with a statistically significant difference (P < 0.05). At the same time, the triceps skinfold thickness (TSF) and upper arm muscle circumference (AMC) of the observation group were generally better than those of the control group, with statistically significant differences (P < 0.05). Furthermore, the incidence of peritonitis, catheter exit site infection, and electrolyte imbalance-related complications in the observation group were lower than those in the control group, with statistically significant differences (P < 0.05). Conclusion: Internet-based “scenario-based” video health education can effectively improve the nutritional status of patients undergoing maintenance peritoneal dialysis. This indicates that this new type of health education model can reduce the risk of complications in patients undergoing maintenance peritoneal dialysis and has a positive impact on enhancing the safety of patient treatment.