Application of transtheoretical model and stages of change in malnutrational hemodialysis patients

Abstract

Objective To explore the health education methods in malnutritional patients on maintenance hemodialysis using the transtheoretical model and stages of change (TTM).And also to help patients to set up scientific behavioral patterns to improve their self- management ability and reduce the incidence of complications.Methods 72 maintenance hemodialysis patients were included in this study.Taking TTM as intervention,we compared the nutritional status and the modified quantitative subjective global assessment (MQSGA) at 4 different time points:before intervention,1month,3 months and 6 months after intervention respectively,and statistically analyzed the data.Results Compared with before intervention,HGB level elevated significantly 1month after intervention ( q =2.08,P ＜ 0.05 ),while ALB was not changed significantly(q =1.22,P ＞ 0.05 ),HCRP dropped significantly ( q =3.06,P ＜ 0.01) and Kt/V increased significantly(q =4.12,P ＜0.01).HGB and Kt/V level increased significantly 3 months after intervention(q =8.20,6.13;P＜0.01),ALB level increased(q =2.81,P ＜0.05),while HCRP dropped significantly(q =8.85,P ＜0.01).HGB,ALB and Kt/V levels all increased significantly 6 months after intervention compared with 3 months after intervention (q =10.89,7.06,9.68,respectively; All P ＜ 0.01),and HCRP dropped significantly(q =13.26,P ＜0.01).The MQSGA improved significantly at both 3 months( x2 =15.84,P ＜0.01)and 6 months( x2 =86.26,P ＜0.01)after intervention compared with before intervention.Conclusions By using the TTM,we can change the life style of the hemodialysis patients,and improve their nutritional status and life quality. Key words: Hemodialysis; Health education; The transtheoretical model and stages of change