Research on effect of the transtheoretical model and stages of change in maintenance hemodialysis patients

Abstract

Objective To investigate effect of the transtheoretical model and stages of change (TTM) on self-management paradigm, serum calcium and phosphorus levels in patients undergoing maintenance hemodialysis (MHD). Methods Total 140 MHD patients were separated into two groups as the intervention group (65 of 70 cases completed with TTM) and the control group (63 of 70 cases completed with routine nursing care) by random number table. Data obtained by using hyperphosphatemia related knowledge questionnaires and Self-management Rating Scale before and after intervention. The levels of serum calcium and phosphorus between the above groups were compared. Results The scores of self-management behavior were higher in control group after 3 months intervention, the differences was statistically significant (P < 0.05), in which the scores of problem solving (2.97 ± 0.28), self care activities (2.99±0.28), relationships (3.13±0.35) and emotional treatment (2.80 ± 0.32) in experimental group was apparently higher than control group at the same time, the scores were (2.63±0.32), (2.67±0.38), (2.76±0.42), (2.44±0.36) respectively in conrtol group, t values were -0.907, -7.68, -6.03 and -8.43, respectively. And also, there was statistically significant difference between the two groups in serum phosphorus level [(1.81±0.49) mmol/L vs. (2.56±0.69) mmol/L], the product of calcium and phosphorus [(55.33±14.45) mg2/dl2 vs. (72.35±20.94) mg2/dl2], serum parathyroid hormone [238.00 (130.35, 413.85) ng/L vs. 297.75 (155.02, 760.37) ng/L] (t= 11.01, 8.43, Z=-2.09, P<0.05). Conclusions TTM is conducive to promote behavior change, improve self-management conduct, and also reduce serum phosphorus level in MHD patients . Key words: Renal dialysis; Serum phosphorus; Transtheoretical model and stages of change