Abstract:

Objective　To explore the application effect of efficacy theory-oriented nursing intervention in patients with multiple myeloma complicated with renal failure. Methods　This was a randomized controlled trial. A total of 98 patients with multiple myeloma complicated with renal failure admitted to Hematology Department, The Second Affiliated Hospital of Shandong First Medical University from April 2020 to March 2023 were selected, and were divided into a control group (49 cases) and an observation group (49 cases) by the random number table method. The control group included 31 males and 18 females, aged (53.42±6.41) years. The observation group included 30 males and 19 females, aged (53.29±6.47) years. The control group was treated with routine nursing, and the observation group was treated with efficacy theory-oriented nursing intervention. Both groups were intervened for 3 months. The Chronic Disease Self-efficacy Scale (CDSES) score, Acute Physiology and Chronic Health Evaluation Ⅱ (APACHEⅡ) score, Self-perceived Burden Scale (SPBS) score, and complication rate were compared between the two groups. t test and χ² test were used. Results　After nursing, the scores of completing self-management, general self-management, achieving results, and dealing with problems of the CDSES in the observation group were (5.92±1.23), (6.15±1.20), (5.64±1.29), and (5.78±1.47) points, respectively, which were higher than those in the control group [(5.34±1.21), (5.62±1.19), (5.03±1.31), and (5.12±1.44) points], with statistically significant differences (t=2.394, P=0.019; t=2.195, P=0.031; t=2.323, P=0.022; t=2.245, P=0.027). After nursing, the scores of APACHEⅡ and SPBS in the observation group were (18.22±1.95) points and (21.15±3.39) points, respectively, which were lower than those in the control group [(19.14±2.11) points and (22.66±3.41) points], with statistically significant differences (t=2.241, P=0.027; t=2.198, P=0.030). The incidence of post-nursing complications in the observation group was 8.16% (4/49), lower than that in the control group [24.49% (12/49)], with a statistically significant difference (χ²=4.780, P=0.029). Conclusion　The application of efficacy theory-oriented nursing intervention in the nursing for multiple myeloma patients with renal failure can improve their self-efficacy, improve their health status and self-perception, and reduce the incidence of complications.

Key words:

Multiple myeloma, Renal failure, Efficacy theory, Nursing measures, Self-efficacy, Complications, Acute Physiology and Chronic Health Evaluation Ⅱ

摘要：

目的　探究以效能理论为导向的护理干预在多发性骨髓瘤合并肾衰竭患者中的应用效果。方法　本文为随机对照试验。选择2020年4月至2023年3月山东第一医科大学第二附属医院血液科收治的98例多发性骨髓瘤合并肾衰竭患者，采用随机数字表法将患者分为对照组（49例）和观察组（49例）。对照组男31例，女18例，年龄（53.42±6.41）岁；观察组男30例，女19例，年龄（53.29±6.47）岁。对照组实施常规护理，观察组实施以效能理论为导向的护理干预，两组均干预3个月。比较两组慢性病自我效能量表（CDSES）评分、急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）评分、自我感受负担量表（SPBS）评分以及并发症发生率。采用t检验和χ²检验。结果　护理后，观察组CDSES中的完成自我管理、一般自我管理、达成效果及应对问题评分分别为（5.92±1.23）分、（6.15±1.20）分、（5.64±1.29）分、（5.78±1.47）分，均高于对照组的（5.34±1.21）分、（5.62±1.19）分、（5.03±1.31）分、（5.12±1.44）分，差异均有统计学意义（t=2.394，P=0.019；t=2.195，P=0.031；t=2.323，P=0.022；t=2.245，P=0.027）；护理后，观察组APACHEⅡ、SPBS评分分别为（18.22±1.95）分、（21.15±3.39）分，均低于对照组的（19.14±2.11）分、（22.66±3.41）分，差异均有统计学意义（t=2.241，P=0.027；t=2.198，P=0.030）；观察组患者护理后并发症的发生率为8.16%（4/49），低于对照组的24.49%（12/49），差异有统计学意义（χ²=4.780，P=0.029）。结论　将以效能理论为导向的护理干预应用于多发性骨髓瘤合并肾衰竭患者的护理中，能提升患者的自我效能，改善患者的健康情况和自我感受，降低并发症的发生率。

关键词:

多发性骨髓瘤, 肾衰竭, 效能理论, 护理措施, 自我效能, 并发症, 急性生理学与慢性健康状况评分系统Ⅱ