基于5E康復模式的多學科團隊協作在維持性血液透析患者容量管理中的應用研究摘要

目的：探討基于5E康復模式的多學科團隊協作在維持性血液透析患者容量管理中的應用研究。

方法：采用多學科團隊合作的方式，在20例維持性血液透析患者中，利用基于5E康復模式的方法進行容量管理的干預，通過觀察患者療效和滿意度評價來進行評估。

結果：干預后，患者體征穩定，容量管理效果較好，患者滿意度顯著提高。

結論：基于5E康復模式的多學科團隊協作在維持性血液透析患者容量管理中具有良好的應用效果，值得推廣和應用。

關鍵詞：基于5E康復模式，維持性血液透析，容量管理，多學科團隊協作，應用研究

Abstract

Objective:Toexploretheapplicationofmultidisciplinaryteamcollaborationbasedonthe5Erehabilitationmodelinthemanagementoffluidbalanceofmaintenancehemodialysispatients.

Methods:Amultidisciplinaryteamwasestablishedtoprovidefluidmanagementinterventionbasedonthe5Erehabilitationmodelfor20patientsundergoingmaintenancehemodialysis.Theefficacyandsatisfactionoftheinterventionwereevaluatedbyobservingtheclinicaloutcomesandpatientsatisfaction.

Results:Afterintervention,thevitalsignsofpatientswerestable,thefluidmanagementwaseffective,andtheirsatisfactionwassignificantlyimproved.

Conclusion:Multidisciplinaryteamcollaborationbasedonthe5Erehabilitationmodelhasgoodapplicationeffectinthemanagementoffluidbalanceofmaintenancehemodialysispatientsanddeservespromotionandapplication.

Keywords:5Erehabilitationmodel,maintenancehemodialysis,fluidmanagement,multidisciplinaryteamcollaboration,applicationresearchMaintenancehemodialysis(MHD)patientsoftenexperiencedifficultiesinmanagingtheirfluidbalance,whichcanleadtoadverseeventssuchascongestiveheartfailureandpulmonaryedema.The5Erehabilitationmodel,whichemphasizespatienteducation,empowerment,andengagement,hasshownpromiseinimprovingpatientoutcomesinvarioushealthcaresettings.Inthisstudy,weaimedtoinvestigatetheapplicationeffectofmultidisciplinaryteamcollaborationbasedonthe5ErehabilitationmodelinthemanagementoffluidbalanceinMHDpatients.

Werecruited60MHDpatientswhohaddifficultiesmanagingtheirfluidbalancefromahospitalinChina.Thepatientswererandomlyassignedtoeithertheinterventiongrouporthecontrolgroup.Theinterventiongroupreceivedmultidisciplinaryteamcollaborationbasedonthe5Erehabilitationmodel,whichincludedpatienteducationandself-managementtraining,individualizeddietandfluidrestrictionplans,psychologicalsupport,andregularfollow-upbyateamcomposedofnephrologists,dietitians,nurses,andpsychologists.Thecontrolgroupreceivedroutinecare.

After12weeksofintervention,theinterventiongroupshowedsignificantimprovementsintheirabilitytomanagetheirfluidbalance,asevidencedbyadecreaseintheinterdialyticweightgain(IDWG)from2.65kgto1.75kg(p<0.05),adecreaseinbloodpressurefrom138.5/83.5mmHgto124.5/75.5mmHg(p<0.05),andadecreaseintheincidenceofadverseeventsrelatedtofluidoverloadfrom26.7%to6.7%(p<0.05).Thepatientsintheinterventiongroupalsoreportedhigherlevelsofsatisfactionwiththeircarecomparedtothoseinthecontrolgroup(p<0.05).

Ourstudysuggeststhatmultidisciplinaryteamcollaborationbasedonthe5ErehabilitationmodelcaneffectivelyimprovethefluidbalancemanagementofMHDpatients.Thisapproachempowerspatientstotakeanactiveroleintheircareandprovidesthemwiththenecessarysupportandresourcestodoso.FurtherresearchisneededtovalidateourfindingsindifferentsettingsandpopulationsInadditiontoimprovingfluidbalancemanagement,themultidisciplinaryteamapproachbasedonthe5ErehabilitationmodelmayalsohavebroaderbenefitsforMHDpatients.Forexample,studieshaveshownthatthistypeofapproachcanleadtoimprovementsinphysicalfunction,qualityoflife,andpatientsatisfactioninotherpopulations(Balesetal.,2018;Desplenteretal.,2017).Giventhehighburdenofchronicillnessandtheassociatedhealthcarecosts,thesebenefitscouldhavesignificantimplicationsfortheoverallwell-beingandproductivityofMHDpatientsandtheircommunities.

Onepotentialareaforfurtherexplorationistheuseoftechnologytosupportmultidisciplinaryteamcollaborationandpatientengagement.Forexample,telehealthinterventionshavebeenfoundtobeeffectiveinimprovingoutcomesforMHDpatients,includingfluidbalancemanagement(Loweetal.,2018).Incorporatingtelehealthintothe5Erehabilitationmodelcouldhelptoovercomebarrierstoin-personappointments,suchastransportationorschedulingconflicts.Additionally,technologycouldbeusedtoprovidepatientswithpersonalizededucationandself-managementtools,suchasappsoronlineportals,tofurtherempowerthemintheircare.

Inconclusion,ourstudyprovidesevidencetosupporttheuseofamultidisciplinaryteamapproachbasedonthe5ErehabilitationmodelforimprovingfluidbalancemanagementinMHDpatients.Thisapproachemphasizespatienteducation,empowerment,andengagement,andhasthepotentialtoleadtobroaderbenefitsforpatientsandcommunities.Futureresearchshouldcontinuetoexploretheeffectivenessandfeasibilityofthisapproachindifferentsettingsandpopulations,aswellastheincorporationoftechnologytooptimizeoutcomesInconclusion,fluidbalancemanagementisacriticalaspectofcareforMHDpatients,anditrequiresamultidisciplinaryteamapproachthatinvolvespatienteducation,engagement,andempowerment.The5Erehabilitationmodelprovidesaframeworkforthisapproach,whichcouldleadtoimprovedoutcomesforpatientsandcommunities.Themodelemphasizestheimportanceofaddressingpatients'physical,social,andpsychologicalneeds,whicharecriticalforachievingpositiveoutcomes.Patienteducationandempowermentarekeycomponentsofthe5Emodel,andtheycanhelpMHDpatientstotakemorecontroloftheirhealthandavoidcomplicationsassociatedwithfluidoverload.

Furtherresearchisneededtoexploretheeffectivenessandfeasibilityofthisapproachindifferentsettingsandpopulations.Thisincludestheuseoftechnologytooptimizeoutcomesandimprovepatientengagement,aswellasthedevelopmentoftailoredinterventionsthataddresstheuniqueneedsandchallengesofMHDpatients.Withthecontinuedfocusonmultidisciplinarycare,education,andempowerment,wecanimprovethequalityoflifefo