Application and evaluation of structured symptom intervention program in patients with chronic kidney disease during peri-dialysis period

PENG Hongmei; PU Shi; WANG Min; LI Yang; HUANG Xia; ZHANG Youying; SHI Yu; ZHAO Rongrong

doi:10.16016/j.2097-0927.202507105

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Application and evaluation of structured symptom intervention program in patients with chronic kidney disease during peri-dialysis period

Clinical Medicine | 更新时间：2025-12-25

- Application and evaluation of structured symptom intervention program in patients with chronic kidney disease during peri-dialysis period
- Journal of Army Medical University Vol. 47, Issue 20, Pages: 2522-2531(2025)
- 作者机构：
  
  1.陆军军医大学（第三军医大学）护理系，重庆
  2.陆军军医大学（第三军医大学）第二附属医院：肾脏内科重庆
  3.陆军军医大学（第三军医大学）第二附属医院：护理教研室，重庆
- 作者简介：
- 基金信息：
  
  the Nursing Talent Construction Project of Second Affiliated Hospital of Army Medical University(2024HLRC15)
- DOI：10.16016/j.2097-0927.202507105
  CLC： R181.32;R473.5;R692.5
- Received：30 July 2025，
  
  Revised：2025-09-30，
  
  Accepted：05 October 2025，
  
  Published：30 October 2025
- 稿件说明：
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彭红梅，蒲诗，王敏，等.结构化症状干预方案在慢性肾脏病围透析期患者中的应用及评价［J］.陆军军医大学学报，2025，47（20）：2522-2531.DOI：10.16016/j.2097-0927.202507105.

PENG H M，PU S，WANG M，et al.Application and evaluation of structured symptom intervention program in patients with chronic kidney disease during peri-dialysis period［J］.J Army Med Univ，2025，47（20）：2522-2531.DOI：10.16016/j.2097-0927.202507105.
彭红梅，蒲诗，王敏，等.结构化症状干预方案在慢性肾脏病围透析期患者中的应用及评价［J］.陆军军医大学学报，2025，47（20）：2522-2531.DOI：10.16016/j.2097-0927.202507105. DOI：

PENG H M，PU S，WANG M，et al.Application and evaluation of structured symptom intervention program in patients with chronic kidney disease during peri-dialysis period［J］.J Army Med Univ，2025，47（20）：2522-2531.DOI：10.16016/j.2097-0927.202507105. DOI：

摘要

目的

评价结构化症状干预方案在慢性肾脏病围透析期患者中的应用效果。

方法

采用非同期对照研究设计，通过便利抽样法选取2024年4-9月在陆军军医大学第二附属医院肾脏内科门诊随访的151例CKD 5期非透析患者，根据患者就诊的时间阶段进行分组：2024年4-6月就诊的患者作为对照组（

=75），2024年7-9月就诊的患者作为试验组（

=76）。对照组实施常规症状干预（电话症状报告+健康教育）；试验组在常规症状干预基础上，应用涵盖症状识别、评估、干预、结局4个循证模块的结构化症状干预方案实施干预。干预前及干预3个月后评价效果：采用透析症状指数量表评估症状困扰程度及症状数量；采用健康调查简表（the MOS 36 Short Form Health Survey， SF-36）评估生活质量；比较2组患者干预后临床指标及终点事件差异。

结果

试验组症状困扰程度总分下降幅度显著大于对照组（

=0.021）；2组症状数量均较干预前减少（

0.001），但组间差异无统计学意义。试验组SF-36心理健康维度评分显著提升（

=0.004），且提升幅度大于对照组（

=0.033）。试验组血清前白蛋白水平高于对照组（

=0.019）；血清白蛋白浓度保持稳定，而对照组显著下降（

=0.035）。试验组终点事件发生率低于对照组（

=0.028）。

结论

结构化症状干预方案通过闭环式的症状干预模块实施干预，可有效缓解围透析期患者的症状困扰，改善心理健康状况，并降低短期内终点事件发生风险。

Abstract

Objective

To evaluate the application efficacy of structured symptom intervention program in patients with chronic kidney disease (CKD) during the peri-dialysis period.

Methods

A non-simultaneous control study was conducted on 151 peri-dialysis outpatients having not yet initiated dialysis and being followed up who were subjected with convenience sampling from Department of Nephrology of Second Affiliated Hospital of Army Medical University from April to September 2024. According to the time period of their visits

the patients who visited from April to June 2024 were assigned into a control group (

=75)

and those from July to September 2024 into an experimental group (

=76). The control group received conventional symptom intervention (telephone symptom re

porting + health education)

while the experimental group received the intervention as the control group and a structured symptom intervention program covering 4 evidence-based modules: symptom identification

assessment

intervention

and outcome. The efficacy of above treatments was evaluated before and at 3 months after intervention. Dialysis symptom index was used to assess the degree of symptom distress and the number of symptoms. MOS 36-Item Short Form Health Survey (SF-36) was employed to evaluate the quality of life. The differences in clinical indicators and endpoint events were compared between the 2 groups after intervention.

Results

The experimental group obtained more significant reduction in the total score of symptom distress than the control group (

=0.021). After intervention

the number of symptoms was decreased in both groups (

0.001)

but no statistical difference was observed between the groups. The score of mental health dimension in SF-36 was obviously improved in the experimental group (

=0.004)

which was notably better than that in the control group (

=0.033). The experimental group exhibited significantly higher prealbumin level than the control group (

=0.019)

and stable albumin level

which was significantly decreased in the control group (

=0.035). The incidence of endpoint events was remarkably lower in the experimental group than the control group (

=0.028).

Conclusion

The structured symptom intervention program implements intervention through a closed-loop symptom module

which can effectively alleviate the symptom distress of patients during the peri-dialysis period

improve mental health and reduce the short-term risk for endpoint events.

关键词

Keywords

references

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