Abstract:
Objective To investigate the effect of plan-do-check-action(PDCA) cycle management on blood pressure and quality of life in patients under maintenance hemodialysis(MHD) and complicated with hypertension. Methods Two hundred and twenty five MHD patients combined with hypertension were recruited from January 2017 to May 2018 and randomly divided into control group(n=113) and study group(n=112) by random number table. Patients in the control group received routine intervention and blood pressure control management, while the study group additionally adopted PDCA cycle management. After 12 months, the effects of different management methods on the quality of life, psychological state and blood pressure variability were evaluated, and the occurrence of complications was counted. Results There was no significant difference in sex, age, dialysis age and blood pressure between the two groups(P>0.05). After 6 months and 12 months of management, the variation coefficient of systolic and diastolic blood pressure(during dialysis and non dialysis period) and standard deviation in both groups were significantly decreased. Further more,the blood pressure variability index in the study group was significantly lower than that in the control group(P<0.05). After 12 months, life-quality-scores increased significantly in each section,including role-physical, physical functioning and social functioning,in both groups,which were even higher in the study group than in the control group(P<0.05). And the self-rating anxiety scale(SAS) and self-rating depression scale(SDS) scores of two groups decreased, with urea clearance index(Kt/V) and urea reduction rate(URR) increased significantly,which all better improved in the study group compared to the control group(P<0.05). During management period, the main complications were edema, infection, blockage of internal fistula and heart failure. The incidence of edema(5.45% vs 13.64%), infection(7.27% vs 15.45%), internal fistula(4.55% vs 10.91%) in the study group was significantly lower than that in the control group(P<0.05). Conclusion PDCA cycle management can effectively stabilize the blood pressure of MHD patients with hypertension and reduce the incidence of complications. Through that it can improve the psychological state, effect of dialysis and quality of life for the patients.