【摘要】目的探讨应用跨理论模型指导维持性血液透析患者规律运动对其生活质量的影响。方法数字随机法将入选的62 例长期血液透析患者分为试验组和对照组。对照组予以常规运动健康指导，试验组以跨理论模型为基础的健康指导，记录0、6 个月后2 组患者的规律运动、体能、血红蛋白、血清白蛋白等指标以及健康状况调查量表SF-36 的分数。结果以跨理论模型为指导，2 组患者在规律运动方面，指导前无统计学差异(t=0.069,P=0.793)，指导后存在统计学差异(t=5.391, P=0.002)；正常步速、最大步速提高有统计学意义(t=2.021, 2.870；P=0.046, 0.006)；血红蛋白、血清白蛋白的改善有统计学意义(t=3.741, 4.587；P=0.024, 0.018)；生活质量调查表(SF-36)中总体健康、精神健康、情感职能、社会功能、活力、躯体疼痛、生理功能、生理职能分数较对照组差异有统计学差异(t 值分别为3.698,4.325,10.362,2.946,3.498,4.264,3.026,4.125，P 值分别为0.025，0.019，＜0.001，0.045，0.027，0.012，0.031，0.015)。结论基于跨理论模型的健康指导可以提高MHD 患者的生活质量，值得在临床推广。

【Abstract】Objective To explore the effect of regular exercise guided by cross- theoretical model (CTM) on quality of life in maintenance hemodialysis (MHD) patients. Methods Sixty-two MHD patients were randomly divided into experimental group and control group. The control group was given routine exercise health guidance, and the experimental group was given the CTM-based health guidance. Regular exercise, physical fitness, hemoglobin, serum albumin and other indicators as well as SF-36 score of health status survey at baseline and after the treatment for 6 months were recorded. Results Regular exercise
had no statistical difference at baseline status between the two groups (t=0.069, P=0.793), but became different after the treatment (t=5.391, P=0.002). The improvement of normal walking speed, maximum stride speed, hemoglobin and serum albumin were statistically significant (t=2.021, 2.870, 3.741 and 4.587 respectively; P=0.046, 0.006, 0.024 and 0.018 respectively). The scores of overall health, mental health, emotional function, social function, energy, body pain, physiological function, physiological function in the SF-36 survey were statistically different (t=3.698, 4.325, 10.362, 2.946, 3.498, 4.264, 3.026 and
4.125 respectively; P=0.025, 0.019, ＜0.001, 0.045, 0.027, 0.012, 0.031 and 0.015 respectively). Conclusion Health guidance based on CTM can improve the quality of life of MHD patients, which is worthwhile to be used in clinical practice.