【摘要】目的探讨感恩拓延-建构理论疗法对腹膜透析患者不良情绪及自我管理的影响。方法纳入陆军军医大学大坪医院腹膜透析中心108 名腹膜透析患者，随机分成研究组和对照组。2 组患者均接受相同的标准治疗方案、饮食指导和常规活动指导建议。采用随机配对分组，对照组采用传统宣教模式；研究组在传统宣教模式基础上增加感恩拓延-建构理论疗法。入组后0、3、6、12 月采用焦虑自评量表(self-rating anxiety scale，SAS)、抑郁自评量表(self-rating depression scale,SDS)、感恩问卷(the gratitude questionnaire-six item form，GQ-6)和腹膜透析患者自我管理行为量表进行评分。结果入组前2 组患者的SAS 评分(t=-0.742, P=0.518)和SDS 评分(t=-0.862,P =0.721)统计学无明显差异。入组后3、6、12 月研究组的SAS 评分(t=-1.792, P=0.042；t= -2.852,P=0.029；t= -3.221,P＜0.001)和SDS 评分(t=-1.781,P =0.046；t=-2.921,P =0.012；t=-3.111, P =0.007)均低于对照组；入组后3、6、12 月研究组的GQ-6 评分均高于对照组(t=-1.981,P=0.021; t=-3.321, P=0.007；t=-4.011,P=0.001)；入组后12 月研究组的SMSPD 评分中换液护理(t=2.962, P=0.004)、出口护理(t=2.835, P=0.006)、导管护理(t=2.813, P=0.007)、导管护理(t=2.813, P= 0.007)、遵医嘱服降压药(t=2.549, P=0.040)、遵医嘱服降磷药(t=2.922, P=0.005)、蛋白质摄入(t=2.853, P= 0.007)、体质量(t=3.116,P=0.003)、超滤量(t=2.911, P=0.005)和并发症(t=2.647,P=0.022)均高于对照组。结论感恩拓延-建构理论疗法能够改善腹膜透析患者不良情绪，提高自我管理能力，具有一定的临床意义和现实意义。

【Abstract】Objective To explore the effect of gratitude extension-construction theory therapy on adverse mood and self-management in patients with peritoneal dialysis (PD). Methods A total of 108 PD patients in our center were randomly divided into a study group and a control group. Both groups of patients received the same standard treatment regimens, dietary guidance, and routine activity guidance recommendations. The groups were randomly matched; the control group used the traditional missionary model, and the study group added gratitude extension-construction theory therapy based on the traditional missionary model. The anxiety scale, depression scale, gratitude questionnaire (GQ-6) and self-management behavior scale for PD patients were used at 0-12 months after check-in. Results There were no significant differences in Self-rating Anxiety
Scale(SAS) scores(t=-0.742, P=0.518) and Self-rating Depression Scale(SDS) scores (t=-0.862, P=0.721) in the control and study groups before enrollment. The SAS scores (t=- 1.792, P=0.042; t=- 2.852, P=0.029; t=- 3.221,P＜0.01) and SDS scores (t=- 1.781,P=0.046;t=- 2.921, P=0.012;t=- 3.111, P=0.007) in the study group were significantly lower than those in the control group 3, 6 and 12 months after enrollment. The GQ-6 scores of the study group were significantly higher than those of the control group after admission (t=-1.981, P=0.021; t=- 3.321, P=0.007; t=- 4.011, P=0.001). After enrollment for 12 months, the SMSPD scores of fluid change nursing (t=2.962,P=0.004), exit nursing (t=2.835,P=0.006), catheter nursing (t=2.813, P=0.007), taking antihypertensive drugs as prescribed by the doctor (t=2.549,P=0.040), taking phosphate-reducing drugs as prescribed by the doctor (t=2.922,P=0.005), protein intake(t=2.853,P=0.007), body weight (t=3.116,P=0.003),
ultrafiltration volume(t=2.911,P=0.005), and complications (t=2.647, P=0.022) in the study group were higher than those in the control group. Conclusion Gratitude extension-construction theory therapy can improve the adverse mood and the self-management ability of PD patients, which has certain clinical significance and practical significance.