【摘要】目的探讨基于自我决定理论的护理干预对维持性血液透析患者居家运动行为的影响，提高维持性血液透析患者居家运动水平。方法选择2020 年8月～12月在湖州市第一人民医院血液透析中心规律进行透析的72例患者，对照组采用常规的护理，试验组采用基于自我决定理论的护理干预。4个月后比较2组患者居家运动行为阶段、运动自我效能、6分钟步行试验(six minute walk test，6MWT)及生活质量指标。结果干预后，2组患者居家运动行为阶段均有不同程度改善，试验组居家规律运动率由38.9%提高到72.2%，对照组由41.7%提高到为44.4%，干预后试验组优于对照组(Z=-1.971,P=0.049)；试验组患者运动自我效能、生活质量评分优于对照组(t=3.382,P=0.001；t=3.504,P=0.001)，6MWT 无统计学差异(t=1.925,P=0.058)。结论基于自我决定理论的护理干预可以提高维持性血液透析患者的运动自我效能，改善患者居家运动水平，提高患者的生活质量。

【Abstract】Objective To explore the effect of nursing intervention based on self-determination theory on the exercise behavior at home in maintenance hemodialysis (MHD) patients, in order to improve the home exercise strength in these patients. Methods A total of 72 MHD patients treated in the Hemodialysis Center of Huzhou First People's Hospital during August 2020 to December 2020 were enrolled in this study. They were divided into control group in which patients were given routine nursing and experiment group in which patients were treated with self-determination theory- based nursing intervention. After the intervention for 4 months, home exercise behavior stage, exercise self-efficacy (ESE), six-minute walk test (6MWT) and Kidney Disease Questionnaire (KDQ) were compared between the two groups. Results Home exercise behavior stage after the intervention improved in both groups, with the rate of regular exercise at home from 38.9% to 72.2% in experiment group better than that from 41.7% to 44.4% in control group (Z=-1.971, P=0.049). The scores of ESE and KDQ were better in experiment group than in control group (t=3.382, P=0.001; t=3.504, P=0.001), but 6MWT had no statistical difference between the two groups (t=1.925, P=0.058). Conclusion Nursing intervention based on self- determination theory increased the ESE, improve the exercise level at
home, and promoted the quality of life in MHD patients.