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目的:探讨跨理论模型指导的321健康教育对血液透析患者的干预效果。方法:选取四川省攀枝花市中心医院2019年1—12月收治的血液透析患者107例，按照随机数字表法分为对照组53例和研究组54例。对照组患者采用常规健康教育方法进行宣教，研究组患者采用由跨理论模型指导的321健康教育。采用慢性病患者健康素养量表、中文版透析患者症状负担调查表（DFSSBI）、中文版肾脏疾病特异性调查表（KDQ）对干预前后2组患者健康素养水平、症状、患者生命质量进行评估。结果:干预后对照组慢性病患者健康素养量表总分和信息获取能力、交流互动能力、改善健康意愿3个维度的评分分别为（89.16 ± 11.04）、（32.62 ± 3.51）、（31.48 ± 3.61）、（16.85 ± 2.57）分，均低于研究组患者的（99.86 ± 11.46）、（35.92 ± 3.42）、（35.73 ± 3.92）、（19.96 ± 2.77）分，2组比较差异有统计学意义（n t值为-21.898~-4.925，均n P<0.01）。干预后对照组患者DFSSBI评分中总分、躯体症状、心理症状评分2个维度的评分分别为（56.39 ± 8.21）、（47.27 ± 6.85）、（9.12 ± 1.31）分，均高于研究组的（49.00 ± 6.31）、（41.81 ± 5.35）、（7.17 ± 0.95）分，2组比较差异有统计学意义（n t值为5.226、4.599、8.827，均n P<0.01）。干预后研究组患者入睡困难、乏力、皮肤干燥、瘙痒、口干症状发生率分别为38.89%（21/54）、38.89%（21/54）、27.78%（15/54）、27.78%（15/54）、25.93%（14/54），均低于对照组的66.04%（35/53）、62.26%（33/53）、49.06%（26/53）、49.06%（26/53）、45.28%（29/53），2组比较差异有统计学意义（n χ2值为5.124~9.224，均n P<0.05或0.01）；对照组患者的入睡困难、乏力、皮肤干燥、瘙痒、口干症状评分分别（7.44 ± 0.81）、（7.34 ± 0.72）、（7.42 ± 0.73）、（8.62 ± 0.72）、（7.82 ± 0.77）分，均高于研究组患者的（6.11 ± 0.65）、（6.02 ± 0.59）、（6.15 ± 0.61）、（7.12 ± 0.65）、（5.84 ± 0.51）分，差异有统计学意义（n t值为9.376~15.710，均n P<0.01）。干预后对照组KDQ总分和躯体症状、疲劳、抑郁3个维度的评分分别为（106.46 ± 13.39）、（23.87 ± 2.40）、（22.71 ± 2.67）、（22.52 ± 2.93）分，均低于研究组的（116.89 ± 14.59）、（27.12 ± 2.53）、（25.16 ± 2.82）、（27.12 ± 3.75）分，差异有统计学意义（n t值为-7.062~-3.851，均n P<0.01）。n 结论:对血液透析患者采用跨理论模型指导的321健康教育，可以提高患者健康素养，改善患者症状，降低患者症状负担评分，提高患者生命质量。“,”Objective:To explore the intervention effect of 321 health education guided by transtheoretical model on hemodialysis patients.Methods:A total of 107 cases of hemodialysis patients from January to December in 2019 in the Central Hospital of Panzhihua, Sichuan Province, were divided into a control group of 53 cases and a study group of 54 cases by table of random number. Patients in the control group received routine health education, and patients in the study group were intervened by 321 health education guided by transtheoretical model. The level of health literacy, symptoms, quality of life of patients in the two groups were evaluated by chronic disease patients health literacy scale, the Chinese version of Dialysis Frequency Severity and Symptom Burden Index (DFSSBI), and the Chinese version of Kidney Disease Questionnaire (KDQ) before and after the intervention.Results:After the intervention, the total score of the health literacy scale of patients with chronic diseases in the control group and the score of the three dimensions of information acquisition ability, communication and interaction ability, and willingness to be healthy were (89.16±11.04), (32.62±3.51), (31.48±3.61), (16.85±2.57), lower than those of the study group (99.86±11.46),(35.92±3.42),(35.73±3.92),(19.96±2.77), respectively, and the differences were statistically significant (n t values were -21.898--4.925, n P<0.01). After the intervention, the total score, physical symptom score and psychological symptom score of the two dimensions of DFSSBI in the control group were (56.39 ± 8.21), (47.27 ± 6.85), (9.12 ± 1.31),higher than those of the control group (49.00 ± 6.31), (41.81 ± 5.35), (7.17 ± 0.95),respectively, and the differences were statistically significant (n t values were 5.226, 4.599, 8.827, n P<0.01). After the intervention, the incidence of difficulty in falling asleep, fatigue, dry skin, itching, dry mouth in the study group were 38.89%(21/54), 38.89%(21/54), 27.78%(15/54), 27.78%(15/54), 25.93%(14/54), lower than those in the control group 66.04%(35/53), 62.26%(33/53), 49.06%(26/53), 49.06%(26/53), 45.28%(29/53), respectively, and the differences were statistically significant(χn 2 values were 5.124-9.224, n P<0.05 or <0.01). The symptom scores of difficulty in falling asleep, fatigue, dry skin, itching, dry mouth in the control group were (7.44 ± 0.81), (7.34 ± 0.72), (7.42 ± 0.73), (8.62 ± 0.72), (7.82 ± 0.77), higher than those in the study group(6.11 ± 0.65), (6.02 ± 0.59), (6.15 ± 0.61), (7.12 ± 0.65), (5.84 ± 0.51) respectively, and the differences were statistically significant (n t values were 9.376-15.710, n P<0.01). After the intervention, the total score of KDQ and the scores of physical symptoms, fatigue and depression in the control group were (106.46 ± 13.39), (23.87 ± 2.40), (22.71 ± 2.67), (22.52 ± 2.93), lower than those in the study group (116.89 ± 14.59), (27.12 ± 2.53), (25.16 ± 2.82), (27.12 ± 3.75), respectively, and the differences were statistically significant (n t values were -7.062--3.851, n P<0.01).n Conclusions:Intervention of 321 health education guided by transtheoretical model on hemodialysis patients can improve their health literacy and symptoms, reduce their symptom burden score and improve their quality of life.