全程健康教育在银屑病防治中的应用

发布时间：2018-01-05 23:23

本文关键词：全程健康教育在银屑病防治中的应用　出处：《新乡医学院》2015年硕士论文　论文类型：学位论文

【摘要】：银屑病是一种常见的红斑鳞屑性皮肤病,病因与多基因遗传有关,且受多种因素如外伤,感染、药物或不健康的生活习惯等影响,其特征是慢性,加重和缓解反复交替发作,使患者身心俱疲,严重影响患者的生活质量。由于患者对疾病认识的有限,在治疗过程中不能正确使用药物,或者滥用药物过度治疗,导致治疗难度增加,甚至.治疗失败,也给患者带来了沉重的经济负担。因此,对银屑病患者进行全程健康教育,可以提高治疗疗效,降低复发率,同时让患者了解到自我管理疾病的方法,提高其生活质量。目的对银屑病患者进行健康教育指导,从治疗疗效、复发率、心理状态及生活质量等多方面的改变与对照组对比,评价银屑病全程健康教育的效果。试图探索科学有效经济的适合银屑病患者的健康教育模式,并拟为在社区推广银屑病及其他慢性皮肤病健康教育提供参考依据。方法选取来我院就诊的寻常型银屑病患者共392例,分为强化管理组(研究组)200例和对照组192例。入组时,全面收集二组患者的基本信息,包括患者性别、年龄、受教育程度、职业、患病时间、既往史、家族史等,对患者的皮损面积和严重程度指数(PASI)进行评分,并由患者逐一填写症状自评量表(SCL-90)、焦虑自评量表(SAS)、抑郁自评量表(SDS)及皮肤病生活质量指数表(DLQI),建立健康档案。其次,二组患者均采用维生素D3类似物(卡泊三醇)外用治疗方案,监测4周、8周、12周后的皮损改善情况,填写PASI评分表,并进行统计学分析,评价二组患者的治疗疗效。另对研究组患者进行教育前评估,了解患者对疾病的认知情况、对疾病知识的渴望程度、日常饮食习惯及生活方式,实施为期12个月的健康教育,指导其正确使用药物,加强日常皮肤护理,并同时跟踪检测及随访,进行适当的心理疏导。健康教育后再次让二组患者填写SCL-90、SAS、SDS、DLQI表,并了解患者的皮损有无复发,对数据进行统计学分析,评价健康教育干预前后二组患者的复发率、心理症状、生活质量是否发生差异性改变,改变量多少。结果对二组患者治疗4周、8周、12周后有效率的比较,治疗4周、8周、12周后其有效率高于对照组,P0.05对比差异有统计学意义；跟踪随访12个月后二组复发率的比较,研究组明显低于对照组,P0.05对比差异有统计学意义；研究组患者前后心理状态测评中躯体化、抑郁、焦虑、敌对得分,抑郁自评量表得分,焦虑自评量表得分较接受健康教育指导前有明显改善,且改善优于对照组,P0.05差异有统计学意义；研究组患者前后皮肤病生活质量指数得分较接受健康教育指导前有明显下降,P0.05差异有统计学意义。结论：本课题通过对研究组银屑病患者开展健康教育,使其加深对银屑病相关知识的理解认识,树立正确对待疾病的态度,规范合理使用药物治疗,养成良好的饮食习惯和生活方式,规避患病风险,从而有效的提高了本病的治疗疗效,降低了复发率,延长疾病的缓解期,促进患者的心理健康,提高其生活质量。通过对患者心理、行为、生活方式等方面的干预,为银屑病的治疗提供了一种廉价、适用的辅助方法,同时增加了医患之间的沟通交流,创建良好的就医环境,构建和谐就医模式,值得进一步的研究和更广泛的推广。
[Abstract]:Psoriasis is a common erythematous scaly skin disease, etiology and genetic, and is affected by many factors such as trauma, infection, drugs or unhealthy habits and so on, which is characterized by chronic, aggravating and relieving alternately repeatedly attack, make fatigued patients, seriously affect the quality of life of patients. Because of the limited knowledge on the disease in patients, not the proper use of drugs in the course of treatment, drug abuse or excessive treatment, resulting in the difficulty of treatment increased. Even treatment failure, also give patients bring heavy economic burden. Therefore, the whole health education to patients with psoriasis, can improve the curative effect, reduce the recurrence rate. At the same time, so that patients understand the disease self-management method, improve their quality of life. The purpose of health education on the patients with psoriasis, the recurrence rate in treatment, and psychological status and quality of life etc. The change compared with the control group, the health education effect evaluation of psoriasis. To explore the scientific and effective economy for health education in patients with psoriasis, and to provide reference for promotion in the community of psoriasis and other chronic skin disease health education. A total of 392 cases in our hospital for treatment of patients with psoriasis vulgaris were divided into methods. Strengthen the management group (Study Group) 200 cases and 192 cases in the control group. In this group, a comprehensive collection of two groups of patients with basic information, including gender, age, education, occupation, duration of illness, past history, family history, for patients with psoriasis area and severity index (PASI) of the score, and by the patient by completing the symptom checklist (SCL-90), self rating Anxiety Scale (SAS), self rating Depression Scale (SDS) and dermatology life quality index (DLQI), the establishment of health records. Secondly, two groups of patients were treated with vitamin D3 analogues (capobenic three alcohol) topical treatment, monitoring for 4 weeks, 8 weeks, 12 weeks after the improvement of skin lesions, PASI score sheet, and statistical analysis, evaluation of curative effect in the treatment of two groups of patients. The other patients in the study group to evaluate education before patients understand the cognition of the disease. For a degree of knowledge of disease, diet habits and life style, the implementation of health education for 12 months, guide the drug use correctly, strengthen the daily skin care, and at the same time tracking detection and follow-up of appropriate psychological counseling. After health education once again asked two groups of patients completed the SCL-90, SAS, SDS, DLQI, and understand the skin lesions of patients with recurrence, the statistical analysis of the data, psychological symptoms of two groups of patients with recurrence, evaluated before and after health education intervention, quality of life whether there are differences in changes, changes in quantity. The results of two groups of patients 4 Week, 8 weeks, 12 weeks after the comparison of efficiency, for 4 weeks, 8 weeks, 12 weeks after its efficiency was higher than the control group, P0.05 was statistically significant differences between the two groups; the recurrence rate of follow-up after 12 months, the study group was significantly lower than the control group, was statistically significant difference P0.05 study group of patients before and after the body; mental state evaluation, depression, anxiety, hostility score, self rating Depression Scale score, self rating Anxiety Scale scores than the accepted health education before have significantly improved and better than the control group, there were significant differences in P0.05; the research group of patients before and after the dermatology life quality index score is accepted health education before decreased significantly, there were significant differences in P0.05. Conclusion: this topic through to carry out health education research group of patients with psoriasis, which deepen the understanding of knowledge related to psoriasis, establish the correct treatment. Disease attitude, normative and rational use of drugs, to develop good eating habits and lifestyle, to avoid the risk, thus effectively improve the curative effect of the treatment of the disease, reduce the recurrence rate, prolong disease remission, promote the patient's mental health, improve their quality of life. The behavior of patients, psychological aspects lifestyle intervention for the treatment of psoriasis provides a cheap, auxiliary applicable method, but also increase the doctor-patient communication, create a good medical environment, building a harmonious medical model, it is worthy of further research and more widely.

【学位授予单位】：新乡医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R473.75

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