基于BCW理论的健康教育模式在癌痛患者中的应用效果研究

发布时间：2017-12-31 20:04

本文关键词：基于BCW理论的健康教育模式在癌痛患者中的应用效果研究　出处：《山东大学》2017年硕士论文　论文类型：学位论文

【摘要】：研究目的:以BCW(Behavior change wheel)理论为框架构建健康教育模式;探讨该模式在癌痛患者中的应用效果,以期为癌痛患者寻求有效的健康教育途径和方法。研究方法:本研究入组患者均为山东省某三级甲等医院肿瘤化疗科收治的66例癌痛患者,随机分组方法分为实验组和对照组,实验组患者采用了基于BCW理论构建的健康教育模式,对照组则给予常规的健康教育。应用一般资料问卷、疼痛控制障碍问卷(Barriers questionnaire,BQ-L)、疼痛数字评估量表(Numeric rating scale,NRS)、Morisky 服药依从性量表(the 8-item Morisky Medication Adherence Scale,MMAS-8)、中国癌症患者生活质量调查问卷(Quality of life questionnaire for Chinese cancer patients,QLQ)对研究对象进行调查。数据整理后应用SPSS17.0进行统计分析。研究结果:1.两组一般资料特征比较:年龄、性别、婚姻状况、文化程度、疾病类型、居住地、费用支付方式、疼痛部位、疼痛性质比较,其差异均无统计学意义(p0.05)。2.两组镇痛药使用情况比较:镇痛药用药种类及途径比较,两组差异均无统计学意义(p0.05)。3.疼痛强度得分比较(1)两组间干预前及干预后疼痛强度得分比较:干预前实验组疼痛强度得分3.39±1.13,对照组疼痛强度得分3.50±1.31,干预前两组疼痛强度得分比较,差异无统计学意义(t=-0.263,p0.05);干预后实验组疼痛强度得分2.30±0.67,对照组疼痛强度得分2.92±0.47,可见干预后实验组疼痛强度得分低于对照组,差异具有统计学意义(t=-3.091,p0.01)。(2)实验组干预前与干预后疼痛强度得分比较:实验组干预前疼痛强度评分为3.39±1.13,干预后疼痛强度评分则2.30士0.67,实验组干预后疼痛强度评分明显低于干预前评分,差异具有统计学意义(t=3.236,p0.05)。(3)对照组干预前与干预后疼痛强度得分比较:对照组干预前疼痛强度得分3.50± 1.31,干预后疼痛强度得分2.92±0.47,对照组干预后疼痛强度得分在数值上略低于干预前,但差异无统计学意义(t=1.364,p0.05)。4.镇痛药物服药依从性比较(1)两组间干预前及干预后镇痛药服药依从性得分比较:干预前实验组镇痛药物服药依从性得分5.64± 1.37,对照组镇痛药物服药依从性得分5.38± 1.39,干预前两组服药依从性等级均为低,两组服药依从性得分差异无统计学意义(t=0.766,p0.05);干预后实验组服药依从性得分6.96±0.83,依从性等级中等,对照组服药依从性得分5.48±1.06,依从性等级低,干预后实验组服药依从性得分明显高于对照组,差异有统计学意义(t=4.737,p0.001)。(2)实验组干预前与干预后镇痛药服药依从性得分比较:实验组干预前镇痛药服药依从性得分5.64± 1.37,得分为8分、依从性高的有3例(9.09%);得分6-7分、依从性中等的有16例(48.48%);得分6分、依从性低的有14例(42.43%)。干预后得分6.96±0.83,得分为8分、依从性高的有13例(39.39%);得分6-7分、依从性中等的有17例(51.52%);得分6分、依从性低的有3例(9.09%)。实验组干预后的服药依从性得分明显高于干预前,差异有统计学意义(t=4.737,p0.001)。(3)对照组干预前与干预后镇痛药服药依从性得分比较:对照组干预前镇痛药服药依从性得分5.38 ± 1.39,干预后镇痛药服药依从性得分5.48±1.06,对照组干预前及干预后镇痛药服药依从性得分的比较,差异无统计学意义(t=-0.117,p0.05)。5.生活质量得分比较(1)两组间干预前及干预后生活质量得分比较:干预前实验组生活质量得分45.16±6.23,对照组生活质量得分则为42.94±5.65,干预前两组间生活质量得分的比较差异无统计学意义(t=0.307,p0.05)。干预后实验组的生活质量得分45.72±5.86,对照组生活质量的得分42.31 ±7.54,干预后两组生活质量得分比较,差异无统计学意义(t=0.310,p0.05)。(2)实验组干预前与干预后的生活质量得分比较:实验组生活质量干预前得分45.16±6.23,干预后生活质量得分45.72±5.86,实验组干预前与干预后的生活质量得分差异无统计学意义(t=0.970,p0.05)。(3)对照组干预前与干预后的生活质量得分比较:对照组干预前生活质量得分42.94±5.65,干预后生活质量得分42.31 ±7.54,对照组干预前与干预后生活质量得分差异无统计学意义(t=1.872,p0.05)。结论:1.基于BCW理论的健康教育模式能够降低癌痛患者的疼痛强度。2.基于BCW理论的健康教育模式能够提高癌痛患者的服药依从性。3.基于BCW理论的健康教育模式对癌痛患者的生活质量无显著影响。
[Abstract]:Objective: To study the BCW (Behavior change wheel) theory to construct the model of health education for the framework; explore the application effect of the model in cancer patients, in order to seek the effective ways and methods of health education for cancer patients. Methods: This study enrolled patients were 66 cases of cancer patients chemotherapy Department of Shandong Province three grade a hospital, randomly divided into experimental group and control group, experimental group were treated by the mode of health education based on the theory of BCW, the control group were given routine health education. With the general information questionnaire, pain control questionnaire (Barriers questionnaire, BQ-L disorder), digital pain assessment scale (Numeric rating scale, NRS Morisky), medication adherence scale (the 8-item Morisky Medication Adherence Scale, MMAS-8), China cancer patients quality of life questionnaire (Quality of life questionnaire fo R Chinese cancer patients, QLQ) were used to investigate the study object. After finishing the SPSS17.0 application data for statistical analysis. Results: comparison of 1. general data of the two groups characteristics: age, marital status, gender, educational level, disease type, residence, payment, pain, pain in nature, the difference was not statistically the significance of.2. (P0.05) two groups using analgesics: comparing analgesic drug types and ways, the differences between the two groups were not statistically significant (P0.05).3. (1) pain intensity scores were compared between the two groups before and after intervention of pain intensity score: before the intervention the experimental group pain intensity score 3.39 + 1.13, control group pain intensity score of 3.50 + 1.31, two groups of pain intensity scores before intervention, the difference was not statistically significant (t=-0.263, P0.05); the intervention group pain intensity score 2.30 + 0.67, the control group pain intensity score 2.92 + 0 .47, the experimental group after the intervention of pain intensity scores than the control group, the difference was statistically significant (t=-3.091, P0.01). (2) compared with the intervention of pain intensity score of the experimental group before the intervention: the experimental group before the intervention of pain intensity score was 3.39 + 1.13, the intervention of pain intensity score is 2.30 + 0.67, the experimental group did prognostic score pain intensity score was significantly lower than that before the intervention, the difference was statistically significant (t=3.236, P0.05). (3) the control group before and after intervention of pain intensity scores: control group before intervention pain intensity score 3.50 + 1.31, the intervention of pain intensity score 2.92 + 0.47, the control group after the intervention of pain intensity score in the numerical slightly lower than before the intervention, but the difference was not statistically significant (t=1.364, P0.05).4. analgesic drug compliance comparison (1) analgesic medication compliance scores were compared between the two groups before and after intervention: before the intervention the experimental group analgesic Material compliance score of 5.64 + 1.37, the control group analgesic medication compliance score of 5.38 + 1.39, the two groups before the intervention compliance levels are low, the two groups had no statistically significant difference in the compliance score (t=0.766, P0.05); the intervention group compliance score 6.96 + 0.83, compliance level medium control group compliance score 5.48 + 1.06, the compliance level is low, the intervention group compliance score significantly higher than the control group, the difference was statistically significant (t=4.737, p0.001). (2) the experimental group before and after intervention analgesic medication compliance score comparison: the experimental group intervention analgesia medicine the compliance score of 5.64 + 1.37, a score of 8 points, high compliance of the 3 cases (9.09%); score 6-7, compliance of the middle 16 cases (48.48%); a score of 6, low compliance of the 14 cases (42.43%). The intervention score of 6.96 + 0.83, a score of 8 divided, compliance High in 13 cases (39.39%); score 6-7, compliance of the middle 17 cases (51.52%); a score of 6, low compliance of the 3 cases (9.09%). The experimental group intervention compliance score was significantly higher than that before intervention, the difference was statistically significant (t=4.737, p0.001). (3) the control group before and after intervention analgesic medication compliance score: the control group and intervention analgesia medication adherence score 5.38 + 1.39, after the intervention of analgesic medication compliance score of 5.48 + 1.06, compare the analgesic medication compliance score of the control group before and after the intervention, the difference was not statistically significant (t=-0.117, P0.05).5. quality of life scores (1) compared the scores of quality of life between the two groups before and after intervention in experimental group before the intervention: quality of life score 45.16 + 6.23, the control group quality of life score was 42.94 + 5.65, the difference between the two groups of quality of life score before the intervention without statistics Learn the meaning of (t=0.307, P0.05). The score of quality of life in the experimental group after 45.72 + 5.86, the control group quality of life score 42.31 + 7.54, compared with two groups of quality of life scores after the intervention, the difference was not statistically significant (t=0.310, P0.05). (2) compared with the quality of life score of the intervention group before intervention the quality of life before the intervention group: experimental score of 45.16 + 6.23, intervention, quality of life score 45.72 + 5.86, and the intervention of quality of life score was no significant difference between the experimental group before intervention (t=0.970, P0.05). (3) the control group before the intervention and the quality of life score after the intervention: the control group before the intervention of quality of life score 42.94 + 5.65, the intervention of quality of life score 42.31 + 7.54, and after the intervention, life quality score was no significant difference in control group before intervention (t=1.872, P0.05). Conclusion: 1. BCW theory of health education mode can reduce cancer patients based on Pain intensity.2. BCW based health education mode can improve the medication adherence of cancer patients..3. based on BCW theory of health education has no significant effect on the quality of life of cancer patients.

【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.73

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