健康教育对学龄期哮喘病患儿的干预效果研究

发布时间：2018-01-29 23:21

本文关键词： 健康教育哮喘病学龄期儿童干预研究　出处：《山东大学》2017年硕士论文　论文类型：学位论文

【摘要】：研究背景:支气管哮喘(bronchial asthma)也可称之为哮喘,作为临床中较为多发且具典型的气道慢性炎性异常反应症状疾病,该病症多由机体T淋巴细胞、嗜酸性粒细胞、中性粒细胞以及气道上皮细胞组共同作用炎性炎性因子所致;可导致患者表现出胸闷、气喘、多咳嗽或喘息不止等症状[1],加之这类病症发作反复性、难以控制或根治,造成患儿长期机体、心理、生活以及学习等活动受阻,产生极大的影响;并且这类病症患儿中约有30～50%中重度哮喘可延展伴随患儿发育成长,有着极高的概率进展为肺心病风险,这对哮喘患儿家庭日常生活带来严重性干扰,同时也加重社会负担。研究目的:为进一步研究探析哮喘患儿后期治疗过程中自我护理能力对疾病防控的作用,本文结合现代医学教育理念增强患儿对疾病相关知识认知能力,目的在于提高患儿后期自我护理能力,降低病患后期哮喘发作频率及痛苦,增强患儿病情稳定性,最终提高病患生活质量,改善机体健康状况。资料与方法:采取回顾性分析研究模式,选取本院2015年1月～2015年10月期间收治的哮喘病患儿91例作为研究对象,按照病患儿就诊时间数字编号分配,患儿及家属知情同意,按照治疗干预指导的差异性设置为两组,均采取全国儿科哮喘防治协作组制定的支气管哮喘规范化治疗方案给予哮喘治疗控制,其中对照组45例,在治疗期间仅单纯应用辅舒酮(EP)气雾剂治疗,并在哮喘发作期间加用支气管扩张剂治疗,给予基本护理知识指导;观察组46例,在规范化治疗护理基础之上进行有组织、有计划,符合患儿心理特点的实施系统全面的健康教育,注重转变过去传统的健康知识灌输式教学模式转换为当前广泛应用的"以人为本"患者为中心科学的个体化教育理念,护理人员在教育过程加强哮喘患儿心理干预护理,提高生理营养、功能、环境支持,给予全面细致用药指导,通过完善健康知识教育以及日常生活护理进行综合性护理服务;所有患儿均定期随访观察12个月,结合本院自制"哮喘疾病知识掌握情况调查表患儿自我正确认识哮喘基本知识掌握情况,利用德国百瑞公司生产的多功能电脑呼吸功能超声仪监测两组患儿护理治疗前后FEV1和PEF占预计值%;记录患儿治疗周期内哮喘发作频率,急诊救治次数;最后依据1998年全国儿科哮喘防治协作组制定的支气管哮喘疗效标准评估两组患儿治疗护理疗效。将数据纳入SPSS19.0统计软件中进行组间对比分析。主要结果:①观察组患儿在12项自我正确认识哮喘基本知识掌握水平均明显高于常规治疗对照组患儿,其观察组患儿经过健康教育后,自我正确认识哮喘基本知识水平合格率基本达到80%以上,然而对照组患儿仅3项哮喘治疗基本知识项目评估达到合格,两组对比(P0.05)差异性明显有统计学意义。②观察组患儿在哮喘病情控制质量显著高于对照组,其观察组显效24例,有效19例,无效3例,治疗总有效率达到93.48%,对照组患儿显效18例,有效13例,无效14例,治疗总有效率为68.89%,对比差异性明显(P0.05)有统计学意义。③通过细致全面护理治疗以及完善的健康教育后,观察组患儿肺功能指标FEV1与PEF占预计值好转效果均明显优于对照组,两组对比差异性明显有统计学意义(P0.05)。④采取系统全面健康教育护理的观察组患儿在自我护理能力方面明显优于常规治疗的对照组,其观察组患儿正确使用MDI、注意预防诱发因素、正确使用峰流速仪、急性发作的应急措施、何时到医院就诊、记录哮喘日记、门诊定期复诊等自我护理知晓率明显高于对照组,差异有统计学意义((P0.05)。⑤观察组患儿在系统全面健康教育指导下有效提高自我管理能力,在持续自我护理12个月期间哮喘发作频率、急诊次数以及缺课天数均明显少于对照组,(P0.05)差异有统计学意义。结论与对策建议:①健康教育的开展可有效提升哮喘患儿对自身病情的认知能力;②健康教育可促进肺功能指标改善,提高哮喘防治能力;③健康教育增强哮喘患儿对疾病的防护效果,增强哮喘病症后期稳定性,减少反复的可能性;④健康教育可提高哮喘患儿自我护理能力,提高哮喘症状控制防护质量,减少哮喘症状对于患儿日常生活的影响。良好优质的健康教育增加患儿对自身疾病的认知能力,提高哮喘病情监测何发病可控性,提升哮喘发作预防效果,通过优质的自我护理对患儿心理情绪进行稳定,患儿注意预防诱发因素,自我坚持治疗和记录哮喘日记,养成良好自我护理习惯,改善患儿后期生活质量。
[Abstract]:Background: bronchial asthma (bronchial asthma) can also be called as asthma, chronic inflammatory airway disease abnormal reaction in clinical symptoms are multiple and typical of the disease from the body of T lymphocytes, eosinophils, neutrophils and bronchial epithelial cells group interaction induced inflammatory inflammatory factor can cause; the patients showed chest tightness, shortness of breath, cough or wheeze symptoms such as [1], and this kind of repeated seizures, difficult to control or cure, cause children long body, psychological, life and learning activities by resistance, greatly influence; and this kind of disease in children is about 30 ~ 50% in severe with the growth of children with asthma can be extended, with the progress of high probability for pulmonary heart disease risk, the families of children with asthma in daily life caused serious interference, but also increases the social burden. The purpose of the study is to enter a Effect of self-care ability of children with asthma treatment of late in the process of disease prevention and control, combined with modern medical education to enhance children disease related knowledge cognitive ability, aims to improve the self-care ability of children with late, reduce patients of asthma later as frequency and pain, enhance the stability of children with the disease, and ultimately improve patient quality of life and improve the health status of the body. Materials and methods: a retrospective analysis research model, in our hospital from January 2015 to October 2015 were treated 91 cases of children with asthma as the research object, in accordance with the treatment time in patients with number distribution of children and their families informed consent, in accordance with the set difference intervention guidance into two groups, adopt standard bronchial asthma treatment national pediatric asthma collaborative group for treatment of asthma control, the control group 45 Patients during treatment is only the simple application of flixotide aerosol therapy (EP), and during an asthma attack with bronchodilator treatment, given the basic knowledge of nursing; the observation group of 46 cases, the standardized treatment and nursing on the basis of organized, planned, in accordance with the implementation of health education system of children psychological characteristics overall, pay attention to change the past health knowledge of the traditional teaching mode to the widely used "people-oriented" with individual education center for science, nursing staff to strengthen psychological nursing intervention in children with asthma in the process of education, improve the physiological function, nutrition, environment support, give a comprehensive and detailed medication guide, through the improvement of health knowledge education and daily life nursing comprehensive nursing service; all patients were regularly followed up for 12 months, with the self-made "adjustment of asthma disease knowledge The look-up table with the correct understanding of the basic knowledge of asthma self mastery, the use of multi function computer respiratory function before and after ultrasound monitoring pari production of two groups of children with nursing care in the treatment of FEV1 and PEF% of expected value; recording period of treatment in children with asthma attack frequency, the number of emergency treatment; according to standard of bronchial asthma in 1998 to develop national pediatric asthma group assessment of treatment in the two groups. The curative effect of nursing data into the SPSS19.0 software were compared between groups. Results: the observation group in the 12 self to understand the basic knowledge of asthma control level were significantly higher than that of the conventional treatment control group, the observation group after health education, the correct understanding of the self the basic level of knowledge of asthma qualification rate reached over 80%, while the control group were only 3 basic knowledge of asthma treatment project evaluation Assessment of qualified, two group comparison (P0.05) difference was statistically significant. The observation group in the quality control of asthma was significantly higher than the control group, the observation group 24 cases, 19 cases were effective, 3 cases ineffective, the total efficiency of the treatment of 93.48% patients in the control group, 18 cases markedly effective in 13 cases. 14 cases were invalid, the total effective rate was 68.89%, the differences were statistically significant (P0.05). Through the comprehensive treatment and nursing health education improve after the observation of FEV1 and PEF group with lung function index% predicted better effect was significantly better than the control group, the differences between the two groups was statistically significant (P0.05). The control group observation group with comprehensive and systematic health education and nursing on self-care ability is superior to conventional treatment, the observation group with the use of MDI correctly, pay attention to the prevention of the induced factors, the correct use of peak flow Instrument, emergency measures of acute attack, when to go to the hospital, recording the asthma diary, self nursing outpatient regular follow-up visits awareness rate was significantly higher than the control group, the difference was statistically significant ((P0.05). The observation group in the comprehensive health education guidance improve the self management ability in continuous self care during the period of the 12 April asthma attack frequency, the number of emergency and missed school days were significantly less than the control group (P0.05), the difference was statistically significant. Conclusions and suggestions: 1. Health education can effectively improve asthma disease on their cognitive ability; health education can promote the improvement of lung function, improve the ability of prevention and treatment of asthma and health; enhance the education of children with asthma has protective effect on the disease, asthma later enhanced stability, reduce the possibility of repeated; health education can improve the self-care ability of children with asthma, improve The symptoms of asthma control and protection of the quality, reduce the impact of asthma symptoms in children's daily life. Good health education quality increase children on their disease cognitive ability, improve asthma monitoring where the incidence of asthma control, enhance the preventive effect, through self nursing on children with mental and emotional stability quality, pay attention to the prevention of children with predisposing factors. Self adhere to treatment and record the asthma diary, develop good habits of self care, improve the quality of life of children later.

【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】：R473.72

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