“知信行模式”健康教育对肝硬化患者生活质量的影响分析

发布时间：2018-03-19 06:17

本文选题：知信行模式　切入点：健康教育　出处：《山东大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的通过对肝硬化患者疾病相关知识、信念、行为状况进行调查,结合健康教育"知信行模式"理论框架,制定"知信行"模式健康教育路径表,对肝硬化患者开展系统化、个性化的健康教育。探讨KAP模式对肝硬化患者并发症发生率、生活质量及护理满意度的影响。对干预方案的有效性进行验证,并为改善肝硬化患者的生活质量及护理水平提供理论依据。方法采用方便抽样的方法。选取2016年5至9月山东省某三甲医院消化科两个病区共121例肝硬化患者为研究对象。采用一般资料问卷、生活质量评价量表(SF-36)、肝硬化患者知信行问卷、满意度调查问卷等对患者进行调查。比较两组患者知信行得分、生活质量水平、并发症的发生率及护理满意度等。运用SPSS17.0软件进行数据录入与分析,具体包括:描述性统计分析、χ2检验、t检验。结果纳入本次研究的患者共121名,对照组失访1例,失访原因为患者死亡。最终完成研究的患者共120例。对照组与干预组各60例。两组患者在性别、年龄、婚姻状况、文化程度、人均月收入、职业、肝硬化Child分级等方面,比较均无统计学差异(P0.05)。具体结果如下:1.两组患者在干预前对肝硬化知识、信念、行为方面及总分均处于较低水平,大多数患者及家属对肝硬化的发生、防护等缺乏认知,两组比较无统计学差异,(P0.05)。干预后,干预组知信行各维度得分及总分均优于对照组。差异有统计学意义(P0.05)。2.干预前:两组患者生活质量总分及各维度得分、躯体健康、精神健康总评分,比较均无统计学意义(P0.05)。干预后,对照组及干预组患者生活质量总分分别为(62.61 ± 14.37)、(72.15±14.21)分;躯体健康总评分分别为(55.55± 13.32)、(70.09± 13.47)分;精神健康总评分分别为(52.69± 17.51)、(74.21 ±18.46)分,差异均有统计学意义(P0.01)。干预组其余各维度得分除躯体疼痛(BP)外,差异均有统计学意义(P0.05)。3.纳入本研究的120例肝硬化患者中:共发生并发症15例,其中对照组12例,分别为消化道出血6例,肝性脑病3例,水电解质紊乱2例,原发性肝癌1例。干预组3例,分别为消化道出血1例,水电解质紊乱1例,原发性肝癌1例。并发症的发生率:干预组明显低于对照组。(P0.05)。4.对照组与干预组满意度分别是(85.14± 10.32)、(91.15±10.31)分;差异有显著统计学意义。(P0.01)。结论用"知信行模式"指导肝硬化患者的健康教育,可以增加疾病相关知识,树立战胜疾病的信念,建立健康的生活方式,从整体提高患者的知、信、行水平。进一步改善患者的生活质量,减少并发症的发生率,最终提升护理服务质量及护理满意度。值得进一步推广。
[Abstract]:Objective to investigate the disease related knowledge, belief and behavior of patients with liver cirrhosis, and to establish the path table of health education for cirrhotic patients by combining the theoretical framework of "knowing, believing and doing" in health education, and to systematize the health education of cirrhotic patients. To explore the effect of KAP model on the incidence of complications, quality of life and nursing satisfaction in patients with liver cirrhosis. To provide theoretical basis for improving the quality of life and nursing care of patients with liver cirrhosis, 121 patients with liver cirrhosis were selected from two departments of digestive department of a third class hospital of Shandong province from 2016 to September, using the method of convenient sampling. Using general information questionnaire, The quality of life (QOL) evaluation scale (SF-36), the questionnaire of knowledge, belief and behavior of patients with liver cirrhosis and the questionnaire of satisfaction were used to investigate the patients. The scores of knowledge, belief and behavior, the quality of life were compared between the two groups. The incidence of complications and nursing satisfaction were analyzed by SPSS17.0 software, including descriptive statistical analysis, 蠂 2 test and t test. The cause of the loss was death. There were 120 patients who finished the study, 60 patients in the control group and 60 patients in the intervention group. The two groups had sex, age, marital status, education level, per capita monthly income, occupation, Child grading of liver cirrhosis, and so on. There was no statistical difference between the two groups (P 0.05). The specific results were as follows: 1.The knowledge, belief, behavior and total score of cirrhosis were lower in the two groups before intervention, and most of the patients and their families lacked cognition about the occurrence and prevention of cirrhosis. There was no statistical difference between the two groups (P 0.05). After intervention, the scores and total scores of each dimension of knowledge, faith and behavior in the intervention group were better than those in the control group. The difference was statistically significant (P 0.05). Before the intervention, the total score of quality of life and the scores of each dimension of the two groups were higher than those of the control group. After intervention, the total scores of quality of life in the control group and the intervention group were 62.61 卤14.37, 72.15 卤14.21, 55.55 卤13.32, 70.09 卤13.47, 52.69 卤17.51, 74.21 卤18.46, respectively. All the differences were statistically significant (P 0.01). The scores of other dimensions in the intervention group were significantly different except for somatic pain (P 0.05). 3. Among the 120 cirrhotic patients in this study, there were 15 cases of complications, including 12 cases in the control group. There were 6 cases of gastrointestinal hemorrhage, 3 cases of hepatic encephalopathy, 2 cases of water electrolyte disorder and 1 case of primary liver cancer. The incidence of complications in the intervention group was significantly lower than that in the control group (P 0.05). 4. The satisfaction degree between the control group and the intervention group was 85.14 卤10.32 and 91.15 卤10.31, respectively. Conclusion the health education of patients with liver cirrhosis under the guidance of "knowing, believing and acting" can increase the knowledge of disease, establish the belief of overcoming disease, establish a healthy life style, and improve the knowledge and belief of patients with liver cirrhosis as a whole. Further improve the quality of life of patients, reduce the incidence of complications, and ultimately improve the quality of nursing care and nursing satisfaction.
【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】：R473.57

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