颅内动脉瘤健康教育手册的编制

发布时间：2018-08-26 08:30

【摘要】：目的编制系统的、便于使用的、具有可读性的颅内动脉瘤患者健康教育手册。一方面为颅内动脉瘤患者及家属提供知识指导,提高健康教育有效性及患者的遵医行为,促使患者采取健康的行为方式,减少颅内动脉瘤破裂或再出血的危险因素,降低并发症的发生率,提高其生命质量,另一方面可以指导和规范护士对患者进行健康教育。方法1.编制颅内动脉瘤患者术前知识态度行为自评问卷:通过文献分析法、头脑风暴法及专家咨询法,借鉴其他疾病的知识态度行为知晓度问卷,自行编制颅内动脉瘤患者术前知识态度行为自评问卷,并对问卷进行信度和效度检验。2.颅内动脉瘤患者健康教育内容的制定:对患者及医护人员进行半结构式访谈,利用信息饱和原则,最终确定18名受访者,使用NVivo质性研究软件结合Colaizzi方法对访谈资料进行编码,并通过文献分析、指南解读,确定颅内动脉瘤患者健康教育的内容。3.手册的排版和编制:选取某三甲医院神经外科医护人员及患者各5名,利用自行设计的调查问卷对手册内容的完整性及准确性、方便实用性等进行评价并提出修改意见,根据反馈的意见进行修改并请专业编辑进行排版校对,编制最终的颅内动脉瘤患者健康教育手册。结果颅内动脉瘤患者术前健康知识态度行为自评问卷包括4个维度,共17个条目:疾病知识知晓(4个条目)、治疗知晓(4个条目)、情绪控制(3个条目)及危险因素知晓(6个条目)。问卷的内容效度检验结果显示评定者间一致性为0.823,CVI值为0.823。Cronbach’sα系数为0.810,折半信度为0.799。对质性访谈资料编码结合文献分析,颅内动脉瘤患者健康教育的内容由8个一级目录、19个二级目录构成。一级目录包括疾病相关知识简介、诱发破裂的危险因素、相关检查的必要性和注意事项、治疗方法、术前术后注意事项、用药指导、出院指导和患者及家属提出的常见问题。结论本研究编制的颅内动脉瘤患者健康教育手册得到了医护人员和患者的高度评价,内容完整、准确、方便实用性,患者可通过填写颅内动脉瘤术前健康知识态度行为自评问卷并阅读健康教育内容,增加患者的疾病相关知识,使患者产生信念,最终促进行为的改变,提高患者的遵医行为和对疾病知识的掌握程度。医护人员也可根据手册对患者实施系统的、有针对的、个体的健康教育。
[Abstract]:Objective to compile a systematic, easy-to-use and readable handbook of health education for patients with intracranial aneurysms. On the one hand, to provide knowledge guidance for intracranial aneurysm patients and their relatives, to improve the effectiveness of health education and patients' compliance with medical treatment, to urge patients to adopt healthy behavior, and to reduce the risk factors of intracranial aneurysm rupture or rebleeding. Reducing the incidence of complications, improving their quality of life, on the other hand, can guide and standardize the health education of patients. Method 1. Self-evaluation questionnaire of knowledge attitude and behavior in patients with intracranial aneurysms was compiled: by literature analysis, brainstorming and expert consultation, the knowledge, attitude and behavior awareness questionnaire of other diseases was used for reference. The self-assessment questionnaire of knowledge, attitude and behavior in patients with intracranial aneurysm was compiled, and the reliability and validity of the questionnaire were tested. 2. The content of health education for patients with intracranial aneurysms was determined by semi-structured interviews with patients and medical staff, and 18 interviewees were determined by the principle of information saturation. The interview data were encoded by NVivo qualitative research software and Colaizzi method. And through the literature analysis, the guide interpretation, determines the intracranial aneurysm patient's health education content. 3. Layout and compilation of the manual: five medical and nursing staff and five patients in neurosurgery of a third Class A hospital were selected to evaluate the completeness, accuracy, convenience and practicability of the contents of the manual by using the self-designed questionnaire, and put forward some suggestions for revision. Revise according to feedback and ask professional editors to edit and proofread the final health education manual for patients with intracranial aneurysms. Results the self-assessment questionnaire of preoperative health knowledge, attitude and behavior in intracranial aneurysms included 17 items: knowledge of disease (4 items), knowledge of treatment (4 items), emotional control (3 items) and knowledge of risk factors (6 items). The results of content validity test showed that the consistency was 0.823%, 0.823.Cronbach's 伪 coefficient was 0.810, and half reliability was 0.799 9. The contents of health education in patients with intracranial aneurysms were composed of 8 primary catalogues and 19 secondary catalogues. The first level catalogue includes a brief introduction of disease related knowledge, risk factors of inducing rupture, necessity and attention of relevant examination, treatment methods, matters needing attention before and after operation, medication guidance, discharge guidance and common questions raised by patients and their families. Conclusion the manual of health education for patients with intracranial aneurysm is highly evaluated by medical staff and patients. It is complete, accurate, convenient and practical. By filling in the questionnaire of health knowledge, attitude and behavior before intracranial aneurysm and reading the contents of health education, the patients can increase their knowledge of disease, make patients have faith, and finally promote the change of behavior. To improve the patient's compliance and knowledge of the disease. Health care workers can also carry out systematic, targeted, individual health education according to the manual.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.74

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