基于健商理念健康教育在提高老年高血压病患者自我护理能力中的应用
发布时间：2018-10-18 07:07
【摘要】：目的:了解老年高血压病患者自我护理能力和高血压健商水平;探讨基于健商理念的健康教育方式对老年高血压病患者自我护理能力水平的影响,为社区实施老年高血压病患者护理干预提供科学的方法和理论依据。方法:1采用随机抽样的方法,抽取广西壮族自治区南宁市西乡塘区北湖南棉社区卫生服务中心的300名老年高血压病患者。使用自制的老年高血压病患者一般情况调查表、高血压自我护理能力调查表、高血压病相关健商情况调查问卷进行调查。使用平均数±标准差描述患者自我护理能力水平、高血压健商水平;使用百分比描述患者一般资料;运用Spearman相关分析研究患者自我护理能力与健商各维度间的关系。2随机临床试验研究。采用随机数字表法,将社区卫生服务中心自愿参加研究的老年高血压病患者分为对照组与干预组,每组34人。对照组实施常规健康教育模式,主要内容为高血压病相关知识、饮食、运动、戒烟戒酒、心理等方面,干预时间为16周。干预组实施基于健商理念的健康教育方式。该方式分为四个阶段,第一阶段:基础知识讲授阶段,时间为第1-4周。内容为在根据实际情况进行有针对性的常规健康教育的基础上,根据健商理念进行自我护理能力、自我保健、高血压—自我保健—自我护理能力三者之间的相互关系等基础知识的教育。同时根据健商理念运用现代医学、传统医学、辅助医学和身心医学的相关内容,分别对健康知识和自我保健的知识和方法进行教育。第二阶段:基础知识巩固及生活方式干预阶段,时间是第5-8周。内容为对之前所学知识进行巩固并根据之前的调查结果,结合健商理念和Omaha系统理论,在根据实际情况进行有针对性的常规健康教育的基础上,再进行有针对性的生活方式知识干预。第三阶段:精神健康干预和所学内容的系统回顾,时间为第9-12周。内容为以健商身心健康的理念为中心,结合调查结果,从逆境商数、信仰空间、情感与免疫系统等方面进行健商精神健康知识的教育。并对所学全部内容进行系统回顾。第四阶段:采用入户、知识趣味竞赛等方式对患者的知识掌握程度进行复习和巩固。时间为第13-16周。分别于干预前、干预第8周、第16周,进行高血压自我护理能力量表、高血压健商量表的评估,同时记录血压值、每日盐的摄入情况和并发症发生情况。最后于第16周干预结束后进行高血压自我护理能力、高血压健商水平、血压值、每日盐的摄入量和并发症发生率的干预效果评价。运用EPidata3.0软件对数据进行双录入;采用SPSS22.0软件进行分析,分析结果以P0.05表示差异有统计学意义。结果:1社区老年高血压病患者自我护理能力处于低等水平,116例(38.7%)具有较高的自我护理能力,184例(61.3%)具有较低的自我护理能力。1.1在自我护理能力量表中,行为量表得分最低(46.47±7.05)分。在量表各因子中,得分最高的是因子10(烟酒因子),最低的为因子1(饮食控制因子)。2社区老年高血压病患者健商水平有待提高。自我保健、健康知识、生活方式、精神状态维度的得分分别为(22.65±5.88)分、(23.26±3.97)分、(23.55±5.51)分、(26.86±3.69)分,其中自我保健、健康知识、生活方式三个维度的得分都低于临界分(24分)。2.1自我保健维度中获得身心健康的方法部分得分最低(5.46±1.52)分;健康知识维度中维护健康的知识部分得分最低(5.78±1.52)分;生活方式维度中饮食、营养与饮食习惯部分得分最低(4.66±1.37)分;精神状态维度中个人信仰部分得分最低(5.68±1.73)分。3社区老年高血压病患者健商各维度与自我护理能力各因子间呈正相关。除自我保健维度与因子4、精神状态维度与因子2、5、6、8、10呈低相关(0.3≤r≤0.5)外,其余维度与各因子间呈显著或高度相关(r0.8或0.5r≤0.8)。4基于健商理念的健康教育方式的应用在社区老年高血压病患者的研究结果如下:4.1基于健商理念的健康教育组在干预后患者自我护理行为、动机、自我效能水平、健商各维度水平、限盐能力、血压控制情况较干预前有所提高,差别有统计学意义。4.2基于健商理念的健康教育组与常规健康教育组相比,两组患者自我护理行为、动机、自我效能水平、健商各维度水平、收缩压等差别均有统计学意义。结论:1社区老年高血压病患者自我护理能力和健商水平大多处于低等水平,且提示我们对患者生活行为方式的干预是提高社区老年高血压病患者自我护理能力的关键,同时可以围绕健商的各维度对患者进行健康教育干预,从而提高其自我护理能力。2与常规健康教育模式相比,基于健商理念的健康教育方式可以更好的提高社区老年高血压病患者的健康知识水平,增强其自我护理动机和自我效能,从而进一步更好的提高患者的行为能力,最终达到患者自我护理能力的提高。同时基于健商理念的健康教育方式可以更进一步的减少患者盐的摄入量、降低患者的血压、控制并发症的发生与发展。
[Abstract]:Objective: To investigate the self-care ability and the level of essential hypertension in elderly patients with essential hypertension, and to explore the effect of health education on the level of self-care ability in elderly patients with essential hypertension. To provide scientific method and theoretical basis for community implementation of nursing intervention in elderly patients with essential hypertension. Methods: A random sampling method was used to extract 300 elderly patients with hypertension in the northern Hunan cotton community health service center. The survey was carried out using self-made questionnaire on general condition of elderly patients with hypertension, questionnaire on self-nursing ability of hypertension, and questionnaire on hypertension-related health quotient. To describe the patient's self-care ability level and the level of essential hypertension; use the percentage to describe the patient's general information; use Spearman-related analysis to study the relationship between self-care ability and the dimensions of healthy quotient. The elderly patients with hypertension who volunteered to participate in the study were divided into control group and intervention group by using random number table method, 34 persons in each group. The control group carried out routine health education mode. The main contents were hypertension-related knowledge, diet, exercise, smoking cessation, alcohol drinking, psychology and so on. The intervention time was 16 weeks. The intervention group carries out the health education mode based on the concept of health business. The method is divided into four stages, the first stage: the basic knowledge teaching phase, the time is the first to fourth week. On the basis of carrying out targeted routine health education according to the actual situation, the author carries on the basic knowledge education such as self-care ability, self-care, hypertension, self-care and self-care ability. At the same time, the knowledge and methods of health knowledge and self-care should be educated according to the relevant contents of modern medicine, medical science, auxiliary medicine and physical and psychological medicine according to the concept of health business. Phase 2: Basic knowledge consolidation and lifestyle intervention phase, time is 5-8 weeks. The content is to consolidate the knowledge before and according to the previous findings, combine the key business philosophy and the Omaha system theory, carry out targeted routine health education on the basis of the actual situation, and then carry out targeted lifestyle knowledge intervention. Phase III: Systematic review of mental health interventions and lessons learned, with a period of 9-12 weeks. The content is centered on the concept of healthy quotient and physical and mental health, combined with the results of investigation, from the aspects of adversity quotient, faith space, emotion and immune system, the education of mental health knowledge is carried out. and the entire content of what is learned is systematically reviewed. Stage 4: Review and consolidate the degree of knowledge of the patients in the way of household, knowledge and competition. Time is 13-16 weeks. Before intervention, intervention week 8, week 16, hypertension self-care energy meter, hypertension key consultation table evaluation, recorded blood pressure value, daily salt intake and complications occurred. Finally, the intervention effect of hypertension self-care ability, hypertension key quotient level, blood pressure value, daily salt intake and complication rate was evaluated after the end of the 16-week intervention. The data were double-entered using EPidata3. 0 software. The analysis was carried out by SPSS 10.0 software. The results showed that the difference was statistically significant with P0.05. Results: The self-nursing ability of elderly patients with hypertension in the community was low, 116 cases (38. 7%) had higher self-care ability, 184 cases (61.3%) had lower self-nursing ability. 1. In the self-care energy table, the score of behavior scale was the lowest (46. 47/ 7. 05). Among the factors of the scale, the score was the highest factor (factor 10), and the lowest factor was factor 1 (diet control factor). The level of health quotient of elderly patients with hypertension in the community should be improved. The scores of self-health, health knowledge, life style and mental state dimension were (22. 65/ 5.88), (23.26-3.97), (23.55-5.51), (26.86-3.69), among which self-care, health knowledge, The scores of the three dimensions of life style were lower than the critical score (24 points). The lowest score of the method for obtaining the physical and mental health in the self-care dimension was lowest (5.46 vs 1. 52); the lowest score of knowledge in maintaining health in the health knowledge dimension (5.78 vs. 1.52) was the lowest (5.78 vs. 1.52); diet in the lifestyle dimension, The score of nutrition and diet was the lowest (4.66/ 1.37). The score of personal beliefs in mental state was the lowest (5.68/ 1.73). The dimensions of health quotient in elderly patients with hypertension were positively correlated with the factors of self-care ability. in addition to that self-care dimension and factor 4, the mental state dimension is low relative to the factors 2, 5, 6, 8, 10 (0.3 r. r. 0. 5), There was a significant or highly correlated (r0. 8 or 0. 5r. 0. 8) among the remaining dimensions. The results of the application of health education based on the concept of health quotient in elderly patients with hypertension in the community were as follows: 4. 1 The self-care behavior and motivation of the health education group based on the concept of health care in the intervention group were as follows: Compared with the routine health education group, the self-efficacy level, the level of each dimension of the healthy quotient, the salt tolerance and the control of blood pressure were increased significantly before the intervention, and the self-nursing behavior, motivation and self-efficacy level of the two groups were compared with those of the routine health education group. The difference of dimension level and systolic blood pressure were statistically significant. Conclusion: The self-care ability and the level of health quotient of elderly patients with hypertension in the community are mostly low, and it is suggested that the intervention of the lifestyle of the patients is the key to improve the self-care ability of elderly patients with hypertension in the community. Compared with the traditional health education mode, the health education mode based on the health quotient concept can better improve the health knowledge level of the elderly patients with hypertension in the community, so that the self-care motivation and self-efficacy of the patient are enhanced, so that the capacity of the patient is further improved, and the self-care capacity of the patient is finally improved. At the same time, the health education mode based on the concept of health business can further reduce the salt intake of the patient, reduce the blood pressure of the patient, and control the occurrence and development of the complications.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.5
本文编号：2278371
[Abstract]:Objective: To investigate the self-care ability and the level of essential hypertension in elderly patients with essential hypertension, and to explore the effect of health education on the level of self-care ability in elderly patients with essential hypertension. To provide scientific method and theoretical basis for community implementation of nursing intervention in elderly patients with essential hypertension. Methods: A random sampling method was used to extract 300 elderly patients with hypertension in the northern Hunan cotton community health service center. The survey was carried out using self-made questionnaire on general condition of elderly patients with hypertension, questionnaire on self-nursing ability of hypertension, and questionnaire on hypertension-related health quotient. To describe the patient's self-care ability level and the level of essential hypertension; use the percentage to describe the patient's general information; use Spearman-related analysis to study the relationship between self-care ability and the dimensions of healthy quotient. The elderly patients with hypertension who volunteered to participate in the study were divided into control group and intervention group by using random number table method, 34 persons in each group. The control group carried out routine health education mode. The main contents were hypertension-related knowledge, diet, exercise, smoking cessation, alcohol drinking, psychology and so on. The intervention time was 16 weeks. The intervention group carries out the health education mode based on the concept of health business. The method is divided into four stages, the first stage: the basic knowledge teaching phase, the time is the first to fourth week. On the basis of carrying out targeted routine health education according to the actual situation, the author carries on the basic knowledge education such as self-care ability, self-care, hypertension, self-care and self-care ability. At the same time, the knowledge and methods of health knowledge and self-care should be educated according to the relevant contents of modern medicine, medical science, auxiliary medicine and physical and psychological medicine according to the concept of health business. Phase 2: Basic knowledge consolidation and lifestyle intervention phase, time is 5-8 weeks. The content is to consolidate the knowledge before and according to the previous findings, combine the key business philosophy and the Omaha system theory, carry out targeted routine health education on the basis of the actual situation, and then carry out targeted lifestyle knowledge intervention. Phase III: Systematic review of mental health interventions and lessons learned, with a period of 9-12 weeks. The content is centered on the concept of healthy quotient and physical and mental health, combined with the results of investigation, from the aspects of adversity quotient, faith space, emotion and immune system, the education of mental health knowledge is carried out. and the entire content of what is learned is systematically reviewed. Stage 4: Review and consolidate the degree of knowledge of the patients in the way of household, knowledge and competition. Time is 13-16 weeks. Before intervention, intervention week 8, week 16, hypertension self-care energy meter, hypertension key consultation table evaluation, recorded blood pressure value, daily salt intake and complications occurred. Finally, the intervention effect of hypertension self-care ability, hypertension key quotient level, blood pressure value, daily salt intake and complication rate was evaluated after the end of the 16-week intervention. The data were double-entered using EPidata3. 0 software. The analysis was carried out by SPSS 10.0 software. The results showed that the difference was statistically significant with P0.05. Results: The self-nursing ability of elderly patients with hypertension in the community was low, 116 cases (38. 7%) had higher self-care ability, 184 cases (61.3%) had lower self-nursing ability. 1. In the self-care energy table, the score of behavior scale was the lowest (46. 47/ 7. 05). Among the factors of the scale, the score was the highest factor (factor 10), and the lowest factor was factor 1 (diet control factor). The level of health quotient of elderly patients with hypertension in the community should be improved. The scores of self-health, health knowledge, life style and mental state dimension were (22. 65/ 5.88), (23.26-3.97), (23.55-5.51), (26.86-3.69), among which self-care, health knowledge, The scores of the three dimensions of life style were lower than the critical score (24 points). The lowest score of the method for obtaining the physical and mental health in the self-care dimension was lowest (5.46 vs 1. 52); the lowest score of knowledge in maintaining health in the health knowledge dimension (5.78 vs. 1.52) was the lowest (5.78 vs. 1.52); diet in the lifestyle dimension, The score of nutrition and diet was the lowest (4.66/ 1.37). The score of personal beliefs in mental state was the lowest (5.68/ 1.73). The dimensions of health quotient in elderly patients with hypertension were positively correlated with the factors of self-care ability. in addition to that self-care dimension and factor 4, the mental state dimension is low relative to the factors 2, 5, 6, 8, 10 (0.3 r. r. 0. 5), There was a significant or highly correlated (r0. 8 or 0. 5r. 0. 8) among the remaining dimensions. The results of the application of health education based on the concept of health quotient in elderly patients with hypertension in the community were as follows: 4. 1 The self-care behavior and motivation of the health education group based on the concept of health care in the intervention group were as follows: Compared with the routine health education group, the self-efficacy level, the level of each dimension of the healthy quotient, the salt tolerance and the control of blood pressure were increased significantly before the intervention, and the self-nursing behavior, motivation and self-efficacy level of the two groups were compared with those of the routine health education group. The difference of dimension level and systolic blood pressure were statistically significant. Conclusion: The self-care ability and the level of health quotient of elderly patients with hypertension in the community are mostly low, and it is suggested that the intervention of the lifestyle of the patients is the key to improve the self-care ability of elderly patients with hypertension in the community. Compared with the traditional health education mode, the health education mode based on the health quotient concept can better improve the health knowledge level of the elderly patients with hypertension in the community, so that the self-care motivation and self-efficacy of the patient are enhanced, so that the capacity of the patient is further improved, and the self-care capacity of the patient is finally improved. At the same time, the health education mode based on the concept of health business can further reduce the salt intake of the patient, reduce the blood pressure of the patient, and control the occurrence and development of the complications.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.5
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