冠脉内支架植入患者健康教育路径的研制与应用

发布时间：2018-02-01 21:53

本文关键词： 冠心病健康教育临床路径德尔菲法知-信-行模式　出处：《重庆医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:1.了解冠状动脉内支架植入患者术后对健康教育的需求,构建冠脉内支架植入患者健康教育路径。2.探讨健康教育路径对冠脉内支架植入患者健康知识、健康信念以及健康行为三方面的干预效果。方法:1.在文献分析的基础上,利用半结构式深入访谈法了解12名住院支架植入患者对健康教育知识的需求,为健康教育路径的内容提供临床资料。2.利用专家函询法,完善冠脉内支架植入患者健康教育路径内容,形成冠脉内支架植入患者健康教育路径。3.采用随机分组法,将重庆某三级甲等医院心内科住院的120名冠脉支架植入患者分为干预组和对照组,每组60人,干预组采用健康教育路径进行健康教育,对照组进行传统健康教育。利用冠心病健康知识和健康信念评价表、冠心病自我管理量表比较两组患者出院时的健康知识、健康信念水平以及出院3个月时的健康行为情况。4.利用SPSS21.0进行统计分析,采用均数、标准差、构成比等来描述患者的一般资料情况以及健康知识、健康信念、自我管理行为的得分;采用析因设计的方差分析来比较两组患者健康知识、健康信念差异,利用t检验来比较自我管理行为的得分及总得分的差异,检验水准为P0.05。结果:1.通过半结构式深入访谈对冠脉内支架植入患者健康教育的需求进行研究,得出四个主题:(1)冠脉内支架植入患者的疾病知识缺乏;(2)健康知识需求迫切,主要表现为冠心病基本知识、支架植入术相关知识、日常生活习惯注意事项三方面知识的缺乏;(3)患者健康知识主要来源于报纸广告、电视保健节目及同伴教育,医院内健康教育主要来源医生,护士健康教育不到位;(4)健康信息获取渠道少,健康促进行为不佳。2.通过专家函询后,最终形成包含入院教育(入院第1天)、术前教育(术前1天)、术后教育(手术当天-术后1天)、康复教育(术后2-3天)、出院教育(出院当天)共5个一级指标,34个二级指标的冠脉内支架植入患者健康教育路径。专家的问卷回收率分别为100.00%、95.65%,分别有73.91%、31.82%的专家对两轮问卷提出修改意见,两轮函询专家权威系数分别为0.925、0.935;经过两轮函询后,一级指标与二级指标的协调系数分别为0.124、0.220,协调系数的统计学检验p0.05,函询结果有较好的科学性,函询结果可取。3.将该路径进行临床应用,干预组知识、信念的得分由干预前(入院时)的37.07±5.42分、14.10±2.48分,提高至干预后(出院时)的55.77±7.71分、18.90±2.06分,差异有统计学意义(p0.05);干预后,干预组的知识、信念得分均高于对照组,差异有统计学意义(p0.05);出院3个月时,干预组的自我管理行为得分为100.73±8.68分,高于对照组的91.13±10.70分,差异有统计学意义(p0.05)。结论:本研究研制了冠脉内支架植入患者健康教育路径,为冠心病患者健康教育提供了科学依据。冠脉内支架植入患者健康教育路径较传统健康教育方式,能提高冠心病患者的健康知识、健康信念及健康行为水平。
[Abstract]:Objective: to understand the needs of health education of 1. coronary artery stent implantation in patients with coronary.2., construct the health education path of stent implantation in patients with health education path on intracoronary stent implantation in patients with health knowledge, health beliefs and health behavior intervention three. Methods: 1. based on the literature analysis, by half structured in-depth interviews to understand the needs of 12 hospitalized patients with stent implantation on the knowledge of health education, and provide clinical data using the.2. expert inquiry method for health education path, improve coronary stenting in patients with health education content, the formation of coronary stent implantation in patients with.3. were randomly divided into health education path, will Chongqing three level of first-class hospital department of Cardiology in 120 coronary stent implantation patients were divided into intervention group and control group, each group of 60 people, the intervention group received health education path Health education, the control group was given conventional health education. The evaluation of health knowledge and health beliefs of coronary heart disease, coronary heart disease self-management scale health knowledge was compared between the two groups at the level of health beliefs and 3 months after discharge. The health behavior of.4. using SPSS21.0 for statistical analysis, using mean, standard deviation, constitution the ratio of the general data to describe patients and health knowledge, health belief, self management behavior score; using ANOVA of factorial design to compare two groups of patients with health knowledge, health belief difference, the difference of the total score and to compare the self - management behavior score using t test, the test level of P0.05. results. 1. through semi-structured in-depth interviews of coronary stent implantation in patients with health education needs of the four topics: (1) coronary stent implantation in patients with the disease knowledge The lack of; (2) the urgent needs for health knowledge, mainly for basic knowledge of coronary heart disease, stent related knowledge, lack of attention to matters three daily habits of knowledge; (3) patients' health knowledge mainly comes from the newspaper ads, TV programs and health peer education, the main source of hospital health education of doctors, nurses and health education is not in place; (4) health information less, health promoting behavior of poor.2. through expert consultation, the final form contains admission education (the first day of admission), preoperative education (1 days before operation), education (1 days after the day of surgery, postoperative rehabilitation education (2-3) days after operation), discharge education (discharge day) a total of 5 first grade indexes, 34 level two indexes of coronary stent implantation in patients with health education. The questionnaire of experts rates were 100%, 95.65%, respectively, 73.91%, 31.82% of the experts proposed amendments to the two rounds of questionnaire, The two letter of inquiry expert authority coefficient were 0.925,0.935; after two rounds of consultation, coordination coefficient level indicators and two indicators were 0.124,0.220, statistical test P0.05 coordination coefficient, the results have good scientific inquiry, inquiry results will take.3. clinical application of the path, the intervention group knowledge, beliefs score before the intervention (admission) 37.07 + 5.42, 14.10 + 2.48, to improve the intervention (discharge) 55.77 + 7.71, 18.90 + 2.06, the difference was statistically significant (P0.05); after the intervention, the intervention group knowledge, belief scores were higher than the control group, the difference was statistically significant (P0.05); 3 months after discharge, the score of self-management behavior in the intervention group was 100.73 + 8.68, 91.13 + 10.70 higher than the control group, the difference was statistically significant (P0.05). Conclusion: This study developed coronary stent implantation in patients with health education path for coronary heart It provides a scientific basis for health education of patients. The health education path of patients with intracoronary stent implantation can improve health knowledge, health belief and health behavior level of patients with coronary heart disease compared with traditional health education.

【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】：R473.5

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