脑卒中患者健康行为现状及影响因素研究

发布时间：2018-06-19 00:07

本文选题：脑卒中 + 健康行为　；参考：《河北大学》2017年硕士论文

【摘要】：目的:应用自行设计的脑卒中患者健康行为问卷,对脑卒中患者健康行为及影响因素进行调查,旨在了解脑卒中患者健康行为现状,探讨脑卒中患者健康行为的影响因素,为有针对性地进行干预提供理论依据。方法:依据脑卒中二级预防指南,编制“脑卒中患者健康行为问卷”。经专家咨询,形成初始问卷,采用项目分析、探索性因子分析确定问卷条目,信度采用内部一致性信度,效度检验采用内容效度和结构效度,最终形成有一定信效度的脑卒中患者健康行为问卷。同时,以知-信-行理论模式为理论框架,探讨脑卒中患者健康行为影响因素。采用方便抽样的方法,抽取保定市三所三级甲等医院神经内科381位脑卒中患者作为研究对象,主要的测量工具包括:一般资料问卷、脑卒中患者健康知识问卷、Champion健康信念模型量表和脑卒中患者健康行为问卷。一般资料、脑卒中患者健康知识、信念及行为现状采用描述性统计分析,健康行为影响因素采用两独立样本t检验、单因素方差分析、相关分析、多元线性回归分析对数据进行统计处理。结果:1.项目分析及信效度检验:最终确定脑卒中患者健康行为问卷由5个维度24个条目组成,问卷总的内容效度(S-CVI)为0.97,各条目内容效度(I-CVI)在0.8~1之间;经过2次探索性因子分析最终剩余24个条目,各因子的累计方差贡献率为54.47%;每个条目在相应公因子的因子载荷量均0.40,共同度均0.3;问卷的Cronbach’sα系数为0.807。2.脑卒中患者健康知识现状:脑卒中患者健康知识总得分为(47.19±7.66)分,健康知识各维度标准得分由高到低依次为:脑卒中发作的预警信号86.30分,服药知识79.50分,脑卒中复发危险因素73.23分,遵循的生活方式知识73.17分。3.脑卒中患者健康信念现状:脑卒中患者健康信念总得分为(119.15±7.01)分,平均得分为(3.40±0.20)分,各维度平均得分由高到低依次为:健康动力(4.11±0.32)分、感知到的益处(3.72±0.46)分、自我效能(3.67±0.37)分、感知到的严重性(3.07±0.45分)、感知到的障碍(2.95±0.43)分、感知到的易感性(2.72±0.86)分。4.脑卒中患者健康行为现状:脑卒中患者的健康行为总得分为(69.76±10.08),平均得分为(2.91±0.42)分,各维度平均得分从高到低依次为戒除不良嗜好行为(4.10±0.85)分、避免有害环境行为(3.39±0.72)分、基本健康行为(2.77±0.44)分、预警行为(2.6±0.61)分、保健行为(1.99±0.70)分。5.脑卒中患者健康行为影响因素:多元逐步回归分析结果显示,最终进入回归方程的自变量是性别、年龄、文化程度、病程、医疗费用支付方式、自我效能、感知到的障碍、感知到的益处。R2显示8个变量共同解释了健康行为总变异的56.40%。从标准化偏回归系数可知,对脑卒中患者健康行为的贡献大小从高到低依次为性别、自我效能、医疗费用、支付方式、年龄、感知到的益处、感知到的障碍、文化程度、病程。结论:1.脑卒中患者健康知识处于中等水平,各维度得分由高到低依次为:脑卒中发作的预警信号、服药知识、脑卒中相关危险因素知识、应遵循的生活方式知识。医护人员要重点告知患者脑卒中危险因素方面的知识。2.脑卒中患者的健康信念得分较低,其中健康动力得分最高,感知到的易感性得分最低。3.脑卒中患者的健康行为得分处于中等水平,各维度平均得分由高到低依次为:戒除不良嗜好行为、避免有害环境行为、基本健康行为、预警行为、保健行为,其中得分最低的5个条目为定期体检、控制体重、进行运动锻炼时达到预期的心率、每周至少做3次30分钟及以上的轻中等强度的有氧运动、阅读关于防治脑卒中的书报或观看相关的电视节目。4.脑卒中患者健康行为的影响因素包括性别、年龄、文化程度、病程、医疗费用支付方式、自我效能、感知到的障碍、感知到的益处。女性、年龄、高中及以上学历、医疗保险、自我效能、感知到的益处、1-3年病程是影响脑卒中患者健康行为水平的促进因素,感知到的障碍是脑卒中患者健康行为水平的阻碍因素。
[Abstract]:Objective: To investigate the health behavior and influencing factors of stroke patients by using a self-designed health behavior questionnaire for stroke patients. The purpose of this study is to understand the status of healthy behavior of stroke patients and to explore the factors influencing the health behavior of stroke patients, and to provide theoretical basis for the intervention of stroke patients. Methods: two stages of stroke prevention is based on the prevention of stroke. The guideline was to compile a "questionnaire on health behavior for stroke patients". After expert consultation, an initial questionnaire was formed. The items were determined by project analysis and exploratory factor analysis. The reliability of the questionnaire was determined by the internal consistency reliability. The validity and validity of the questionnaire were tested by the validity and validity of the questionnaire. With the theoretical framework of knowledge and line theory as the theoretical framework, the factors affecting the health behavior of stroke patients were discussed. 381 stroke patients in the neurology department of three grade A hospitals in Baoding city were selected by convenient sampling. The main measurement tools included the general data questionnaire, the health knowledge questionnaire for stroke patients, Champio N health belief model scale and health behavior questionnaire for stroke patients. General data, health knowledge, belief and behavior status of stroke patients were analyzed by descriptive statistical analysis. Two independent sample t test, single factor variance analysis, correlation analysis, multi element linear regression analysis were used to deal with the data. 1. project analysis and reliability and validity test: the final determination of the health behavior questionnaire of stroke patients was made up of 5 dimensions and 24 items. The total content validity (S-CVI) of the questionnaire was 0.97 and the content validity of each item (I-CVI) was between 0.8~1. After 2 exploratory factor analysis, the total variance contribution rate of each factor was 54.47%; each factor was 54.47%. The factor load of the corresponding factor was 0.40 and the common degree was 0.3. The Cronbach 's alpha coefficient of the questionnaire was the status of health knowledge of stroke patients with 0.807.2.: the total score of health knowledge of stroke patients was (47.19 + 7.66), and the standard scores of health knowledge were from high to low, 86.30 points and medicine knowledge. 79.50 points, the risk factors of stroke recurrence were 73.23 points, and the life style knowledge was followed by 73.17 points.3. stroke patients' health belief status: the total score of stroke patients' health belief was (119.15 + 7.01) scores (119.15 + 7.01), the average score was (3.40 + 0.20) points, and the average scores from high to low in each dimension were: health motivation (4.11 + 0.32), and perceived benefits (3.72 The score of 0.46), self efficacy (3.67 + 0.37), perceived severity (3.07 + 0.45), perceived barrier (2.95 + 0.43), perceived susceptibility (2.72 + 0.86).4. stroke patients' healthy behavior status: the total score of stroke patients' health behavior was (69.76 + 10.08), average score was (2.91 + 0.42) scores, and the average score of each dimension was higher. The lower order was to abstinate bad hobby behavior (4.10 + 0.85), avoid harmful environmental behavior (3.39 + 0.72), basic health behavior (2.77 + 0.44), early warning (2.6 + 0.61), health behavior (1.99 + 0.70) (1.99 + 0.70) of the health behavior of stroke patients: multivariate stepwise regression analysis showed that the independent variables of the regression equation were finally entered. Gender, age, age, education, course of illness, medical expenses, self-efficacy, perceived barriers, and perceived benefits.R2 showed that 8 variables co explained the 56.40%. of the total variation of health behavior from the standardized partial regression coefficient, and the contribution size of stroke patients from high to low to sex and self-efficacy, Medical expenses, ways of payment, age, perceived benefits, perceived barriers, cultural degree, and course of illness. Conclusion: 1. the health knowledge of stroke patients is at the middle level, and the scores from high to low in each dimension are the early warning signal of stroke attack, knowledge of medication, knowledge of related risk factors in the stroke and the knowledge of life style that should be followed. The people should focus on the knowledge of the risk factors of stroke in patients with.2., the scores of health beliefs of stroke patients were lower, among which the score of health motivation was the highest and the scores of perceived susceptibility to the lowest.3. stroke patients were at the middle level, and the average scores from high to low were the following: abstinence of bad habits, Avoid harmful environmental behavior, basic health behavior, early warning behavior, health behavior, of which 5 items with the lowest score are regular physical examination, control of body weight, exercise to the expected heart rate, at least 3 times of mild and moderate aerobic exercise for 30 minutes or more per week, reading about the prevention and treatment of stroke, reading or watching The factors affecting health behavior of stroke patients in.4. include gender, age, age, course of illness, medical expenses, self-efficacy, perceived barriers, perceived benefits. Women, age, high school and above, medical insurance, self-efficacy, perceived benefits, and 1-3 years' course of illness that affect stroke patients' health. Perceived barriers are a hindrance to the level of health behaviors of stroke patients.
【学位授予单位】：河北大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.3

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