本文關(guān)鍵詞：基于BCW理論的健康教育模式在癌痛患者中的應(yīng)用效果研究　出處：《山東大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 癌痛 健康教育 行為改變輪理論

【摘要】：研究目的:以BCW(Behavior change wheel)理論為框架構(gòu)建健康教育模式;探討該模式在癌痛患者中的應(yīng)用效果,以期為癌痛患者尋求有效的健康教育途徑和方法。研究方法:本研究入組患者均為山東省某三級(jí)甲等醫(yī)院腫瘤化療科收治的66例癌痛患者,隨機(jī)分組方法分為實(shí)驗(yàn)組和對(duì)照組,實(shí)驗(yàn)組患者采用了基于BCW理論構(gòu)建的健康教育模式,對(duì)照組則給予常規(guī)的健康教育。應(yīng)用一般資料問卷、疼痛控制障礙問卷(Barriers questionnaire,BQ-L)、疼痛數(shù)字評(píng)估量表(Numeric rating scale,NRS)、Morisky 服藥依從性量表(the 8-item Morisky Medication Adherence Scale,MMAS-8)、中國癌癥患者生活質(zhì)量調(diào)查問卷(Quality of life questionnaire for Chinese cancer patients,QLQ)對(duì)研究對(duì)象進(jìn)行調(diào)查。數(shù)據(jù)整理后應(yīng)用SPSS17.0進(jìn)行統(tǒng)計(jì)分析。研究結(jié)果:1.兩組一般資料特征比較:年齡、性別、婚姻狀況、文化程度、疾病類型、居住地、費(fèi)用支付方式、疼痛部位、疼痛性質(zhì)比較,其差異均無統(tǒng)計(jì)學(xué)意義(p0.05)。2.兩組鎮(zhèn)痛藥使用情況比較:鎮(zhèn)痛藥用藥種類及途徑比較,兩組差異均無統(tǒng)計(jì)學(xué)意義(p0.05)。3.疼痛強(qiáng)度得分比較(1)兩組間干預(yù)前及干預(yù)后疼痛強(qiáng)度得分比較:干預(yù)前實(shí)驗(yàn)組疼痛強(qiáng)度得分3.39±1.13,對(duì)照組疼痛強(qiáng)度得分3.50±1.31,干預(yù)前兩組疼痛強(qiáng)度得分比較,差異無統(tǒng)計(jì)學(xué)意義(t=-0.263,p0.05);干預(yù)后實(shí)驗(yàn)組疼痛強(qiáng)度得分2.30±0.67,對(duì)照組疼痛強(qiáng)度得分2.92±0.47,可見干預(yù)后實(shí)驗(yàn)組疼痛強(qiáng)度得分低于對(duì)照組,差異具有統(tǒng)計(jì)學(xué)意義(t=-3.091,p0.01)。(2)實(shí)驗(yàn)組干預(yù)前與干預(yù)后疼痛強(qiáng)度得分比較:實(shí)驗(yàn)組干預(yù)前疼痛強(qiáng)度評(píng)分為3.39±1.13,干預(yù)后疼痛強(qiáng)度評(píng)分則2.30士0.67,實(shí)驗(yàn)組干預(yù)后疼痛強(qiáng)度評(píng)分明顯低于干預(yù)前評(píng)分,差異具有統(tǒng)計(jì)學(xué)意義(t=3.236,p0.05)。(3)對(duì)照組干預(yù)前與干預(yù)后疼痛強(qiáng)度得分比較:對(duì)照組干預(yù)前疼痛強(qiáng)度得分3.50± 1.31,干預(yù)后疼痛強(qiáng)度得分2.92±0.47,對(duì)照組干預(yù)后疼痛強(qiáng)度得分在數(shù)值上略低于干預(yù)前,但差異無統(tǒng)計(jì)學(xué)意義(t=1.364,p0.05)。4.鎮(zhèn)痛藥物服藥依從性比較(1)兩組間干預(yù)前及干預(yù)后鎮(zhèn)痛藥服藥依從性得分比較:干預(yù)前實(shí)驗(yàn)組鎮(zhèn)痛藥物服藥依從性得分5.64± 1.37,對(duì)照組鎮(zhèn)痛藥物服藥依從性得分5.38± 1.39,干預(yù)前兩組服藥依從性等級(jí)均為低,兩組服藥依從性得分差異無統(tǒng)計(jì)學(xué)意義(t=0.766,p0.05);干預(yù)后實(shí)驗(yàn)組服藥依從性得分6.96±0.83,依從性等級(jí)中等,對(duì)照組服藥依從性得分5.48±1.06,依從性等級(jí)低,干預(yù)后實(shí)驗(yàn)組服藥依從性得分明顯高于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(t=4.737,p0.001)。(2)實(shí)驗(yàn)組干預(yù)前與干預(yù)后鎮(zhèn)痛藥服藥依從性得分比較:實(shí)驗(yàn)組干預(yù)前鎮(zhèn)痛藥服藥依從性得分5.64± 1.37,得分為8分、依從性高的有3例(9.09%);得分6-7分、依從性中等的有16例(48.48%);得分6分、依從性低的有14例(42.43%)。干預(yù)后得分6.96±0.83,得分為8分、依從性高的有13例(39.39%);得分6-7分、依從性中等的有17例(51.52%);得分6分、依從性低的有3例(9.09%)。實(shí)驗(yàn)組干預(yù)后的服藥依從性得分明顯高于干預(yù)前,差異有統(tǒng)計(jì)學(xué)意義(t=4.737,p0.001)。(3)對(duì)照組干預(yù)前與干預(yù)后鎮(zhèn)痛藥服藥依從性得分比較:對(duì)照組干預(yù)前鎮(zhèn)痛藥服藥依從性得分5.38 ± 1.39,干預(yù)后鎮(zhèn)痛藥服藥依從性得分5.48±1.06,對(duì)照組干預(yù)前及干預(yù)后鎮(zhèn)痛藥服藥依從性得分的比較,差異無統(tǒng)計(jì)學(xué)意義(t=-0.117,p0.05)。5.生活質(zhì)量得分比較(1)兩組間干預(yù)前及干預(yù)后生活質(zhì)量得分比較:干預(yù)前實(shí)驗(yàn)組生活質(zhì)量得分45.16±6.23,對(duì)照組生活質(zhì)量得分則為42.94±5.65,干預(yù)前兩組間生活質(zhì)量得分的比較差異無統(tǒng)計(jì)學(xué)意義(t=0.307,p0.05)。干預(yù)后實(shí)驗(yàn)組的生活質(zhì)量得分45.72±5.86,對(duì)照組生活質(zhì)量的得分42.31 ±7.54,干預(yù)后兩組生活質(zhì)量得分比較,差異無統(tǒng)計(jì)學(xué)意義(t=0.310,p0.05)。(2)實(shí)驗(yàn)組干預(yù)前與干預(yù)后的生活質(zhì)量得分比較:實(shí)驗(yàn)組生活質(zhì)量干預(yù)前得分45.16±6.23,干預(yù)后生活質(zhì)量得分45.72±5.86,實(shí)驗(yàn)組干預(yù)前與干預(yù)后的生活質(zhì)量得分差異無統(tǒng)計(jì)學(xué)意義(t=0.970,p0.05)。(3)對(duì)照組干預(yù)前與干預(yù)后的生活質(zhì)量得分比較:對(duì)照組干預(yù)前生活質(zhì)量得分42.94±5.65,干預(yù)后生活質(zhì)量得分42.31 ±7.54,對(duì)照組干預(yù)前與干預(yù)后生活質(zhì)量得分差異無統(tǒng)計(jì)學(xué)意義(t=1.872,p0.05)。結(jié)論:1.基于BCW理論的健康教育模式能夠降低癌痛患者的疼痛強(qiáng)度。2.基于BCW理論的健康教育模式能夠提高癌痛患者的服藥依從性。3.基于BCW理論的健康教育模式對(duì)癌痛患者的生活質(zhì)量無顯著影響。
[Abstract]:Objective: To study the BCW (Behavior change wheel) theory to construct the model of health education for the framework; explore the application effect of the model in cancer patients, in order to seek the effective ways and methods of health education for cancer patients. Methods: This study enrolled patients were 66 cases of cancer patients chemotherapy Department of Shandong Province three grade a hospital, randomly divided into experimental group and control group, experimental group were treated by the mode of health education based on the theory of BCW, the control group were given routine health education. With the general information questionnaire, pain control questionnaire (Barriers questionnaire, BQ-L disorder), digital pain assessment scale (Numeric rating scale, NRS Morisky), medication adherence scale (the 8-item Morisky Medication Adherence Scale, MMAS-8), China cancer patients quality of life questionnaire (Quality of life questionnaire fo R Chinese cancer patients, QLQ) were used to investigate the study object. After finishing the SPSS17.0 application data for statistical analysis. Results: comparison of 1. general data of the two groups characteristics: age, marital status, gender, educational level, disease type, residence, payment, pain, pain in nature, the difference was not statistically the significance of.2. (P0.05) two groups using analgesics: comparing analgesic drug types and ways, the differences between the two groups were not statistically significant (P0.05).3. (1) pain intensity scores were compared between the two groups before and after intervention of pain intensity score: before the intervention the experimental group pain intensity score 3.39 + 1.13, control group pain intensity score of 3.50 + 1.31, two groups of pain intensity scores before intervention, the difference was not statistically significant (t=-0.263, P0.05); the intervention group pain intensity score 2.30 + 0.67, the control group pain intensity score 2.92 + 0 .47, the experimental group after the intervention of pain intensity scores than the control group, the difference was statistically significant (t=-3.091, P0.01). (2) compared with the intervention of pain intensity score of the experimental group before the intervention: the experimental group before the intervention of pain intensity score was 3.39 + 1.13, the intervention of pain intensity score is 2.30 + 0.67, the experimental group did prognostic score pain intensity score was significantly lower than that before the intervention, the difference was statistically significant (t=3.236, P0.05). (3) the control group before and after intervention of pain intensity scores: control group before intervention pain intensity score 3.50 + 1.31, the intervention of pain intensity score 2.92 + 0.47, the control group after the intervention of pain intensity score in the numerical slightly lower than before the intervention, but the difference was not statistically significant (t=1.364, P0.05).4. analgesic drug compliance comparison (1) analgesic medication compliance scores were compared between the two groups before and after intervention: before the intervention the experimental group analgesic Material compliance score of 5.64 + 1.37, the control group analgesic medication compliance score of 5.38 + 1.39, the two groups before the intervention compliance levels are low, the two groups had no statistically significant difference in the compliance score (t=0.766, P0.05); the intervention group compliance score 6.96 + 0.83, compliance level medium control group compliance score 5.48 + 1.06, the compliance level is low, the intervention group compliance score significantly higher than the control group, the difference was statistically significant (t=4.737, p0.001). (2) the experimental group before and after intervention analgesic medication compliance score comparison: the experimental group intervention analgesia medicine the compliance score of 5.64 + 1.37, a score of 8 points, high compliance of the 3 cases (9.09%); score 6-7, compliance of the middle 16 cases (48.48%); a score of 6, low compliance of the 14 cases (42.43%). The intervention score of 6.96 + 0.83, a score of 8 divided, compliance High in 13 cases (39.39%); score 6-7, compliance of the middle 17 cases (51.52%); a score of 6, low compliance of the 3 cases (9.09%). The experimental group intervention compliance score was significantly higher than that before intervention, the difference was statistically significant (t=4.737, p0.001). (3) the control group before and after intervention analgesic medication compliance score: the control group and intervention analgesia medication adherence score 5.38 + 1.39, after the intervention of analgesic medication compliance score of 5.48 + 1.06, compare the analgesic medication compliance score of the control group before and after the intervention, the difference was not statistically significant (t=-0.117, P0.05).5. quality of life scores (1) compared the scores of quality of life between the two groups before and after intervention in experimental group before the intervention: quality of life score 45.16 + 6.23, the control group quality of life score was 42.94 + 5.65, the difference between the two groups of quality of life score before the intervention without statistics Learn the meaning of (t=0.307, P0.05). The score of quality of life in the experimental group after 45.72 + 5.86, the control group quality of life score 42.31 + 7.54, compared with two groups of quality of life scores after the intervention, the difference was not statistically significant (t=0.310, P0.05). (2) compared with the quality of life score of the intervention group before intervention the quality of life before the intervention group: experimental score of 45.16 + 6.23, intervention, quality of life score 45.72 + 5.86, and the intervention of quality of life score was no significant difference between the experimental group before intervention (t=0.970, P0.05). (3) the control group before the intervention and the quality of life score after the intervention: the control group before the intervention of quality of life score 42.94 + 5.65, the intervention of quality of life score 42.31 + 7.54, and after the intervention, life quality score was no significant difference in control group before intervention (t=1.872, P0.05). Conclusion: 1. BCW theory of health education mode can reduce cancer patients based on Pain intensity.2. BCW based health education mode can improve the medication adherence of cancer patients..3. based on BCW theory of health education has no significant effect on the quality of life of cancer patients.

【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R473.73

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