本文關(guān)鍵詞： 健康教育 哮喘病 學(xué)齡期兒童 干預(yù)研究　出處：《山東大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：研究背景:支氣管哮喘(bronchial asthma)也可稱之為哮喘,作為臨床中較為多發(fā)且具典型的氣道慢性炎性異常反應(yīng)癥狀疾病,該病癥多由機(jī)體T淋巴細(xì)胞、嗜酸性粒細(xì)胞、中性粒細(xì)胞以及氣道上皮細(xì)胞組共同作用炎性炎性因子所致;可導(dǎo)致患者表現(xiàn)出胸悶、氣喘、多咳嗽或喘息不止等癥狀[1],加之這類病癥發(fā)作反復(fù)性、難以控制或根治,造成患兒長(zhǎng)期機(jī)體、心理、生活以及學(xué)習(xí)等活動(dòng)受阻,產(chǎn)生極大的影響;并且這類病癥患兒中約有30～50%中重度哮喘可延展伴隨患兒發(fā)育成長(zhǎng),有著極高的概率進(jìn)展為肺心病風(fēng)險(xiǎn),這對(duì)哮喘患兒家庭日常生活帶來(lái)嚴(yán)重性干擾,同時(shí)也加重社會(huì)負(fù)擔(dān)。研究目的:為進(jìn)一步研究探析哮喘患兒后期治療過(guò)程中自我護(hù)理能力對(duì)疾病防控的作用,本文結(jié)合現(xiàn)代醫(yī)學(xué)教育理念增強(qiáng)患兒對(duì)疾病相關(guān)知識(shí)認(rèn)知能力,目的在于提高患兒后期自我護(hù)理能力,降低病患后期哮喘發(fā)作頻率及痛苦,增強(qiáng)患兒病情穩(wěn)定性,最終提高病患生活質(zhì)量,改善機(jī)體健康狀況。資料與方法:采取回顧性分析研究模式,選取本院2015年1月～2015年10月期間收治的哮喘病患兒91例作為研究對(duì)象,按照病患兒就診時(shí)間數(shù)字編號(hào)分配,患兒及家屬知情同意,按照治療干預(yù)指導(dǎo)的差異性設(shè)置為兩組,均采取全國(guó)兒科哮喘防治協(xié)作組制定的支氣管哮喘規(guī)范化治療方案給予哮喘治療控制,其中對(duì)照組45例,在治療期間僅單純應(yīng)用輔舒酮(EP)氣霧劑治療,并在哮喘發(fā)作期間加用支氣管擴(kuò)張劑治療,給予基本護(hù)理知識(shí)指導(dǎo);觀察組46例,在規(guī)范化治療護(hù)理基礎(chǔ)之上進(jìn)行有組織、有計(jì)劃,符合患兒心理特點(diǎn)的實(shí)施系統(tǒng)全面的健康教育,注重轉(zhuǎn)變過(guò)去傳統(tǒng)的健康知識(shí)灌輸式教學(xué)模式轉(zhuǎn)換為當(dāng)前廣泛應(yīng)用的"以人為本"患者為中心科學(xué)的個(gè)體化教育理念,護(hù)理人員在教育過(guò)程加強(qiáng)哮喘患兒心理干預(yù)護(hù)理,提高生理營(yíng)養(yǎng)、功能、環(huán)境支持,給予全面細(xì)致用藥指導(dǎo),通過(guò)完善健康知識(shí)教育以及日常生活護(hù)理進(jìn)行綜合性護(hù)理服務(wù);所有患兒均定期隨訪觀察12個(gè)月,結(jié)合本院自制"哮喘疾病知識(shí)掌握情況調(diào)查表患兒自我正確認(rèn)識(shí)哮喘基本知識(shí)掌握情況,利用德國(guó)百瑞公司生產(chǎn)的多功能電腦呼吸功能超聲儀監(jiān)測(cè)兩組患兒護(hù)理治療前后FEV1和PEF占預(yù)計(jì)值%;記錄患兒治療周期內(nèi)哮喘發(fā)作頻率,急診救治次數(shù);最后依據(jù)1998年全國(guó)兒科哮喘防治協(xié)作組制定的支氣管哮喘療效標(biāo)準(zhǔn)評(píng)估兩組患兒治療護(hù)理療效。將數(shù)據(jù)納入SPSS19.0統(tǒng)計(jì)軟件中進(jìn)行組間對(duì)比分析。主要結(jié)果:①觀察組患兒在12項(xiàng)自我正確認(rèn)識(shí)哮喘基本知識(shí)掌握水平均明顯高于常規(guī)治療對(duì)照組患兒,其觀察組患兒經(jīng)過(guò)健康教育后,自我正確認(rèn)識(shí)哮喘基本知識(shí)水平合格率基本達(dá)到80%以上,然而對(duì)照組患兒僅3項(xiàng)哮喘治療基本知識(shí)項(xiàng)目評(píng)估達(dá)到合格,兩組對(duì)比(P0.05)差異性明顯有統(tǒng)計(jì)學(xué)意義。②觀察組患兒在哮喘病情控制質(zhì)量顯著高于對(duì)照組,其觀察組顯效24例,有效19例,無(wú)效3例,治療總有效率達(dá)到93.48%,對(duì)照組患兒顯效18例,有效13例,無(wú)效14例,治療總有效率為68.89%,對(duì)比差異性明顯(P0.05)有統(tǒng)計(jì)學(xué)意義。③通過(guò)細(xì)致全面護(hù)理治療以及完善的健康教育后,觀察組患兒肺功能指標(biāo)FEV1與PEF占預(yù)計(jì)值好轉(zhuǎn)效果均明顯優(yōu)于對(duì)照組,兩組對(duì)比差異性明顯有統(tǒng)計(jì)學(xué)意義(P0.05)。④采取系統(tǒng)全面健康教育護(hù)理的觀察組患兒在自我護(hù)理能力方面明顯優(yōu)于常規(guī)治療的對(duì)照組,其觀察組患兒正確使用MDI、注意預(yù)防誘發(fā)因素、正確使用峰流速儀、急性發(fā)作的應(yīng)急措施、何時(shí)到醫(yī)院就診、記錄哮喘日記、門診定期復(fù)診等自我護(hù)理知曉率明顯高于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義((P0.05)。⑤觀察組患兒在系統(tǒng)全面健康教育指導(dǎo)下有效提高自我管理能力,在持續(xù)自我護(hù)理12個(gè)月期間哮喘發(fā)作頻率、急診次數(shù)以及缺課天數(shù)均明顯少于對(duì)照組,(P0.05)差異有統(tǒng)計(jì)學(xué)意義。結(jié)論與對(duì)策建議:①健康教育的開展可有效提升哮喘患兒對(duì)自身病情的認(rèn)知能力;②健康教育可促進(jìn)肺功能指標(biāo)改善,提高哮喘防治能力;③健康教育增強(qiáng)哮喘患兒對(duì)疾病的防護(hù)效果,增強(qiáng)哮喘病癥后期穩(wěn)定性,減少反復(fù)的可能性;④健康教育可提高哮喘患兒自我護(hù)理能力,提高哮喘癥狀控制防護(hù)質(zhì)量,減少哮喘癥狀對(duì)于患兒日常生活的影響。良好優(yōu)質(zhì)的健康教育增加患兒對(duì)自身疾病的認(rèn)知能力,提高哮喘病情監(jiān)測(cè)何發(fā)病可控性,提升哮喘發(fā)作預(yù)防效果,通過(guò)優(yōu)質(zhì)的自我護(hù)理對(duì)患兒心理情緒進(jìn)行穩(wěn)定,患兒注意預(yù)防誘發(fā)因素,自我堅(jiān)持治療和記錄哮喘日記,養(yǎng)成良好自我護(hù)理習(xí)慣,改善患兒后期生活質(zhì)量。
[Abstract]:Background: bronchial asthma (bronchial asthma) can also be called as asthma, chronic inflammatory airway disease abnormal reaction in clinical symptoms are multiple and typical of the disease from the body of T lymphocytes, eosinophils, neutrophils and bronchial epithelial cells group interaction induced inflammatory inflammatory factor can cause; the patients showed chest tightness, shortness of breath, cough or wheeze symptoms such as [1], and this kind of repeated seizures, difficult to control or cure, cause children long body, psychological, life and learning activities by resistance, greatly influence; and this kind of disease in children is about 30 ~ 50% in severe with the growth of children with asthma can be extended, with the progress of high probability for pulmonary heart disease risk, the families of children with asthma in daily life caused serious interference, but also increases the social burden. The purpose of the study is to enter a Effect of self-care ability of children with asthma treatment of late in the process of disease prevention and control, combined with modern medical education to enhance children disease related knowledge cognitive ability, aims to improve the self-care ability of children with late, reduce patients of asthma later as frequency and pain, enhance the stability of children with the disease, and ultimately improve patient quality of life and improve the health status of the body. Materials and methods: a retrospective analysis research model, in our hospital from January 2015 to October 2015 were treated 91 cases of children with asthma as the research object, in accordance with the treatment time in patients with number distribution of children and their families informed consent, in accordance with the set difference intervention guidance into two groups, adopt standard bronchial asthma treatment national pediatric asthma collaborative group for treatment of asthma control, the control group 45 Patients during treatment is only the simple application of flixotide aerosol therapy (EP), and during an asthma attack with bronchodilator treatment, given the basic knowledge of nursing; the observation group of 46 cases, the standardized treatment and nursing on the basis of organized, planned, in accordance with the implementation of health education system of children psychological characteristics overall, pay attention to change the past health knowledge of the traditional teaching mode to the widely used "people-oriented" with individual education center for science, nursing staff to strengthen psychological nursing intervention in children with asthma in the process of education, improve the physiological function, nutrition, environment support, give a comprehensive and detailed medication guide, through the improvement of health knowledge education and daily life nursing comprehensive nursing service; all patients were regularly followed up for 12 months, with the self-made "adjustment of asthma disease knowledge The look-up table with the correct understanding of the basic knowledge of asthma self mastery, the use of multi function computer respiratory function before and after ultrasound monitoring pari production of two groups of children with nursing care in the treatment of FEV1 and PEF% of expected value; recording period of treatment in children with asthma attack frequency, the number of emergency treatment; according to standard of bronchial asthma in 1998 to develop national pediatric asthma group assessment of treatment in the two groups. The curative effect of nursing data into the SPSS19.0 software were compared between groups. Results: the observation group in the 12 self to understand the basic knowledge of asthma control level were significantly higher than that of the conventional treatment control group, the observation group after health education, the correct understanding of the self the basic level of knowledge of asthma qualification rate reached over 80%, while the control group were only 3 basic knowledge of asthma treatment project evaluation Assessment of qualified, two group comparison (P0.05) difference was statistically significant. The observation group in the quality control of asthma was significantly higher than the control group, the observation group 24 cases, 19 cases were effective, 3 cases ineffective, the total efficiency of the treatment of 93.48% patients in the control group, 18 cases markedly effective in 13 cases. 14 cases were invalid, the total effective rate was 68.89%, the differences were statistically significant (P0.05). Through the comprehensive treatment and nursing health education improve after the observation of FEV1 and PEF group with lung function index% predicted better effect was significantly better than the control group, the differences between the two groups was statistically significant (P0.05). The control group observation group with comprehensive and systematic health education and nursing on self-care ability is superior to conventional treatment, the observation group with the use of MDI correctly, pay attention to the prevention of the induced factors, the correct use of peak flow Instrument, emergency measures of acute attack, when to go to the hospital, recording the asthma diary, self nursing outpatient regular follow-up visits awareness rate was significantly higher than the control group, the difference was statistically significant ((P0.05). The observation group in the comprehensive health education guidance improve the self management ability in continuous self care during the period of the 12 April asthma attack frequency, the number of emergency and missed school days were significantly less than the control group (P0.05), the difference was statistically significant. Conclusions and suggestions: 1. Health education can effectively improve asthma disease on their cognitive ability; health education can promote the improvement of lung function, improve the ability of prevention and treatment of asthma and health; enhance the education of children with asthma has protective effect on the disease, asthma later enhanced stability, reduce the possibility of repeated; health education can improve the self-care ability of children with asthma, improve The symptoms of asthma control and protection of the quality, reduce the impact of asthma symptoms in children's daily life. Good health education quality increase children on their disease cognitive ability, improve asthma monitoring where the incidence of asthma control, enhance the preventive effect, through self nursing on children with mental and emotional stability quality, pay attention to the prevention of children with predisposing factors. Self adhere to treatment and record the asthma diary, develop good habits of self care, improve the quality of life of children later.

【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)】：R473.72

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