發(fā)布時間：2018-03-19 06:17

  本文選題：知信行模式　切入點：健康教育　出處：《山東大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的通過對肝硬化患者疾病相關(guān)知識、信念、行為狀況進(jìn)行調(diào)查,結(jié)合健康教育"知信行模式"理論框架,制定"知信行"模式健康教育路徑表,對肝硬化患者開展系統(tǒng)化、個性化的健康教育。探討KAP模式對肝硬化患者并發(fā)癥發(fā)生率、生活質(zhì)量及護(hù)理滿意度的影響。對干預(yù)方案的有效性進(jìn)行驗證,并為改善肝硬化患者的生活質(zhì)量及護(hù)理水平提供理論依據(jù)。方法采用方便抽樣的方法。選取2016年5至9月山東省某三甲醫(yī)院消化科兩個病區(qū)共121例肝硬化患者為研究對象。采用一般資料問卷、生活質(zhì)量評價量表(SF-36)、肝硬化患者知信行問卷、滿意度調(diào)查問卷等對患者進(jìn)行調(diào)查。比較兩組患者知信行得分、生活質(zhì)量水平、并發(fā)癥的發(fā)生率及護(hù)理滿意度等。運用SPSS17.0軟件進(jìn)行數(shù)據(jù)錄入與分析,具體包括:描述性統(tǒng)計分析、χ2檢驗、t檢驗。結(jié)果納入本次研究的患者共121名,對照組失訪1例,失訪原因為患者死亡。最終完成研究的患者共120例。對照組與干預(yù)組各60例。兩組患者在性別、年齡、婚姻狀況、文化程度、人均月收入、職業(yè)、肝硬化Child分級等方面,比較均無統(tǒng)計學(xué)差異(P0.05)。具體結(jié)果如下:1.兩組患者在干預(yù)前對肝硬化知識、信念、行為方面及總分均處于較低水平,大多數(shù)患者及家屬對肝硬化的發(fā)生、防護(hù)等缺乏認(rèn)知,兩組比較無統(tǒng)計學(xué)差異,(P0.05)。干預(yù)后,干預(yù)組知信行各維度得分及總分均優(yōu)于對照組。差異有統(tǒng)計學(xué)意義(P0.05)。2.干預(yù)前:兩組患者生活質(zhì)量總分及各維度得分、軀體健康、精神健康總評分,比較均無統(tǒng)計學(xué)意義(P0.05)。干預(yù)后,對照組及干預(yù)組患者生活質(zhì)量總分分別為(62.61 ± 14.37)、(72.15±14.21)分;軀體健康總評分分別為(55.55± 13.32)、(70.09± 13.47)分;精神健康總評分分別為(52.69± 17.51)、(74.21 ±18.46)分,差異均有統(tǒng)計學(xué)意義(P0.01)。干預(yù)組其余各維度得分除軀體疼痛(BP)外,差異均有統(tǒng)計學(xué)意義(P0.05)。3.納入本研究的120例肝硬化患者中:共發(fā)生并發(fā)癥15例,其中對照組12例,分別為消化道出血6例,肝性腦病3例,水電解質(zhì)紊亂2例,原發(fā)性肝癌1例。干預(yù)組3例,分別為消化道出血1例,水電解質(zhì)紊亂1例,原發(fā)性肝癌1例。并發(fā)癥的發(fā)生率:干預(yù)組明顯低于對照組。(P0.05)。4.對照組與干預(yù)組滿意度分別是(85.14± 10.32)、(91.15±10.31)分;差異有顯著統(tǒng)計學(xué)意義。(P0.01)。結(jié)論用"知信行模式"指導(dǎo)肝硬化患者的健康教育,可以增加疾病相關(guān)知識,樹立戰(zhàn)勝疾病的信念,建立健康的生活方式,從整體提高患者的知、信、行水平。進(jìn)一步改善患者的生活質(zhì)量,減少并發(fā)癥的發(fā)生率,最終提升護(hù)理服務(wù)質(zhì)量及護(hù)理滿意度。值得進(jìn)一步推廣。
[Abstract]:Objective to investigate the disease related knowledge, belief and behavior of patients with liver cirrhosis, and to establish the path table of health education for cirrhotic patients by combining the theoretical framework of "knowing, believing and doing" in health education, and to systematize the health education of cirrhotic patients. To explore the effect of KAP model on the incidence of complications, quality of life and nursing satisfaction in patients with liver cirrhosis. To provide theoretical basis for improving the quality of life and nursing care of patients with liver cirrhosis, 121 patients with liver cirrhosis were selected from two departments of digestive department of a third class hospital of Shandong province from 2016 to September, using the method of convenient sampling. Using general information questionnaire, The quality of life (QOL) evaluation scale (SF-36), the questionnaire of knowledge, belief and behavior of patients with liver cirrhosis and the questionnaire of satisfaction were used to investigate the patients. The scores of knowledge, belief and behavior, the quality of life were compared between the two groups. The incidence of complications and nursing satisfaction were analyzed by SPSS17.0 software, including descriptive statistical analysis, 蠂 2 test and t test. The cause of the loss was death. There were 120 patients who finished the study, 60 patients in the control group and 60 patients in the intervention group. The two groups had sex, age, marital status, education level, per capita monthly income, occupation, Child grading of liver cirrhosis, and so on. There was no statistical difference between the two groups (P 0.05). The specific results were as follows: 1.The knowledge, belief, behavior and total score of cirrhosis were lower in the two groups before intervention, and most of the patients and their families lacked cognition about the occurrence and prevention of cirrhosis. There was no statistical difference between the two groups (P 0.05). After intervention, the scores and total scores of each dimension of knowledge, faith and behavior in the intervention group were better than those in the control group. The difference was statistically significant (P 0.05). Before the intervention, the total score of quality of life and the scores of each dimension of the two groups were higher than those of the control group. After intervention, the total scores of quality of life in the control group and the intervention group were 62.61 鹵14.37, 72.15 鹵14.21, 55.55 鹵13.32, 70.09 鹵13.47, 52.69 鹵17.51, 74.21 鹵18.46, respectively. All the differences were statistically significant (P 0.01). The scores of other dimensions in the intervention group were significantly different except for somatic pain (P 0.05). 3. Among the 120 cirrhotic patients in this study, there were 15 cases of complications, including 12 cases in the control group. There were 6 cases of gastrointestinal hemorrhage, 3 cases of hepatic encephalopathy, 2 cases of water electrolyte disorder and 1 case of primary liver cancer. The incidence of complications in the intervention group was significantly lower than that in the control group (P 0.05). 4. The satisfaction degree between the control group and the intervention group was 85.14 鹵10.32 and 91.15 鹵10.31, respectively. Conclusion the health education of patients with liver cirrhosis under the guidance of "knowing, believing and acting" can increase the knowledge of disease, establish the belief of overcoming disease, establish a healthy life style, and improve the knowledge and belief of patients with liver cirrhosis as a whole. Further improve the quality of life of patients, reduce the incidence of complications, and ultimately improve the quality of nursing care and nursing satisfaction.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R473.57

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