【摘要】：目的編制系統(tǒng)的、便于使用的、具有可讀性的顱內動脈瘤患者健康教育手冊。一方面為顱內動脈瘤患者及家屬提供知識指導,提高健康教育有效性及患者的遵醫(yī)行為,促使患者采取健康的行為方式,減少顱內動脈瘤破裂或再出血的危險因素,降低并發(fā)癥的發(fā)生率,提高其生命質量,另一方面可以指導和規(guī)范護士對患者進行健康教育。方法1.編制顱內動脈瘤患者術前知識態(tài)度行為自評問卷:通過文獻分析法、頭腦風暴法及專家咨詢法,借鑒其他疾病的知識態(tài)度行為知曉度問卷,自行編制顱內動脈瘤患者術前知識態(tài)度行為自評問卷,并對問卷進行信度和效度檢驗。2.顱內動脈瘤患者健康教育內容的制定:對患者及醫(yī)護人員進行半結構式訪談,利用信息飽和原則,最終確定18名受訪者,使用NVivo質性研究軟件結合Colaizzi方法對訪談資料進行編碼,并通過文獻分析、指南解讀,確定顱內動脈瘤患者健康教育的內容。3.手冊的排版和編制:選取某三甲醫(yī)院神經(jīng)外科醫(yī)護人員及患者各5名,利用自行設計的調查問卷對手冊內容的完整性及準確性、方便實用性等進行評價并提出修改意見,根據(jù)反饋的意見進行修改并請專業(yè)編輯進行排版校對,編制最終的顱內動脈瘤患者健康教育手冊。結果顱內動脈瘤患者術前健康知識態(tài)度行為自評問卷包括4個維度,共17個條目:疾病知識知曉(4個條目)、治療知曉(4個條目)、情緒控制(3個條目)及危險因素知曉(6個條目)。問卷的內容效度檢驗結果顯示評定者間一致性為0.823,CVI值為0.823。Cronbach’sα系數(shù)為0.810,折半信度為0.799。對質性訪談資料編碼結合文獻分析,顱內動脈瘤患者健康教育的內容由8個一級目錄、19個二級目錄構成。一級目錄包括疾病相關知識簡介、誘發(fā)破裂的危險因素、相關檢查的必要性和注意事項、治療方法、術前術后注意事項、用藥指導、出院指導和患者及家屬提出的常見問題。結論本研究編制的顱內動脈瘤患者健康教育手冊得到了醫(yī)護人員和患者的高度評價,內容完整、準確、方便實用性,患者可通過填寫顱內動脈瘤術前健康知識態(tài)度行為自評問卷并閱讀健康教育內容,增加患者的疾病相關知識,使患者產(chǎn)生信念,最終促進行為的改變,提高患者的遵醫(yī)行為和對疾病知識的掌握程度。醫(yī)護人員也可根據(jù)手冊對患者實施系統(tǒng)的、有針對的、個體的健康教育。
[Abstract]:Objective to compile a systematic, easy-to-use and readable handbook of health education for patients with intracranial aneurysms. On the one hand, to provide knowledge guidance for intracranial aneurysm patients and their relatives, to improve the effectiveness of health education and patients' compliance with medical treatment, to urge patients to adopt healthy behavior, and to reduce the risk factors of intracranial aneurysm rupture or rebleeding. Reducing the incidence of complications, improving their quality of life, on the other hand, can guide and standardize the health education of patients. Method 1. Self-evaluation questionnaire of knowledge attitude and behavior in patients with intracranial aneurysms was compiled: by literature analysis, brainstorming and expert consultation, the knowledge, attitude and behavior awareness questionnaire of other diseases was used for reference. The self-assessment questionnaire of knowledge, attitude and behavior in patients with intracranial aneurysm was compiled, and the reliability and validity of the questionnaire were tested. 2. The content of health education for patients with intracranial aneurysms was determined by semi-structured interviews with patients and medical staff, and 18 interviewees were determined by the principle of information saturation. The interview data were encoded by NVivo qualitative research software and Colaizzi method. And through the literature analysis, the guide interpretation, determines the intracranial aneurysm patient's health education content. 3. Layout and compilation of the manual: five medical and nursing staff and five patients in neurosurgery of a third Class A hospital were selected to evaluate the completeness, accuracy, convenience and practicability of the contents of the manual by using the self-designed questionnaire, and put forward some suggestions for revision. Revise according to feedback and ask professional editors to edit and proofread the final health education manual for patients with intracranial aneurysms. Results the self-assessment questionnaire of preoperative health knowledge, attitude and behavior in intracranial aneurysms included 17 items: knowledge of disease (4 items), knowledge of treatment (4 items), emotional control (3 items) and knowledge of risk factors (6 items). The results of content validity test showed that the consistency was 0.823%, 0.823.Cronbach's 偽 coefficient was 0.810, and half reliability was 0.799 9. The contents of health education in patients with intracranial aneurysms were composed of 8 primary catalogues and 19 secondary catalogues. The first level catalogue includes a brief introduction of disease related knowledge, risk factors of inducing rupture, necessity and attention of relevant examination, treatment methods, matters needing attention before and after operation, medication guidance, discharge guidance and common questions raised by patients and their families. Conclusion the manual of health education for patients with intracranial aneurysm is highly evaluated by medical staff and patients. It is complete, accurate, convenient and practical. By filling in the questionnaire of health knowledge, attitude and behavior before intracranial aneurysm and reading the contents of health education, the patients can increase their knowledge of disease, make patients have faith, and finally promote the change of behavior. To improve the patient's compliance and knowledge of the disease. Health care workers can also carry out systematic, targeted, individual health education according to the manual.
【學位授予單位】：重慶醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R473.74

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