基于健商理念健康教育在提高老年高血壓病患者自我護理能力中的應用
發(fā)布時間：2018-10-18 07:07
【摘要】：目的:了解老年高血壓病患者自我護理能力和高血壓健商水平;探討基于健商理念的健康教育方式對老年高血壓病患者自我護理能力水平的影響,為社區(qū)實施老年高血壓病患者護理干預提供科學的方法和理論依據(jù)。方法:1采用隨機抽樣的方法,抽取廣西壯族自治區(qū)南寧市西鄉(xiāng)塘區(qū)北湖南棉社區(qū)衛(wèi)生服務中心的300名老年高血壓病患者。使用自制的老年高血壓病患者一般情況調(diào)查表、高血壓自我護理能力調(diào)查表、高血壓病相關健商情況調(diào)查問卷進行調(diào)查。使用平均數(shù)±標準差描述患者自我護理能力水平、高血壓健商水平;使用百分比描述患者一般資料;運用Spearman相關分析研究患者自我護理能力與健商各維度間的關系。2隨機臨床試驗研究。采用隨機數(shù)字表法,將社區(qū)衛(wèi)生服務中心自愿參加研究的老年高血壓病患者分為對照組與干預組,每組34人。對照組實施常規(guī)健康教育模式,主要內(nèi)容為高血壓病相關知識、飲食、運動、戒煙戒酒、心理等方面,干預時間為16周。干預組實施基于健商理念的健康教育方式。該方式分為四個階段,第一階段:基礎知識講授階段,時間為第1-4周。內(nèi)容為在根據(jù)實際情況進行有針對性的常規(guī)健康教育的基礎上,根據(jù)健商理念進行自我護理能力、自我保健、高血壓—自我保健—自我護理能力三者之間的相互關系等基礎知識的教育。同時根據(jù)健商理念運用現(xiàn)代醫(yī)學、傳統(tǒng)醫(yī)學、輔助醫(yī)學和身心醫(yī)學的相關內(nèi)容,分別對健康知識和自我保健的知識和方法進行教育。第二階段:基礎知識鞏固及生活方式干預階段,時間是第5-8周。內(nèi)容為對之前所學知識進行鞏固并根據(jù)之前的調(diào)查結果,結合健商理念和Omaha系統(tǒng)理論,在根據(jù)實際情況進行有針對性的常規(guī)健康教育的基礎上,再進行有針對性的生活方式知識干預。第三階段:精神健康干預和所學內(nèi)容的系統(tǒng)回顧,時間為第9-12周。內(nèi)容為以健商身心健康的理念為中心,結合調(diào)查結果,從逆境商數(shù)、信仰空間、情感與免疫系統(tǒng)等方面進行健商精神健康知識的教育。并對所學全部內(nèi)容進行系統(tǒng)回顧。第四階段:采用入戶、知識趣味競賽等方式對患者的知識掌握程度進行復習和鞏固。時間為第13-16周。分別于干預前、干預第8周、第16周,進行高血壓自我護理能力量表、高血壓健商量表的評估,同時記錄血壓值、每日鹽的攝入情況和并發(fā)癥發(fā)生情況。最后于第16周干預結束后進行高血壓自我護理能力、高血壓健商水平、血壓值、每日鹽的攝入量和并發(fā)癥發(fā)生率的干預效果評價。運用EPidata3.0軟件對數(shù)據(jù)進行雙錄入;采用SPSS22.0軟件進行分析,分析結果以P0.05表示差異有統(tǒng)計學意義。結果:1社區(qū)老年高血壓病患者自我護理能力處于低等水平,116例(38.7%)具有較高的自我護理能力,184例(61.3%)具有較低的自我護理能力。1.1在自我護理能力量表中,行為量表得分最低(46.47±7.05)分。在量表各因子中,得分最高的是因子10(煙酒因子),最低的為因子1(飲食控制因子)。2社區(qū)老年高血壓病患者健商水平有待提高。自我保健、健康知識、生活方式、精神狀態(tài)維度的得分分別為(22.65±5.88)分、(23.26±3.97)分、(23.55±5.51)分、(26.86±3.69)分,其中自我保健、健康知識、生活方式三個維度的得分都低于臨界分(24分)。2.1自我保健維度中獲得身心健康的方法部分得分最低(5.46±1.52)分;健康知識維度中維護健康的知識部分得分最低(5.78±1.52)分;生活方式維度中飲食、營養(yǎng)與飲食習慣部分得分最低(4.66±1.37)分;精神狀態(tài)維度中個人信仰部分得分最低(5.68±1.73)分。3社區(qū)老年高血壓病患者健商各維度與自我護理能力各因子間呈正相關。除自我保健維度與因子4、精神狀態(tài)維度與因子2、5、6、8、10呈低相關(0.3≤r≤0.5)外,其余維度與各因子間呈顯著或高度相關(r0.8或0.5r≤0.8)。4基于健商理念的健康教育方式的應用在社區(qū)老年高血壓病患者的研究結果如下:4.1基于健商理念的健康教育組在干預后患者自我護理行為、動機、自我效能水平、健商各維度水平、限鹽能力、血壓控制情況較干預前有所提高,差別有統(tǒng)計學意義。4.2基于健商理念的健康教育組與常規(guī)健康教育組相比,兩組患者自我護理行為、動機、自我效能水平、健商各維度水平、收縮壓等差別均有統(tǒng)計學意義。結論:1社區(qū)老年高血壓病患者自我護理能力和健商水平大多處于低等水平,且提示我們對患者生活行為方式的干預是提高社區(qū)老年高血壓病患者自我護理能力的關鍵,同時可以圍繞健商的各維度對患者進行健康教育干預,從而提高其自我護理能力。2與常規(guī)健康教育模式相比,基于健商理念的健康教育方式可以更好的提高社區(qū)老年高血壓病患者的健康知識水平,增強其自我護理動機和自我效能,從而進一步更好的提高患者的行為能力,最終達到患者自我護理能力的提高。同時基于健商理念的健康教育方式可以更進一步的減少患者鹽的攝入量、降低患者的血壓、控制并發(fā)癥的發(fā)生與發(fā)展。
[Abstract]:Objective: To investigate the self-care ability and the level of essential hypertension in elderly patients with essential hypertension, and to explore the effect of health education on the level of self-care ability in elderly patients with essential hypertension. To provide scientific method and theoretical basis for community implementation of nursing intervention in elderly patients with essential hypertension. Methods: A random sampling method was used to extract 300 elderly patients with hypertension in the northern Hunan cotton community health service center. The survey was carried out using self-made questionnaire on general condition of elderly patients with hypertension, questionnaire on self-nursing ability of hypertension, and questionnaire on hypertension-related health quotient. To describe the patient's self-care ability level and the level of essential hypertension; use the percentage to describe the patient's general information; use Spearman-related analysis to study the relationship between self-care ability and the dimensions of healthy quotient. The elderly patients with hypertension who volunteered to participate in the study were divided into control group and intervention group by using random number table method, 34 persons in each group. The control group carried out routine health education mode. The main contents were hypertension-related knowledge, diet, exercise, smoking cessation, alcohol drinking, psychology and so on. The intervention time was 16 weeks. The intervention group carries out the health education mode based on the concept of health business. The method is divided into four stages, the first stage: the basic knowledge teaching phase, the time is the first to fourth week. On the basis of carrying out targeted routine health education according to the actual situation, the author carries on the basic knowledge education such as self-care ability, self-care, hypertension, self-care and self-care ability. At the same time, the knowledge and methods of health knowledge and self-care should be educated according to the relevant contents of modern medicine, medical science, auxiliary medicine and physical and psychological medicine according to the concept of health business. Phase 2: Basic knowledge consolidation and lifestyle intervention phase, time is 5-8 weeks. The content is to consolidate the knowledge before and according to the previous findings, combine the key business philosophy and the Omaha system theory, carry out targeted routine health education on the basis of the actual situation, and then carry out targeted lifestyle knowledge intervention. Phase III: Systematic review of mental health interventions and lessons learned, with a period of 9-12 weeks. The content is centered on the concept of healthy quotient and physical and mental health, combined with the results of investigation, from the aspects of adversity quotient, faith space, emotion and immune system, the education of mental health knowledge is carried out. and the entire content of what is learned is systematically reviewed. Stage 4: Review and consolidate the degree of knowledge of the patients in the way of household, knowledge and competition. Time is 13-16 weeks. Before intervention, intervention week 8, week 16, hypertension self-care energy meter, hypertension key consultation table evaluation, recorded blood pressure value, daily salt intake and complications occurred. Finally, the intervention effect of hypertension self-care ability, hypertension key quotient level, blood pressure value, daily salt intake and complication rate was evaluated after the end of the 16-week intervention. The data were double-entered using EPidata3. 0 software. The analysis was carried out by SPSS 10.0 software. The results showed that the difference was statistically significant with P0.05. Results: The self-nursing ability of elderly patients with hypertension in the community was low, 116 cases (38. 7%) had higher self-care ability, 184 cases (61.3%) had lower self-nursing ability. 1. In the self-care energy table, the score of behavior scale was the lowest (46. 47/ 7. 05). Among the factors of the scale, the score was the highest factor (factor 10), and the lowest factor was factor 1 (diet control factor). The level of health quotient of elderly patients with hypertension in the community should be improved. The scores of self-health, health knowledge, life style and mental state dimension were (22. 65/ 5.88), (23.26-3.97), (23.55-5.51), (26.86-3.69), among which self-care, health knowledge, The scores of the three dimensions of life style were lower than the critical score (24 points). The lowest score of the method for obtaining the physical and mental health in the self-care dimension was lowest (5.46 vs 1. 52); the lowest score of knowledge in maintaining health in the health knowledge dimension (5.78 vs. 1.52) was the lowest (5.78 vs. 1.52); diet in the lifestyle dimension, The score of nutrition and diet was the lowest (4.66/ 1.37). The score of personal beliefs in mental state was the lowest (5.68/ 1.73). The dimensions of health quotient in elderly patients with hypertension were positively correlated with the factors of self-care ability. in addition to that self-care dimension and factor 4, the mental state dimension is low relative to the factors 2, 5, 6, 8, 10 (0.3 r. r. 0. 5), There was a significant or highly correlated (r0. 8 or 0. 5r. 0. 8) among the remaining dimensions. The results of the application of health education based on the concept of health quotient in elderly patients with hypertension in the community were as follows: 4. 1 The self-care behavior and motivation of the health education group based on the concept of health care in the intervention group were as follows: Compared with the routine health education group, the self-efficacy level, the level of each dimension of the healthy quotient, the salt tolerance and the control of blood pressure were increased significantly before the intervention, and the self-nursing behavior, motivation and self-efficacy level of the two groups were compared with those of the routine health education group. The difference of dimension level and systolic blood pressure were statistically significant. Conclusion: The self-care ability and the level of health quotient of elderly patients with hypertension in the community are mostly low, and it is suggested that the intervention of the lifestyle of the patients is the key to improve the self-care ability of elderly patients with hypertension in the community. Compared with the traditional health education mode, the health education mode based on the health quotient concept can better improve the health knowledge level of the elderly patients with hypertension in the community, so that the self-care motivation and self-efficacy of the patient are enhanced, so that the capacity of the patient is further improved, and the self-care capacity of the patient is finally improved. At the same time, the health education mode based on the concept of health business can further reduce the salt intake of the patient, reduce the blood pressure of the patient, and control the occurrence and development of the complications.
【學位授予單位】：廣西中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R473.5
本文編號：2278371
[Abstract]:Objective: To investigate the self-care ability and the level of essential hypertension in elderly patients with essential hypertension, and to explore the effect of health education on the level of self-care ability in elderly patients with essential hypertension. To provide scientific method and theoretical basis for community implementation of nursing intervention in elderly patients with essential hypertension. Methods: A random sampling method was used to extract 300 elderly patients with hypertension in the northern Hunan cotton community health service center. The survey was carried out using self-made questionnaire on general condition of elderly patients with hypertension, questionnaire on self-nursing ability of hypertension, and questionnaire on hypertension-related health quotient. To describe the patient's self-care ability level and the level of essential hypertension; use the percentage to describe the patient's general information; use Spearman-related analysis to study the relationship between self-care ability and the dimensions of healthy quotient. The elderly patients with hypertension who volunteered to participate in the study were divided into control group and intervention group by using random number table method, 34 persons in each group. The control group carried out routine health education mode. The main contents were hypertension-related knowledge, diet, exercise, smoking cessation, alcohol drinking, psychology and so on. The intervention time was 16 weeks. The intervention group carries out the health education mode based on the concept of health business. The method is divided into four stages, the first stage: the basic knowledge teaching phase, the time is the first to fourth week. On the basis of carrying out targeted routine health education according to the actual situation, the author carries on the basic knowledge education such as self-care ability, self-care, hypertension, self-care and self-care ability. At the same time, the knowledge and methods of health knowledge and self-care should be educated according to the relevant contents of modern medicine, medical science, auxiliary medicine and physical and psychological medicine according to the concept of health business. Phase 2: Basic knowledge consolidation and lifestyle intervention phase, time is 5-8 weeks. The content is to consolidate the knowledge before and according to the previous findings, combine the key business philosophy and the Omaha system theory, carry out targeted routine health education on the basis of the actual situation, and then carry out targeted lifestyle knowledge intervention. Phase III: Systematic review of mental health interventions and lessons learned, with a period of 9-12 weeks. The content is centered on the concept of healthy quotient and physical and mental health, combined with the results of investigation, from the aspects of adversity quotient, faith space, emotion and immune system, the education of mental health knowledge is carried out. and the entire content of what is learned is systematically reviewed. Stage 4: Review and consolidate the degree of knowledge of the patients in the way of household, knowledge and competition. Time is 13-16 weeks. Before intervention, intervention week 8, week 16, hypertension self-care energy meter, hypertension key consultation table evaluation, recorded blood pressure value, daily salt intake and complications occurred. Finally, the intervention effect of hypertension self-care ability, hypertension key quotient level, blood pressure value, daily salt intake and complication rate was evaluated after the end of the 16-week intervention. The data were double-entered using EPidata3. 0 software. The analysis was carried out by SPSS 10.0 software. The results showed that the difference was statistically significant with P0.05. Results: The self-nursing ability of elderly patients with hypertension in the community was low, 116 cases (38. 7%) had higher self-care ability, 184 cases (61.3%) had lower self-nursing ability. 1. In the self-care energy table, the score of behavior scale was the lowest (46. 47/ 7. 05). Among the factors of the scale, the score was the highest factor (factor 10), and the lowest factor was factor 1 (diet control factor). The level of health quotient of elderly patients with hypertension in the community should be improved. The scores of self-health, health knowledge, life style and mental state dimension were (22. 65/ 5.88), (23.26-3.97), (23.55-5.51), (26.86-3.69), among which self-care, health knowledge, The scores of the three dimensions of life style were lower than the critical score (24 points). The lowest score of the method for obtaining the physical and mental health in the self-care dimension was lowest (5.46 vs 1. 52); the lowest score of knowledge in maintaining health in the health knowledge dimension (5.78 vs. 1.52) was the lowest (5.78 vs. 1.52); diet in the lifestyle dimension, The score of nutrition and diet was the lowest (4.66/ 1.37). The score of personal beliefs in mental state was the lowest (5.68/ 1.73). The dimensions of health quotient in elderly patients with hypertension were positively correlated with the factors of self-care ability. in addition to that self-care dimension and factor 4, the mental state dimension is low relative to the factors 2, 5, 6, 8, 10 (0.3 r. r. 0. 5), There was a significant or highly correlated (r0. 8 or 0. 5r. 0. 8) among the remaining dimensions. The results of the application of health education based on the concept of health quotient in elderly patients with hypertension in the community were as follows: 4. 1 The self-care behavior and motivation of the health education group based on the concept of health care in the intervention group were as follows: Compared with the routine health education group, the self-efficacy level, the level of each dimension of the healthy quotient, the salt tolerance and the control of blood pressure were increased significantly before the intervention, and the self-nursing behavior, motivation and self-efficacy level of the two groups were compared with those of the routine health education group. The difference of dimension level and systolic blood pressure were statistically significant. Conclusion: The self-care ability and the level of health quotient of elderly patients with hypertension in the community are mostly low, and it is suggested that the intervention of the lifestyle of the patients is the key to improve the self-care ability of elderly patients with hypertension in the community. Compared with the traditional health education mode, the health education mode based on the health quotient concept can better improve the health knowledge level of the elderly patients with hypertension in the community, so that the self-care motivation and self-efficacy of the patient are enhanced, so that the capacity of the patient is further improved, and the self-care capacity of the patient is finally improved. At the same time, the health education mode based on the concept of health business can further reduce the salt intake of the patient, reduce the blood pressure of the patient, and control the occurrence and development of the complications.
【學位授予單位】：廣西中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R473.5
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