發(fā)布時間：2018-03-06 00:00

  本文選題：信息-動機(jī)-行為技巧模型　切入點：心力衰竭　出處：《山東大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的了解心力衰竭(HF)患者自我管理現(xiàn)狀;探討信息-動機(jī)-行為技巧模型(IMB)在心力衰竭患者自我管理中的干預(yù)效果;為發(fā)展心力衰竭患者從醫(yī)院到家庭的延續(xù)護(hù)理提供干預(yù)策略。方法采取整群抽樣的方法,按照納入和排除標(biāo)準(zhǔn)將2016年1月1日至2016年12月31日在山東省某三級甲等醫(yī)院心血管內(nèi)科住院的200例心力衰竭患者選為研究對象。應(yīng)用IMB模型理論制訂并實施自我管理干預(yù)策略。用患者一般資料調(diào)查表、明尼蘇達(dá)心力衰竭生活質(zhì)量量表、心力衰竭自我管理知識問卷、心力衰竭自我護(hù)理指數(shù)量表對研究對象進(jìn)行自我管理能力和干預(yù)效果的調(diào)查和測評。收集入院時、出院時和出院2周時,患者自我管理知識、自我管理能力的變化情況。數(shù)據(jù)分析用SPSS23.0統(tǒng)計軟件,統(tǒng)計指標(biāo)有均數(shù)、標(biāo)準(zhǔn)差、率、構(gòu)成比等,重復(fù)測量資料用方差分析。結(jié)果1.本研究納入標(biāo)準(zhǔn)的200例心力衰竭患者中,5例死亡,7例失訪,有效樣本量188例,樣本有效率94.00%。2.研究對象人口學(xué)特征:心力衰竭患者60歲以上者達(dá)81.91%;性別構(gòu)成男性62.23%高于女性的37.77%,男女比例為1.65:1;初中以下學(xué)歷者居多143人,占76.06%;配偶和/或子女照顧患者占60.64%;心衰患病率城市55.32%與農(nóng)村44.68%相接近;患者以醫(yī)療保險支付費(fèi)用占比達(dá)到96.28%。3.研究對象疾病特征:188例心力衰竭患者紐約心功能分級Ⅲ～Ⅳ級占89.89%,Ⅰ～Ⅱ級僅占10.11%;冠心病居心衰病因之首占54.79%,其次為心肌病占25.00%,而高血壓、瓣膜病分別為14.98%和13.83%;合并高血壓居多占34.04%,其次為糖尿病占28.72%。4.心力衰竭患者生活質(zhì)量差(得分為69.02±16.31分);各維度得分為:身體領(lǐng)域27.63±7.45分,情緒領(lǐng)域15.94±5.06分,其他領(lǐng)域25.45±6.21分。5.本研究心力衰竭患者自我管理能力水平偏低(得分42.42±9.37分)。通過IMB模型理論制訂自我管理干預(yù)措施及內(nèi)容,對心衰患者進(jìn)行干預(yù)后,入院時、出院時、出院2周后重復(fù)測量資料方差分析顯示,患者的自我管理知識、自我護(hù)理維持、自我護(hù)理管理、自我護(hù)理信心和自我護(hù)理能力總分在干預(yù)前后有顯著不同P0.001(F=620.75,P=0.000;F=216.66,P=0.000;F=412.76,P=0.000;F=171.35,P=0.000;F=492.44,P=0.000)。結(jié)論心力衰竭患者生活質(zhì)量差,自我管理能力水平偏低。依據(jù)IMB模型理論開展的個性化心力衰竭自我管理干預(yù),提供給患者自我管理知識、動機(jī)和技能,提高了心衰患者的自我管理能力。
[Abstract]:Objective to investigate the heart failure (HF) patients self management status; to explore the information motivation behavioral skills model (IMB) intervention in self management of patients with heart failure in patients with heart failure; for the development from the hospital to the family to provide continuing nursing intervention strategies. Methods cluster sampling method, according to the inclusion and exclusion criteria from January 1, 2016 to December 31, 2016 selected as the research object in the 200 cases of heart failure patients in Shandong Province three level of first-class hospital in hospital. The application of IMB model to develop and implement the strategy of self management intervention. Patients with general information questionnaire, Minnesota heart failure quality of life scale, self management questionnaire of heart failure, heart failure self care index questionnaire and evaluation of self management the ability and effect of intervention on the object of study. Collected at admission, discharge and 2 weeks, Patient self management knowledge, the change of self management ability. Statistical analysis software using SPSS23.0 data, statistical indicators mean, standard deviation, rate, constituent ratio, repeated measurement data by variance analysis. Results 200 cases of 1. patients with heart failure were included in the study standard, 5 cases died, 7 cases were lost, effective the sample of 188 cases, the effective rate of sample 94.00%.2. on demographic characteristics: heart failure patients over the age of 60 to 81.91%; 62.23% male gender 37.77% higher than female, male to female ratio was 1.65:1; the junior high school education are 143 people, accounting for 76.06%; the spouse and / or children to take care of patients with heart failure accounted for 60.64%; the prevalence rate of 55.32% and the city close to 44.68% patients in rural areas; medical insurance payments accounted for 96.28%.3. research object: 188 cases of heart failure in patients with the disease characteristics of New York heart function grade III ~ IV grade I-II accounted for 89.89%, accounted for only 10.1 1%; coronary heart disease heart failure first accounted for 54.79%, followed by cardiomyopathy was 25%, hypertension, valvular heart disease were 14.98% and 13.83%; the majority of hypertension accounted for 34.04%, followed by diabetes accounted for 28.72%.4. of poor quality of life of the patients with heart failure (score 69.02 + 16.31 points); the scores for 27.63 + 7.45 points: physical field 15.94, emotion + 5.06, 25.45 + 6.21.5. in other areas of our patients self management ability of the low level of heart failure (score 42.42 + 9.37 points). The IMB model for self management interventions for patients with heart failure and content, intervention, admission, discharge, discharge after 2 weeks of repeated measurement data variance analysis showed that the patients' self-management knowledge, self-care maintenance, self nursing management, nursing self confidence and self care ability scores were significantly different before and after intervention in P0.001 (F=620.75, P=0.000; F =216.66, P=0.000; F=412.76, P=0.000; F=171.35, P=0.000; F=492.44, P=0.000). Conclusion patients with heart failure and poor quality of life, the ability of self management level is low. The IMB model based on personalized heart failure theory of self management intervention, provide self-management knowledge, motivation and skills, improve the self-management ability of patients with heart failure.

【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】：R473.5

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