本文關(guān)鍵詞： 冠心病 健康教育 臨床路徑 德爾菲法 知-信-行模式　出處：《重慶醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:1.了解冠狀動(dòng)脈內(nèi)支架植入患者術(shù)后對健康教育的需求,構(gòu)建冠脈內(nèi)支架植入患者健康教育路徑。2.探討健康教育路徑對冠脈內(nèi)支架植入患者健康知識、健康信念以及健康行為三方面的干預(yù)效果。方法:1.在文獻(xiàn)分析的基礎(chǔ)上,利用半結(jié)構(gòu)式深入訪談法了解12名住院支架植入患者對健康教育知識的需求,為健康教育路徑的內(nèi)容提供臨床資料。2.利用專家函詢法,完善冠脈內(nèi)支架植入患者健康教育路徑內(nèi)容,形成冠脈內(nèi)支架植入患者健康教育路徑。3.采用隨機(jī)分組法,將重慶某三級甲等醫(yī)院心內(nèi)科住院的120名冠脈支架植入患者分為干預(yù)組和對照組,每組60人,干預(yù)組采用健康教育路徑進(jìn)行健康教育,對照組進(jìn)行傳統(tǒng)健康教育。利用冠心病健康知識和健康信念評價(jià)表、冠心病自我管理量表比較兩組患者出院時(shí)的健康知識、健康信念水平以及出院3個(gè)月時(shí)的健康行為情況。4.利用SPSS21.0進(jìn)行統(tǒng)計(jì)分析,采用均數(shù)、標(biāo)準(zhǔn)差、構(gòu)成比等來描述患者的一般資料情況以及健康知識、健康信念、自我管理行為的得分;采用析因設(shè)計(jì)的方差分析來比較兩組患者健康知識、健康信念差異,利用t檢驗(yàn)來比較自我管理行為的得分及總得分的差異,檢驗(yàn)水準(zhǔn)為P0.05。結(jié)果:1.通過半結(jié)構(gòu)式深入訪談對冠脈內(nèi)支架植入患者健康教育的需求進(jìn)行研究,得出四個(gè)主題:(1)冠脈內(nèi)支架植入患者的疾病知識缺乏;(2)健康知識需求迫切,主要表現(xiàn)為冠心病基本知識、支架植入術(shù)相關(guān)知識、日常生活習(xí)慣注意事項(xiàng)三方面知識的缺乏;(3)患者健康知識主要來源于報(bào)紙廣告、電視保健節(jié)目及同伴教育,醫(yī)院內(nèi)健康教育主要來源醫(yī)生,護(hù)士健康教育不到位;(4)健康信息獲取渠道少,健康促進(jìn)行為不佳。2.通過專家函詢后,最終形成包含入院教育(入院第1天)、術(shù)前教育(術(shù)前1天)、術(shù)后教育(手術(shù)當(dāng)天-術(shù)后1天)、康復(fù)教育(術(shù)后2-3天)、出院教育(出院當(dāng)天)共5個(gè)一級指標(biāo),34個(gè)二級指標(biāo)的冠脈內(nèi)支架植入患者健康教育路徑。專家的問卷回收率分別為100.00%、95.65%,分別有73.91%、31.82%的專家對兩輪問卷提出修改意見,兩輪函詢專家權(quán)威系數(shù)分別為0.925、0.935;經(jīng)過兩輪函詢后,一級指標(biāo)與二級指標(biāo)的協(xié)調(diào)系數(shù)分別為0.124、0.220,協(xié)調(diào)系數(shù)的統(tǒng)計(jì)學(xué)檢驗(yàn)p0.05,函詢結(jié)果有較好的科學(xué)性,函詢結(jié)果可取。3.將該路徑進(jìn)行臨床應(yīng)用,干預(yù)組知識、信念的得分由干預(yù)前(入院時(shí))的37.07±5.42分、14.10±2.48分,提高至干預(yù)后(出院時(shí))的55.77±7.71分、18.90±2.06分,差異有統(tǒng)計(jì)學(xué)意義(p0.05);干預(yù)后,干預(yù)組的知識、信念得分均高于對照組,差異有統(tǒng)計(jì)學(xué)意義(p0.05);出院3個(gè)月時(shí),干預(yù)組的自我管理行為得分為100.73±8.68分,高于對照組的91.13±10.70分,差異有統(tǒng)計(jì)學(xué)意義(p0.05)。結(jié)論:本研究研制了冠脈內(nèi)支架植入患者健康教育路徑,為冠心病患者健康教育提供了科學(xué)依據(jù)。冠脈內(nèi)支架植入患者健康教育路徑較傳統(tǒng)健康教育方式,能提高冠心病患者的健康知識、健康信念及健康行為水平。
[Abstract]:Objective: to understand the needs of health education of 1. coronary artery stent implantation in patients with coronary.2., construct the health education path of stent implantation in patients with health education path on intracoronary stent implantation in patients with health knowledge, health beliefs and health behavior intervention three. Methods: 1. based on the literature analysis, by half structured in-depth interviews to understand the needs of 12 hospitalized patients with stent implantation on the knowledge of health education, and provide clinical data using the.2. expert inquiry method for health education path, improve coronary stenting in patients with health education content, the formation of coronary stent implantation in patients with.3. were randomly divided into health education path, will Chongqing three level of first-class hospital department of Cardiology in 120 coronary stent implantation patients were divided into intervention group and control group, each group of 60 people, the intervention group received health education path Health education, the control group was given conventional health education. The evaluation of health knowledge and health beliefs of coronary heart disease, coronary heart disease self-management scale health knowledge was compared between the two groups at the level of health beliefs and 3 months after discharge. The health behavior of.4. using SPSS21.0 for statistical analysis, using mean, standard deviation, constitution the ratio of the general data to describe patients and health knowledge, health belief, self management behavior score; using ANOVA of factorial design to compare two groups of patients with health knowledge, health belief difference, the difference of the total score and to compare the self - management behavior score using t test, the test level of P0.05. results. 1. through semi-structured in-depth interviews of coronary stent implantation in patients with health education needs of the four topics: (1) coronary stent implantation in patients with the disease knowledge The lack of; (2) the urgent needs for health knowledge, mainly for basic knowledge of coronary heart disease, stent related knowledge, lack of attention to matters three daily habits of knowledge; (3) patients' health knowledge mainly comes from the newspaper ads, TV programs and health peer education, the main source of hospital health education of doctors, nurses and health education is not in place; (4) health information less, health promoting behavior of poor.2. through expert consultation, the final form contains admission education (the first day of admission), preoperative education (1 days before operation), education (1 days after the day of surgery, postoperative rehabilitation education (2-3) days after operation), discharge education (discharge day) a total of 5 first grade indexes, 34 level two indexes of coronary stent implantation in patients with health education. The questionnaire of experts rates were 100%, 95.65%, respectively, 73.91%, 31.82% of the experts proposed amendments to the two rounds of questionnaire, The two letter of inquiry expert authority coefficient were 0.925,0.935; after two rounds of consultation, coordination coefficient level indicators and two indicators were 0.124,0.220, statistical test P0.05 coordination coefficient, the results have good scientific inquiry, inquiry results will take.3. clinical application of the path, the intervention group knowledge, beliefs score before the intervention (admission) 37.07 + 5.42, 14.10 + 2.48, to improve the intervention (discharge) 55.77 + 7.71, 18.90 + 2.06, the difference was statistically significant (P0.05); after the intervention, the intervention group knowledge, belief scores were higher than the control group, the difference was statistically significant (P0.05); 3 months after discharge, the score of self-management behavior in the intervention group was 100.73 + 8.68, 91.13 + 10.70 higher than the control group, the difference was statistically significant (P0.05). Conclusion: This study developed coronary stent implantation in patients with health education path for coronary heart It provides a scientific basis for health education of patients. The health education path of patients with intracoronary stent implantation can improve health knowledge, health belief and health behavior level of patients with coronary heart disease compared with traditional health education.

【學(xué)位授予單位】：重慶醫(yī)科大學(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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