本文選題：腦卒中 + 健康行為�。� 參考：《河北大學(xué)》2017年碩士論文

【摘要】：目的:應(yīng)用自行設(shè)計(jì)的腦卒中患者健康行為問卷,對腦卒中患者健康行為及影響因素進(jìn)行調(diào)查,旨在了解腦卒中患者健康行為現(xiàn)狀,探討腦卒中患者健康行為的影響因素,為有針對性地進(jìn)行干預(yù)提供理論依據(jù)。方法:依據(jù)腦卒中二級預(yù)防指南,編制“腦卒中患者健康行為問卷”。經(jīng)專家咨詢,形成初始問卷,采用項(xiàng)目分析、探索性因子分析確定問卷?xiàng)l目,信度采用內(nèi)部一致性信度,效度檢驗(yàn)采用內(nèi)容效度和結(jié)構(gòu)效度,最終形成有一定信效度的腦卒中患者健康行為問卷。同時(shí),以知-信-行理論模式為理論框架,探討腦卒中患者健康行為影響因素。采用方便抽樣的方法,抽取保定市三所三級甲等醫(yī)院神經(jīng)內(nèi)科381位腦卒中患者作為研究對象,主要的測量工具包括:一般資料問卷、腦卒中患者健康知識問卷、Champion健康信念模型量表和腦卒中患者健康行為問卷。一般資料、腦卒中患者健康知識、信念及行為現(xiàn)狀采用描述性統(tǒng)計(jì)分析,健康行為影響因素采用兩獨(dú)立樣本t檢驗(yàn)、單因素方差分析、相關(guān)分析、多元線性回歸分析對數(shù)據(jù)進(jìn)行統(tǒng)計(jì)處理。結(jié)果:1.項(xiàng)目分析及信效度檢驗(yàn):最終確定腦卒中患者健康行為問卷由5個(gè)維度24個(gè)條目組成,問卷總的內(nèi)容效度(S-CVI)為0.97,各條目內(nèi)容效度(I-CVI)在0.8~1之間;經(jīng)過2次探索性因子分析最終剩余24個(gè)條目,各因子的累計(jì)方差貢獻(xiàn)率為54.47%;每個(gè)條目在相應(yīng)公因子的因子載荷量均0.40,共同度均0.3;問卷的Cronbach’sα系數(shù)為0.807。2.腦卒中患者健康知識現(xiàn)狀:腦卒中患者健康知識總得分為(47.19±7.66)分,健康知識各維度標(biāo)準(zhǔn)得分由高到低依次為:腦卒中發(fā)作的預(yù)警信號86.30分,服藥知識79.50分,腦卒中復(fù)發(fā)危險(xiǎn)因素73.23分,遵循的生活方式知識73.17分。3.腦卒中患者健康信念現(xiàn)狀:腦卒中患者健康信念總得分為(119.15±7.01)分,平均得分為(3.40±0.20)分,各維度平均得分由高到低依次為:健康動(dòng)力(4.11±0.32)分、感知到的益處(3.72±0.46)分、自我效能(3.67±0.37)分、感知到的嚴(yán)重性(3.07±0.45分)、感知到的障礙(2.95±0.43)分、感知到的易感性(2.72±0.86)分。4.腦卒中患者健康行為現(xiàn)狀:腦卒中患者的健康行為總得分為(69.76±10.08),平均得分為(2.91±0.42)分,各維度平均得分從高到低依次為戒除不良嗜好行為(4.10±0.85)分、避免有害環(huán)境行為(3.39±0.72)分、基本健康行為(2.77±0.44)分、預(yù)警行為(2.6±0.61)分、保健行為(1.99±0.70)分。5.腦卒中患者健康行為影響因素:多元逐步回歸分析結(jié)果顯示,最終進(jìn)入回歸方程的自變量是性別、年齡、文化程度、病程、醫(yī)療費(fèi)用支付方式、自我效能、感知到的障礙、感知到的益處。R2顯示8個(gè)變量共同解釋了健康行為總變異的56.40%。從標(biāo)準(zhǔn)化偏回歸系數(shù)可知,對腦卒中患者健康行為的貢獻(xiàn)大小從高到低依次為性別、自我效能、醫(yī)療費(fèi)用、支付方式、年齡、感知到的益處、感知到的障礙、文化程度、病程。結(jié)論:1.腦卒中患者健康知識處于中等水平,各維度得分由高到低依次為:腦卒中發(fā)作的預(yù)警信號、服藥知識、腦卒中相關(guān)危險(xiǎn)因素知識、應(yīng)遵循的生活方式知識。醫(yī)護(hù)人員要重點(diǎn)告知患者腦卒中危險(xiǎn)因素方面的知識。2.腦卒中患者的健康信念得分較低,其中健康動(dòng)力得分最高,感知到的易感性得分最低。3.腦卒中患者的健康行為得分處于中等水平,各維度平均得分由高到低依次為:戒除不良嗜好行為、避免有害環(huán)境行為、基本健康行為、預(yù)警行為、保健行為,其中得分最低的5個(gè)條目為定期體檢、控制體重、進(jìn)行運(yùn)動(dòng)鍛煉時(shí)達(dá)到預(yù)期的心率、每周至少做3次30分鐘及以上的輕中等強(qiáng)度的有氧運(yùn)動(dòng)、閱讀關(guān)于防治腦卒中的書報(bào)或觀看相關(guān)的電視節(jié)目。4.腦卒中患者健康行為的影響因素包括性別、年齡、文化程度、病程、醫(yī)療費(fèi)用支付方式、自我效能、感知到的障礙、感知到的益處。女性、年齡、高中及以上學(xué)歷、醫(yī)療保險(xiǎn)、自我效能、感知到的益處、1-3年病程是影響腦卒中患者健康行為水平的促進(jìn)因素,感知到的障礙是腦卒中患者健康行為水平的阻礙因素。
[Abstract]:Objective: To investigate the health behavior and influencing factors of stroke patients by using a self-designed health behavior questionnaire for stroke patients. The purpose of this study is to understand the status of healthy behavior of stroke patients and to explore the factors influencing the health behavior of stroke patients, and to provide theoretical basis for the intervention of stroke patients. Methods: two stages of stroke prevention is based on the prevention of stroke. The guideline was to compile a "questionnaire on health behavior for stroke patients". After expert consultation, an initial questionnaire was formed. The items were determined by project analysis and exploratory factor analysis. The reliability of the questionnaire was determined by the internal consistency reliability. The validity and validity of the questionnaire were tested by the validity and validity of the questionnaire. With the theoretical framework of knowledge and line theory as the theoretical framework, the factors affecting the health behavior of stroke patients were discussed. 381 stroke patients in the neurology department of three grade A hospitals in Baoding city were selected by convenient sampling. The main measurement tools included the general data questionnaire, the health knowledge questionnaire for stroke patients, Champio N health belief model scale and health behavior questionnaire for stroke patients. General data, health knowledge, belief and behavior status of stroke patients were analyzed by descriptive statistical analysis. Two independent sample t test, single factor variance analysis, correlation analysis, multi element linear regression analysis were used to deal with the data. 1. project analysis and reliability and validity test: the final determination of the health behavior questionnaire of stroke patients was made up of 5 dimensions and 24 items. The total content validity (S-CVI) of the questionnaire was 0.97 and the content validity of each item (I-CVI) was between 0.8~1. After 2 exploratory factor analysis, the total variance contribution rate of each factor was 54.47%; each factor was 54.47%. The factor load of the corresponding factor was 0.40 and the common degree was 0.3. The Cronbach 's alpha coefficient of the questionnaire was the status of health knowledge of stroke patients with 0.807.2.: the total score of health knowledge of stroke patients was (47.19 + 7.66), and the standard scores of health knowledge were from high to low, 86.30 points and medicine knowledge. 79.50 points, the risk factors of stroke recurrence were 73.23 points, and the life style knowledge was followed by 73.17 points.3. stroke patients' health belief status: the total score of stroke patients' health belief was (119.15 + 7.01) scores (119.15 + 7.01), the average score was (3.40 + 0.20) points, and the average scores from high to low in each dimension were: health motivation (4.11 + 0.32), and perceived benefits (3.72 The score of 0.46), self efficacy (3.67 + 0.37), perceived severity (3.07 + 0.45), perceived barrier (2.95 + 0.43), perceived susceptibility (2.72 + 0.86).4. stroke patients' healthy behavior status: the total score of stroke patients' health behavior was (69.76 + 10.08), average score was (2.91 + 0.42) scores, and the average score of each dimension was higher. The lower order was to abstinate bad hobby behavior (4.10 + 0.85), avoid harmful environmental behavior (3.39 + 0.72), basic health behavior (2.77 + 0.44), early warning (2.6 + 0.61), health behavior (1.99 + 0.70) (1.99 + 0.70) of the health behavior of stroke patients: multivariate stepwise regression analysis showed that the independent variables of the regression equation were finally entered. Gender, age, age, education, course of illness, medical expenses, self-efficacy, perceived barriers, and perceived benefits.R2 showed that 8 variables co explained the 56.40%. of the total variation of health behavior from the standardized partial regression coefficient, and the contribution size of stroke patients from high to low to sex and self-efficacy, Medical expenses, ways of payment, age, perceived benefits, perceived barriers, cultural degree, and course of illness. Conclusion: 1. the health knowledge of stroke patients is at the middle level, and the scores from high to low in each dimension are the early warning signal of stroke attack, knowledge of medication, knowledge of related risk factors in the stroke and the knowledge of life style that should be followed. The people should focus on the knowledge of the risk factors of stroke in patients with.2., the scores of health beliefs of stroke patients were lower, among which the score of health motivation was the highest and the scores of perceived susceptibility to the lowest.3. stroke patients were at the middle level, and the average scores from high to low were the following: abstinence of bad habits, Avoid harmful environmental behavior, basic health behavior, early warning behavior, health behavior, of which 5 items with the lowest score are regular physical examination, control of body weight, exercise to the expected heart rate, at least 3 times of mild and moderate aerobic exercise for 30 minutes or more per week, reading about the prevention and treatment of stroke, reading or watching The factors affecting health behavior of stroke patients in.4. include gender, age, age, course of illness, medical expenses, self-efficacy, perceived barriers, perceived benefits. Women, age, high school and above, medical insurance, self-efficacy, perceived benefits, and 1-3 years' course of illness that affect stroke patients' health. Perceived barriers are a hindrance to the level of health behaviors of stroke patients.
【學(xué)位授予單位】：河北大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R743.3

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