中文版患者学习需求量表（PLNS）的研制及在冠心病患者中的初步应用
|
摘要
目的:(1)对英文原版患者学习需求量表(Patients Learning Needs Scale,PLNS)进行中文版的开发研制,评价其信效度,为我国出院患者健康教育需求评估提供测量工具。
(2)将中文PLNS量表进行临床应用,测量冠心病患者出院健康教育学习需求及影响因素,为冠心病患者出院健康教育提供指导,提高患者康复护理质量。
方法:(1)中文版患者学习需求量表(PLNS)的研制:由量表原作者Galloway于2007年12月授权提供源量表,遵循目前国际通行的“翻译-逆向翻译-文化调适-预试验”国外量表引进程序,译制并修订PLNS。通过运用中文版PLNS调查385例临床样本,对其临床可行性、内部一致性、分半信度和结构效度进行评定。
(2)中文版PLNS在冠心病患者中的临床初步应用:采用本研究研制的中文版PLNS及自行设计的冠心病患者资料调查表,调查3所医院146例冠心病出院患者的健康教育需求状况,对冠心病出院患者学习需求的影响因素做探索性分析。
结果:(1)对原版PLNS进行译制及修订,形成中文版患者学习需求量表。经临床考核,中文版PLNS有良好的科学性。问卷有效回收率为96.25%,,完成问卷时间为13.75±4.36min;总量表克朗巴赫系数(Cronbach'αCoefficient)为0.95,5个领域的Cronbach'α系数分别为:社区支持与照顾0.858,用药0.841,日常治疗与活动0.853,症状0.841,其他疾病相关0.753。总量表分半信度为0.935,5个领域的分半信度在分别为:社区支持与照顾0.877,用药0.856,日常治疗与活动0.867,症状0.845,其他疾病相关0.803。八名专家对量表内容效度评价的CVI值为0.78～0.99,全部条目的平均CVI为0.86。经主成分及因子分析,抽取特征值＞1的9个主成分,累计贡献率达64.553%,基本涵盖了社区支持与照顾、用药、症状、日常治疗与活动、其他疾病相关6个领域,证实该量表有较好的结构效度。
(2)冠心病患者学习需求状况:中文版PLNS显示了良好的内部一致性和稳定性(总量表Cronbach'α系数0.94,分半信度0.954:5个领域Cronbach'α介于0.734～0.949,分半信度0.757～0.856)。调查表明冠心病患者存在不同程度的学习需求感受。调查表中得分前5位的条目全部属于症状和用药方面。量表各领域得分从高到低依次为:症状、用药、日常治疗与活动、其他疾病相关、社区支持与照顾,且差别有统计学意义(P＜0.01)。
(3)冠心病患者学习需求影响因素:单因素分析结果显示与患者学习需求有关的因素包括:患者年龄、婚姻状况、文化程度、医疗费用支付形式、冠心病住院次数、用药情况、是否介入治疗/检查、临床类型。
多因素分析结果显示,患者总学习需求的主要影响因素由大到小排列为:冠心病自捍问⒘俅怖嘈汀⒁搅品延弥Ц缎问健！吧缜С钟胝展恕狈矫嫜靶枨蟮闹饕跋煲蛩匚幕潭取！坝靡狈矫嫜靶枨蟮闹饕跋煲蛩赜纱蟮叫∨帕形?医疗费用支付形式、用药情况、冠心病住院次数。“日常治疗与活动”方面学习需求的主要影响因素由大到小排列为:冠心病住院次数、治疗方式。“并发症与症状”方面学习需求的主要影响因素由大到小排列为:医疗费用支付形式、治疗方式。“其他疾病相关”方面学习需求的主要影响因素是临床类型。
结论:(1)研究结果显示中文版PLNS有良好的可行性及信度效度,可望为出院患者健康教育学习需求的评价及科研工作提供一个科学的评估工具。
(2)冠心病患者普遍存在较高程度的学习需求,且具有多维性。影响冠心病患者学习需求的人口统计学主要因素是:年龄、婚姻状况、文化程度、医疗费用支付形式。影响冠心病患者学习需求的疾病相关特征主要因素是:冠心病住院次数、临床类型、用药情况、治疗方式。
Objective: To develop the Chinese version of Patient Learning Needs Scale(PLNS), and evaluate feasibility, validity and reliability of the developed scale. Supply an instrument to measure patients' perception of learning needs at time of discharge for clinical nurses. To explore the learning needs of patients who have received treatment for Coronary Heart Disease (CHD) before their discharge home from hospital.
Methods: (1) Development Chinese version of PLNS: The standard procedure of cross-culture adaptation was used to develop the Chinese version PLNS. A total of 385 adults hospitalized with a medical or surgical illness completed the Chinese version PLNS. The feasibility and psychometric properties of the scale such as internal consistency, split-half reliability, content validity and construct validity were evaluated.
(2) Preliminary Application in Patient with Coronary Heart Disease: The Chinese Version of Patient Learning Needs Scale was completed by 135 CHD patients within 72 hours of their intended discharge. Quantitative descriptive and inferential analysis was conducted using Statistical Package for Social Sciences.
Result: (1) The Chinese version of PLNS was developed which consist of 40items and 5 subscales:①Support and Care in the Community (10 items);②Medications (8 items);③Treatment and Activities of Living (8 items);④Complications and symptoms (8 items);⑤Illness-Related Concerns (6 items).These are evaluated using a five-point likert scale, responses ranging from 1 (not at all important) to 5 (extremely important).
(2) The Chinese version of PLNS has satisfactory feasibility, validity and reliability. Questionnaire recovery rate of the investigation was 98.5%, the completion rate was 97.7%. Average time of completing was 13.75±4.36min. The overall Cronbach'sαcoefficient was 0.95 and the value ofαin 5 subscales of PLNS ranged from 0.75 to 0.86. The overall split-half reliability coefficient was 0.95 and the value of split-half in 5 subscales of PLNS ranged from 0.802 to 0.876. the CVI for content validity was 0.86. The construct validity was confirmed by factor analysis with 55, 08 % variance was explained by 9 factors.
(3) CHD patients indicated how important it was to know about each of 40 information items before discharge from hospital. The 5 item which scores are all higher than the others are all belong to the dimensions of symptom and medication. Subscales relating to medications, complications and symptoms, treatment and activities of living were rated highly.
Univariate analysis revealed a significant association between patients' leaning needs and patients' age, education level, marriage status, ways of payment, times of hospitalization, ways of treatment, clinical type of CHD and medication.
Stepwise canonical discriminant analysis found that three factors, times of hospitalization, clinical type, ways of payment, were the important influencing factors of total score. The important influencing factor of Support and Care in the Community is patients' education level. The important influencing factors of Medications are ways of payment, types of medication, marriage status and times of hospitalization. The important influencing factor of Treatment and Activities of Living are times of hospitalization and ways of treatment. The important influencing factors of Complications and Symptoms are ways of payment and ways of treatment and. The important influencing factor of Illness-Related Concerns is clinical type.
Conclusion: (1) An acceptable psychometric property of the Chinese version of PLNS was indicated. PLNS could be used as positive aspects measurement of general patients' perceptions of learning needs to manage their care at home at time of discharge from hospital to home for further clinical study and nursing care.
(2) The perception of learning needs of CHD patient is existed in every dimensions. The main influencing factors of patients' learning needs are the following such as patients' education level, ways of payment, types of medication, marriage status, times of hospitalization, hospitalization days, clinical type of CHD and ways of treatment. Further should be taken to meet patients' needs for information and continuing support. Comprehensive and scientific health education based on individual differences in patients with CHD should be carried out to meet the needs of patients in support of health information.
(2)将中文PLNS量表进行临床应用,测量冠心病患者出院健康教育学习需求及影响因素,为冠心病患者出院健康教育提供指导,提高患者康复护理质量。
方法:(1)中文版患者学习需求量表(PLNS)的研制:由量表原作者Galloway于2007年12月授权提供源量表,遵循目前国际通行的“翻译-逆向翻译-文化调适-预试验”国外量表引进程序,译制并修订PLNS。通过运用中文版PLNS调查385例临床样本,对其临床可行性、内部一致性、分半信度和结构效度进行评定。
(2)中文版PLNS在冠心病患者中的临床初步应用:采用本研究研制的中文版PLNS及自行设计的冠心病患者资料调查表,调查3所医院146例冠心病出院患者的健康教育需求状况,对冠心病出院患者学习需求的影响因素做探索性分析。
结果:(1)对原版PLNS进行译制及修订,形成中文版患者学习需求量表。经临床考核,中文版PLNS有良好的科学性。问卷有效回收率为96.25%,,完成问卷时间为13.75±4.36min;总量表克朗巴赫系数(Cronbach'αCoefficient)为0.95,5个领域的Cronbach'α系数分别为:社区支持与照顾0.858,用药0.841,日常治疗与活动0.853,症状0.841,其他疾病相关0.753。总量表分半信度为0.935,5个领域的分半信度在分别为:社区支持与照顾0.877,用药0.856,日常治疗与活动0.867,症状0.845,其他疾病相关0.803。八名专家对量表内容效度评价的CVI值为0.78～0.99,全部条目的平均CVI为0.86。经主成分及因子分析,抽取特征值＞1的9个主成分,累计贡献率达64.553%,基本涵盖了社区支持与照顾、用药、症状、日常治疗与活动、其他疾病相关6个领域,证实该量表有较好的结构效度。
(2)冠心病患者学习需求状况:中文版PLNS显示了良好的内部一致性和稳定性(总量表Cronbach'α系数0.94,分半信度0.954:5个领域Cronbach'α介于0.734～0.949,分半信度0.757～0.856)。调查表明冠心病患者存在不同程度的学习需求感受。调查表中得分前5位的条目全部属于症状和用药方面。量表各领域得分从高到低依次为:症状、用药、日常治疗与活动、其他疾病相关、社区支持与照顾,且差别有统计学意义(P＜0.01)。
(3)冠心病患者学习需求影响因素:单因素分析结果显示与患者学习需求有关的因素包括:患者年龄、婚姻状况、文化程度、医疗费用支付形式、冠心病住院次数、用药情况、是否介入治疗/检查、临床类型。
多因素分析结果显示,患者总学习需求的主要影响因素由大到小排列为:冠心病自捍问⒘俅怖嘈汀⒁搅品延弥Ц缎问健！吧缜С钟胝展恕狈矫嫜靶枨蟮闹饕跋煲蛩匚幕潭取！坝靡狈矫嫜靶枨蟮闹饕跋煲蛩赜纱蟮叫∨帕形?医疗费用支付形式、用药情况、冠心病住院次数。“日常治疗与活动”方面学习需求的主要影响因素由大到小排列为:冠心病住院次数、治疗方式。“并发症与症状”方面学习需求的主要影响因素由大到小排列为:医疗费用支付形式、治疗方式。“其他疾病相关”方面学习需求的主要影响因素是临床类型。
结论:(1)研究结果显示中文版PLNS有良好的可行性及信度效度,可望为出院患者健康教育学习需求的评价及科研工作提供一个科学的评估工具。
(2)冠心病患者普遍存在较高程度的学习需求,且具有多维性。影响冠心病患者学习需求的人口统计学主要因素是:年龄、婚姻状况、文化程度、医疗费用支付形式。影响冠心病患者学习需求的疾病相关特征主要因素是:冠心病住院次数、临床类型、用药情况、治疗方式。
Objective: To develop the Chinese version of Patient Learning Needs Scale(PLNS), and evaluate feasibility, validity and reliability of the developed scale. Supply an instrument to measure patients' perception of learning needs at time of discharge for clinical nurses. To explore the learning needs of patients who have received treatment for Coronary Heart Disease (CHD) before their discharge home from hospital.
Methods: (1) Development Chinese version of PLNS: The standard procedure of cross-culture adaptation was used to develop the Chinese version PLNS. A total of 385 adults hospitalized with a medical or surgical illness completed the Chinese version PLNS. The feasibility and psychometric properties of the scale such as internal consistency, split-half reliability, content validity and construct validity were evaluated.
(2) Preliminary Application in Patient with Coronary Heart Disease: The Chinese Version of Patient Learning Needs Scale was completed by 135 CHD patients within 72 hours of their intended discharge. Quantitative descriptive and inferential analysis was conducted using Statistical Package for Social Sciences.
Result: (1) The Chinese version of PLNS was developed which consist of 40items and 5 subscales:①Support and Care in the Community (10 items);②Medications (8 items);③Treatment and Activities of Living (8 items);④Complications and symptoms (8 items);⑤Illness-Related Concerns (6 items).These are evaluated using a five-point likert scale, responses ranging from 1 (not at all important) to 5 (extremely important).
(2) The Chinese version of PLNS has satisfactory feasibility, validity and reliability. Questionnaire recovery rate of the investigation was 98.5%, the completion rate was 97.7%. Average time of completing was 13.75±4.36min. The overall Cronbach'sαcoefficient was 0.95 and the value ofαin 5 subscales of PLNS ranged from 0.75 to 0.86. The overall split-half reliability coefficient was 0.95 and the value of split-half in 5 subscales of PLNS ranged from 0.802 to 0.876. the CVI for content validity was 0.86. The construct validity was confirmed by factor analysis with 55, 08 % variance was explained by 9 factors.
(3) CHD patients indicated how important it was to know about each of 40 information items before discharge from hospital. The 5 item which scores are all higher than the others are all belong to the dimensions of symptom and medication. Subscales relating to medications, complications and symptoms, treatment and activities of living were rated highly.
Univariate analysis revealed a significant association between patients' leaning needs and patients' age, education level, marriage status, ways of payment, times of hospitalization, ways of treatment, clinical type of CHD and medication.
Stepwise canonical discriminant analysis found that three factors, times of hospitalization, clinical type, ways of payment, were the important influencing factors of total score. The important influencing factor of Support and Care in the Community is patients' education level. The important influencing factors of Medications are ways of payment, types of medication, marriage status and times of hospitalization. The important influencing factor of Treatment and Activities of Living are times of hospitalization and ways of treatment. The important influencing factors of Complications and Symptoms are ways of payment and ways of treatment and. The important influencing factor of Illness-Related Concerns is clinical type.
Conclusion: (1) An acceptable psychometric property of the Chinese version of PLNS was indicated. PLNS could be used as positive aspects measurement of general patients' perceptions of learning needs to manage their care at home at time of discharge from hospital to home for further clinical study and nursing care.
(2) The perception of learning needs of CHD patient is existed in every dimensions. The main influencing factors of patients' learning needs are the following such as patients' education level, ways of payment, types of medication, marriage status, times of hospitalization, hospitalization days, clinical type of CHD and ways of treatment. Further should be taken to meet patients' needs for information and continuing support. Comprehensive and scientific health education based on individual differences in patients with CHD should be carried out to meet the needs of patients in support of health information.
引文
[1]黄津芳,刘玉莹.护理健康教育学.2005.北京.科学技术文献出版社.
[2]沈燕萍,鄢圣英.对杭州周边农村地区中医药需求的调查与分析[J].中国中医药信息杂志,2006,13(12):1-2.
[3]薛志萍.健康教育在老年患者出院前的实施与成效[J].中国临床保健杂志,2006,5(505-506).
[4]彭迳英,关月嫦.老年冠心病患者出院前的健康教育[J].心血管康复医学杂志,2001,10(3):283-284.
[5]Rich MW,Beckham V,Wittenberg C,et al.A multidisciplinary intervention to prevent the readmission of elderly patients with congestive heart failure[J].N Engl J Meal,1995,333(18):1190-1195.
[6]CMJ C,BYA I,Willenheimer RB,et al.Cost effective management programme for heart failure reduces hospitalisation.Heart London.5(442-446),1998.
[7]陈健香.出院前健康教育在急性心肌梗死患者中的应用[J].实用临床医学,2003,4(2):111-112.
[8]李新毅.对出院患者进行电话随访健康教育初探[J].中国妇幼保健,2007,22(14):1879-1880.
[9]姜燕,王亚力,王丽萍,侯晓乐.健康教育对神经症病人焦虑、抑郁情绪的影响研究[J].护理研究:下旬版,2007,21(6):1622-1623.
[10]Parker SG,Peet SM,McPherson A,et al.A systematic review of discharge arrangements for older people[J].Health Technol Assess,2002,6(4):181-183.
[11]傅燕飞,涂国红,张成芳.针对性健康教育对慢性心力衰竭患者的影响.现代护理:上旬版.2007.13(4):920-921.
[12]姚远峰.Andragogy:一种基于成人学习的教育学[J].湖北大学成人教育学院学报,2004,22(5):26-28.
[13]Knowles M.The Adult Learner:A Neglected Species(2nd ed.)[M].Houston:Gluf Publish Company Book Division,1978.
[14]Maureen AF,Christina LS,Diane MN.King's Conceptual System and Theory of Goal Attainment:Past,Present,and Future[J].Nurs Sci Q,2002,(15):107-112.
[15]李峥.心肌梗塞患者对健康教育的需求调查[J].中华护理杂志,1998,33(6):355-357.
[18]张颖杰,徐健,吴琮.急性冠脉综合征的院外康复期治疗[J].中国医学研究与临床,2004,5(8):50-51.
[19]Mistiaen P.Interventions aimed at reducing problems in adult patients discharged from hospital to home:a systematic meta-review[J].BMC Health Serv Res,2007,7(10):47-65.
[20]祝秋萍,周海芸,陈惠娟.不同入院次数冠心病患者健康教育需求差异分析[J].护理学杂志,2008,23(9):63-64.
[21]Jonathan S.Information needs before hospital discharge of myocardial infarction patients:a comparative,descriptive study[J].Journal of Clinical Nursing,2007,16(4):622-671.
[22]刘艳萍.老年冠心病患不同住院时期健康教育的需求及护理对策[J].中国实用护理杂志:下旬版, 2007,23(1):57-58.
[23]矫向前,周素娟,姚小弟,等.门诊老年冠心病患者用药知识需求的调查[J].中国健康教育,2007,23(2):154-155.
[24]齐风玲,侯芳丽,付洪芝.中青年冠心病患者的健康教育[J].齐鲁护理杂志,2006,12(10B):2066-2067.
[25]肖灿华.冠心病介入治疗患者家属健康教育需求的调查分析[J].中华护理杂志,2001,36(7):543-544.
[26]付菊芳,李婵娟,张茹英,等.晚期癌症病人需求评估问卷的综合评价[J].护理研究:上旬版,2005,19(11):2274-2277.
[27]黄雪薇,张瑛,王秀利,等.癌症患者的信息需求--《癌症患者信息选择问卷》的编制与评估[J].中国心理卫生杂志,2003,17(11):750-753.
[28]刘辉,王丽姿.重危患者家属需求量表中文修订版的探讨[J].护理学报,2006,13(4):84-86.
[29]Redman B.Measurement Tools in Patient Education[M].2nd editioned.New York,NY:Springer Publishing Compan,2003.3-5,15-18.
[30]Johansson K,Hupli M,Salantera S.Patients' learning needs after hip arthroplasty.[J].J Clin Nurs,2002,11(5):634-9.
[31]Bubela N,Galloway S,McCay E,et al.The Patient Learning Needs Scale:reliability and validity[J].J Adv Nurs,1990,15(10):1181-1187.
[32]Galloway SC,Graydn JE.Ucertainty,Symptom distress,and information needs after surgery for cacer of the colon[J].Cancer Nursing,1996,19:112-117.
[33]Galloway S,Bubela N,McKibbon A,et al.Symptom distress,anxiety,depression,and discharge information needs after peripheral arterial bypass[J].J Vase Nuts,1995,13:35-40.
[34]Jickling JL,Graydon JE.The information needs at time of hospital discharge of male and female patients who have undergone coronary artery bypass grafting:a pilot study[J].Heart Lung,1997,26(5):350-357.
[35]Kheradmand M,Salman YN,Ali KM,et al.investigating the learning needs of the mothers regarding post operative surgery heart care of their infants in the health centers in tehran[J].Iran Journal of Nursing,2005,18(43):39-47.
[36]Bubela N,Galloway S,McCay E,et al.Factors influencing patients' informational needs at time of hospital discharge[J].Patient Educ Couns,1990,16(1):21-28.
[37]尹慧丽.统计工作中调查问卷设计的质量控制[J].科学决策,2008,(9):31-33.
[38]王家良.临床流行病学:临床科研设计、衡量与评价[M].上海:上海科学技术出版社,2002.
[39]Redman BK.Measurement Tools in Patient Education,2nd edition.[M].New York,NY:Springer Publishing Company,2003.
[40]卢奕云,郝元涛,林愈灯.儿童生存质量测定量表PedsQL4.0中文版的信度利效度分析[J].中山大学学报:医学科学版,2008,29(3):328-331.
[41]吴明隆.SPSS统计应用实务[M].北京:科学出版社,2003.12-119.
[42]郭素花.实用医学调查分析技术[M].北京:人民军医出版社,2005.
[43]刘建平.循证中医药临床研究方法学[M].北京:人民卫生出版社,2006.
[44]刘明芝,周仁郁.中医药统计学与软件应用[M].北京:中国中医药出版社,2006.209-215.
[45]Hopkins KD,Stanley JC,Hopkins BR.Educational and Psychological measurement and evaluation[M]:Pretice Hall Inc,1990.
[46]Xenitidis K,Thornicroft G,Leese M,et al.Reliability and validity of the CANDID - a needs assessment instrument for adults with learning disabilities and mentalhealth problems[J].British Journal of Psychiatr,2000,176:473 - 478.
[47]Osse BHP,Vernooij-Dassen MJ,deVree BPW,et al.Assessment of the need for palliative care as perceived by individual cancer patients and their families:A review of instruments for improving patient participation in palliative care[J].Cancer,2000,88(4):900-911.
[48]Hyland ME,Jones RC,Hanney KE.The Lung Information Needs Questionnaire:Development,preliminary validation and findings[J].Respir Med,2006,100(10):1870-16.
[49]付菊芳,李婵娟,张茹英,等.晚期癌症病人需求评估问卷的综合评价[J].护理研究:上旬版,2005,19(11):2274-2277.
[50]Becton DE,Bombardier C,Guillemin F,et al.Guidelines for the process of cross-cultural adaptation of self-report measures[J].Spine,2000,25(3186):3191.
[51]金娣,王刚.教育评价与测量[M].北京:教育科学出版社,2001.
[52]刘明芝,周仁郁.中医药统计学与软件应用[M].北京:中国中医药出版社,2006.
[53]Guyatt G,Walter S,Norman G.Measuring change over time:assessing the usefuInes sof valuative struments[J].J Chorn Dis,1987,40(2):171-8.
[54]Smith J,Liles C.Information needs before hospital discharge of myocardial infarction patients:a comparative,descriptive study.[J].J Clin Nurs,2007,16(4):662-71.
[55]Jacobs V.Informational needs of surgical patients following discharge[J].Applied Nursing Research,2000,13(1):12-18.
[56]Kheradmand M.SYN,Ali Khani M.HH.Investigating The Learning Needs Of The Mothers Regarding Post Operative Surgery Heart Care Of Their Infants In The Health Centers In Tehran[J].Quarterly Iran Journal Of Nursing,2005,18(43):31-38.
[57]Knowles M.The Adult Learner:A Neglected Species[M].2nd eded.Houston:Gluf Publish Company Book Division,1978.
[58]Scott JT,Thompson DR.Assessing the information needs of post-myocardial infarction patients:a systematic review.[J].Patient Educ Couns,2003,50(2):167-77.
[59]Czar ML,Engler MM.Perceived learning needs of patients with coronary artery disease using a questionnaire assessment tool.[J].Heart Lung,1997,26(2):109-17.
[60]郑春玲,林平,刘雅楠.冠心病病人疾病不确定感状况及影响因素调查[J].护理研究:中旬版, 2008,(1):110-112.
[61]Searson F.Meeting the information needs of patients with chronic heart failure.[J].Nurs Stand,2007,22(14-16):52-7;quiz 58.
[62]Timmins F,Kaliszer M.Information needs of myocardial infarction patients.[J].Eur J Cardiovasc Nurs,2003,2(1):57-65.
[63]胡丽青.冠心病患者健康教育需求调查与对策[J].护士进修杂志,2006,21(1):74-75.
[64]Ashton KC.Perceived learning needs of men and women after myocardial infarction[J].J Cardiovasc Nurs,1997,12:93-100.
[65]李健,梁玉环.老年冠心病的特点及其治疗[J].心血管康复医学杂志,2005,14(1):91-93.
[66]张艳梅.120例糖尿病病人自我护理能力的调查[J].齐齐哈尔医学院学报,2008,29(12):1506-1507.
[67]赵华,刘晓英,单玉香.住院初诊白血病病人健康信息需求及其影响因素[J].护理研究:上旬版,2008,22(9):2279-2283.
[68]王玲风,施跃健.城市空巢老人的社会支持及其与心理健康状况的关系[J].中国心理卫生杂志,2008,22(2):118-122.
[69]林婷,黄俊山,姜小鹰.社区老年人生活质量及其社区护理需求调查分析[J].护理学杂志:外科版,2006,21(9):4-7.
[70]张红,覃俊.冠心病患者焦虑抑郁与社会支持的相关性研究[J].陕西医学杂志,2008,37(4):438-439.
[71]叶丽琴.浅谈健康教育投资的经济效益[J].中国热带医学,2006,(03):546-547.
[72]方秀萍,朱敏.87例慢性肾脏病患者用药依从性影响因素调查[J].中医药临床杂志,2007,19(4):349-350.
[73]Stewart DE,Abbey SE,Shnek ZM,et al.Gender differences in health information needs and decisional preferences in patients recovering from an acute ischemic coronary event.[J].Psychosom Med,2004,66(1):42-8.
[74]费翔,吴昭琪,胡欣.冠心病患者健康知识水平及其影响因素的调查[J].解放军护理杂志,2007,24(2):30-31.
[75]叶坤琴,符中明,等.成人高原心脏病97例的心理护理[J].解放军护理杂志,2002,19(5):28-29.
[76]刘艳,罗晓.冠心病中医药治疗进展[J].中国社区医师:综合版,2008,10(15):11-11.
[77]柴云,徐增光,王保郧,等.武当山镇农村居民中医药利用及倾向研究[J].陕西中医学院学报,2005,28(1):67-68.
[78]杨芳,任蔚虹.冠状动脉介入病人应用信息交流袋减轻围术期疾病不确定感的临床研究[J].护理研究:上旬版,2008,22(5):1151-1154.
[79]舒琴,张秋兰.护理健康教育存在的问题与思考[J].时珍国医国药,2007,18(6):1521-1521.
[80]Montgomery DA,Amos RJ.Nutrition information needs during cardiac rehabilitation:perceptions of the cardiac patient and spouse.[J].J Am Diet Assoc,1991,91(9):1078-83.
[81] Day W, Batten L. Cardiac rehabilitation for women: one size does not fit all.[J]. Aust J Adv Nurs, 2006,24(1):21-6.
[82] Cebeci F, Celik SS. Discharge training and counselling increase self-care ability and reduce postdischarge problems in CABG patients.[J]. J Clin Nurs, 2008,17(3):412-20.
[83] Yap TL, Davis LS. Physical activity: the science of health promotion through tailored messages.[J]. Rehabil Nurs, 2008,33(2):55-62.
[84] Becton DE, Bombardier C, Guillemin F, et al. Cross-cultural adaptation of the Roland-Morris questionnaire for German-speaking patients with low back pain[J]. Spine, 1999,24:1099-1103.
[1]林清然.美国医院系统化健康教育的启示[J].广东医学,2008,29(7):1232-1233.
[2]Dodge J.Factors related to patients' perceptions of their cognitive needs[J].Nursing Research,1969,18(6):502-503.
[3]Redman BK.Measurement Tools in Patient Education[M].2nd editioned.New York,NY:Springer Publishing Compan,2003.3-5,15-18.
[4]王海东.美国当代成人学习理论述评[J].中国成人教育,2007,(1):126-128.
[5]Mirka T.Meeting the learning needs of post-myocardial infarction patients[J].Nurs Educ Today,1994,(14):448-456.
[6]舒琴,张秋兰.护理健康教育存在的问题与思考[J].时珍国医国药,2007,18(6):1521-1521.
[7]Killeen MB KIM.Viewpoint:use of King's conceptual system,nursing informatics,and nursing classification systems for global communication.[J].Int J Nurs Terminol Classif,2007,18(4):156.
[8]刘巍,刘玉锦.量性研究和质性研究在护理研究中的综合运用[J].吉林医学,2008,29(14):1147-1148.
[9]Baldie DJ EVA,Davey PG.The information and support needs of patients discharged after a short hospital stay for treatment of low-risk Community Acquired Pneumonia:implications for treatment without admission.[J].BMC Pulm Med.2008 Jul 29;8:11,2008,(8):11.
[10]Pelchat D LH,Levert MJ DC.Information needs of families of children with a disability:the viewpoint of parents and health professionals[J].Rech Soins Infirm.2008 Mar;(92):59-67,2008,(92):59-67.
[11]Smith J,Liles C.Information needs before hospital discharge of myocardial infarction patients:a comparative,descriptive study.[J].J Clin Nurs,2007,16(4):662-71.
[12]Johansson K,Hupli M,Salantera S.Patients' learning needs after hip arthroplasty.[J].J Clin Nurs,2002,11(5):634-9.
[13]黄雪薇,王秀利,张瑛,等.癌症患者的信息需求--信息选择情况及影响因素分析[J].中国心理卫生杂志,2003,17(11):754-756,753.
[14]Bubela N GS,McCay E MA,Nagle L PD,et al.The Patient Learning Needs Scale:reliability and validity[J].J Adv Nurs,1990,15(10):1181-1187.
[15]Jonathan S CL.Information needs before hospital discharge of myocardial infarction patients:a comparative,descriptive study[J].Journal Of Clinical Nursing,2007,16(4):622-671.
[16]Galloway SGJE.Ucertainty,Symptom distress,and information needs after surgery for cacer of the colon[J].Cancer Nursing,1996,19:112-117.
[17]Kheradmand M.SYN,Ali Khani M.HH.Investigating The Learning Needs Of The Mothers Regarding Post Operative Surgery Heart Care Of Their Infants In The Health Centers In Tehran[J].Quarterly Iran Journal Of Nursing,2005,18(43):31-38.
[18]Hyland ME JRC,Hanney KE.The Lung Information Needs Questionnaire:Development,preliminary validation and findings.[J].Respir Med,2006,100(10):1870-16.
[19]Sauro A GA,Greco PL SF,Sirignano AR SD,et al.The COPD Italian Lung Information Needs Questionnaire(LINQ):Development,preliminary validation,and findings.[J].Eur J Gen Pract.2008Sep 27:1-3,2008,(9):1-3.
[20]Gerard PS,Peterson LM.Learning needs of cardiac patients.[J].Cardiovasc Nurs,1984,20(2):7-11.
[21]Frattini E,Lindsay P,Kerr E,et al.Learning needs of congestive heart failure patients.[J].Prog Cardiovasc Nurs,1998,13(2):11-6,33.
[22]Galloway S,Graydon J,Harrison D,et al.Informational needs of women with a recent diagnosis of breast cancer:development and initial testing of a tool.[J].J Adv Nurs,1997,25(6):1175-83.
[23]Templeton HR,Coates VE.Adaptation of an instrument to measure the informational needs of men with prostate cancer.[J].J Adv Nurs,2001,35(3):357-64.
[24]李峥.心肌梗塞患者对健康教育的需求调查[J].中华护理杂志,1998,33(6):355-357.
[25]肖灿华.冠心病介入治疗患者家属健康教育需求的调查分析[J].中华护理杂志,2001,36(7):543-543.
[26]黄雪薇,张瑛,王秀利,等.癌症患者的信息需求--《癌症患者信息选择问卷》的编制与评估[J].中国心理卫生杂志,2003,17(11):750-753.
[27]Davies NJ KG,Thomas RJ BT.Information satisfaction in breast and prostate cancer patients:implications for quality of life.[J].Psychooncology,2008,17(10):1048-52.
[2]沈燕萍,鄢圣英.对杭州周边农村地区中医药需求的调查与分析[J].中国中医药信息杂志,2006,13(12):1-2.
[3]薛志萍.健康教育在老年患者出院前的实施与成效[J].中国临床保健杂志,2006,5(505-506).
[4]彭迳英,关月嫦.老年冠心病患者出院前的健康教育[J].心血管康复医学杂志,2001,10(3):283-284.
[5]Rich MW,Beckham V,Wittenberg C,et al.A multidisciplinary intervention to prevent the readmission of elderly patients with congestive heart failure[J].N Engl J Meal,1995,333(18):1190-1195.
[6]CMJ C,BYA I,Willenheimer RB,et al.Cost effective management programme for heart failure reduces hospitalisation.Heart London.5(442-446),1998.
[7]陈健香.出院前健康教育在急性心肌梗死患者中的应用[J].实用临床医学,2003,4(2):111-112.
[8]李新毅.对出院患者进行电话随访健康教育初探[J].中国妇幼保健,2007,22(14):1879-1880.
[9]姜燕,王亚力,王丽萍,侯晓乐.健康教育对神经症病人焦虑、抑郁情绪的影响研究[J].护理研究:下旬版,2007,21(6):1622-1623.
[10]Parker SG,Peet SM,McPherson A,et al.A systematic review of discharge arrangements for older people[J].Health Technol Assess,2002,6(4):181-183.
[11]傅燕飞,涂国红,张成芳.针对性健康教育对慢性心力衰竭患者的影响.现代护理:上旬版.2007.13(4):920-921.
[12]姚远峰.Andragogy:一种基于成人学习的教育学[J].湖北大学成人教育学院学报,2004,22(5):26-28.
[13]Knowles M.The Adult Learner:A Neglected Species(2nd ed.)[M].Houston:Gluf Publish Company Book Division,1978.
[14]Maureen AF,Christina LS,Diane MN.King's Conceptual System and Theory of Goal Attainment:Past,Present,and Future[J].Nurs Sci Q,2002,(15):107-112.
[15]李峥.心肌梗塞患者对健康教育的需求调查[J].中华护理杂志,1998,33(6):355-357.
[18]张颖杰,徐健,吴琮.急性冠脉综合征的院外康复期治疗[J].中国医学研究与临床,2004,5(8):50-51.
[19]Mistiaen P.Interventions aimed at reducing problems in adult patients discharged from hospital to home:a systematic meta-review[J].BMC Health Serv Res,2007,7(10):47-65.
[20]祝秋萍,周海芸,陈惠娟.不同入院次数冠心病患者健康教育需求差异分析[J].护理学杂志,2008,23(9):63-64.
[21]Jonathan S.Information needs before hospital discharge of myocardial infarction patients:a comparative,descriptive study[J].Journal of Clinical Nursing,2007,16(4):622-671.
[22]刘艳萍.老年冠心病患不同住院时期健康教育的需求及护理对策[J].中国实用护理杂志:下旬版, 2007,23(1):57-58.
[23]矫向前,周素娟,姚小弟,等.门诊老年冠心病患者用药知识需求的调查[J].中国健康教育,2007,23(2):154-155.
[24]齐风玲,侯芳丽,付洪芝.中青年冠心病患者的健康教育[J].齐鲁护理杂志,2006,12(10B):2066-2067.
[25]肖灿华.冠心病介入治疗患者家属健康教育需求的调查分析[J].中华护理杂志,2001,36(7):543-544.
[26]付菊芳,李婵娟,张茹英,等.晚期癌症病人需求评估问卷的综合评价[J].护理研究:上旬版,2005,19(11):2274-2277.
[27]黄雪薇,张瑛,王秀利,等.癌症患者的信息需求--《癌症患者信息选择问卷》的编制与评估[J].中国心理卫生杂志,2003,17(11):750-753.
[28]刘辉,王丽姿.重危患者家属需求量表中文修订版的探讨[J].护理学报,2006,13(4):84-86.
[29]Redman B.Measurement Tools in Patient Education[M].2nd editioned.New York,NY:Springer Publishing Compan,2003.3-5,15-18.
[30]Johansson K,Hupli M,Salantera S.Patients' learning needs after hip arthroplasty.[J].J Clin Nurs,2002,11(5):634-9.
[31]Bubela N,Galloway S,McCay E,et al.The Patient Learning Needs Scale:reliability and validity[J].J Adv Nurs,1990,15(10):1181-1187.
[32]Galloway SC,Graydn JE.Ucertainty,Symptom distress,and information needs after surgery for cacer of the colon[J].Cancer Nursing,1996,19:112-117.
[33]Galloway S,Bubela N,McKibbon A,et al.Symptom distress,anxiety,depression,and discharge information needs after peripheral arterial bypass[J].J Vase Nuts,1995,13:35-40.
[34]Jickling JL,Graydon JE.The information needs at time of hospital discharge of male and female patients who have undergone coronary artery bypass grafting:a pilot study[J].Heart Lung,1997,26(5):350-357.
[35]Kheradmand M,Salman YN,Ali KM,et al.investigating the learning needs of the mothers regarding post operative surgery heart care of their infants in the health centers in tehran[J].Iran Journal of Nursing,2005,18(43):39-47.
[36]Bubela N,Galloway S,McCay E,et al.Factors influencing patients' informational needs at time of hospital discharge[J].Patient Educ Couns,1990,16(1):21-28.
[37]尹慧丽.统计工作中调查问卷设计的质量控制[J].科学决策,2008,(9):31-33.
[38]王家良.临床流行病学:临床科研设计、衡量与评价[M].上海:上海科学技术出版社,2002.
[39]Redman BK.Measurement Tools in Patient Education,2nd edition.[M].New York,NY:Springer Publishing Company,2003.
[40]卢奕云,郝元涛,林愈灯.儿童生存质量测定量表PedsQL4.0中文版的信度利效度分析[J].中山大学学报:医学科学版,2008,29(3):328-331.
[41]吴明隆.SPSS统计应用实务[M].北京:科学出版社,2003.12-119.
[42]郭素花.实用医学调查分析技术[M].北京:人民军医出版社,2005.
[43]刘建平.循证中医药临床研究方法学[M].北京:人民卫生出版社,2006.
[44]刘明芝,周仁郁.中医药统计学与软件应用[M].北京:中国中医药出版社,2006.209-215.
[45]Hopkins KD,Stanley JC,Hopkins BR.Educational and Psychological measurement and evaluation[M]:Pretice Hall Inc,1990.
[46]Xenitidis K,Thornicroft G,Leese M,et al.Reliability and validity of the CANDID - a needs assessment instrument for adults with learning disabilities and mentalhealth problems[J].British Journal of Psychiatr,2000,176:473 - 478.
[47]Osse BHP,Vernooij-Dassen MJ,deVree BPW,et al.Assessment of the need for palliative care as perceived by individual cancer patients and their families:A review of instruments for improving patient participation in palliative care[J].Cancer,2000,88(4):900-911.
[48]Hyland ME,Jones RC,Hanney KE.The Lung Information Needs Questionnaire:Development,preliminary validation and findings[J].Respir Med,2006,100(10):1870-16.
[49]付菊芳,李婵娟,张茹英,等.晚期癌症病人需求评估问卷的综合评价[J].护理研究:上旬版,2005,19(11):2274-2277.
[50]Becton DE,Bombardier C,Guillemin F,et al.Guidelines for the process of cross-cultural adaptation of self-report measures[J].Spine,2000,25(3186):3191.
[51]金娣,王刚.教育评价与测量[M].北京:教育科学出版社,2001.
[52]刘明芝,周仁郁.中医药统计学与软件应用[M].北京:中国中医药出版社,2006.
[53]Guyatt G,Walter S,Norman G.Measuring change over time:assessing the usefuInes sof valuative struments[J].J Chorn Dis,1987,40(2):171-8.
[54]Smith J,Liles C.Information needs before hospital discharge of myocardial infarction patients:a comparative,descriptive study.[J].J Clin Nurs,2007,16(4):662-71.
[55]Jacobs V.Informational needs of surgical patients following discharge[J].Applied Nursing Research,2000,13(1):12-18.
[56]Kheradmand M.SYN,Ali Khani M.HH.Investigating The Learning Needs Of The Mothers Regarding Post Operative Surgery Heart Care Of Their Infants In The Health Centers In Tehran[J].Quarterly Iran Journal Of Nursing,2005,18(43):31-38.
[57]Knowles M.The Adult Learner:A Neglected Species[M].2nd eded.Houston:Gluf Publish Company Book Division,1978.
[58]Scott JT,Thompson DR.Assessing the information needs of post-myocardial infarction patients:a systematic review.[J].Patient Educ Couns,2003,50(2):167-77.
[59]Czar ML,Engler MM.Perceived learning needs of patients with coronary artery disease using a questionnaire assessment tool.[J].Heart Lung,1997,26(2):109-17.
[60]郑春玲,林平,刘雅楠.冠心病病人疾病不确定感状况及影响因素调查[J].护理研究:中旬版, 2008,(1):110-112.
[61]Searson F.Meeting the information needs of patients with chronic heart failure.[J].Nurs Stand,2007,22(14-16):52-7;quiz 58.
[62]Timmins F,Kaliszer M.Information needs of myocardial infarction patients.[J].Eur J Cardiovasc Nurs,2003,2(1):57-65.
[63]胡丽青.冠心病患者健康教育需求调查与对策[J].护士进修杂志,2006,21(1):74-75.
[64]Ashton KC.Perceived learning needs of men and women after myocardial infarction[J].J Cardiovasc Nurs,1997,12:93-100.
[65]李健,梁玉环.老年冠心病的特点及其治疗[J].心血管康复医学杂志,2005,14(1):91-93.
[66]张艳梅.120例糖尿病病人自我护理能力的调查[J].齐齐哈尔医学院学报,2008,29(12):1506-1507.
[67]赵华,刘晓英,单玉香.住院初诊白血病病人健康信息需求及其影响因素[J].护理研究:上旬版,2008,22(9):2279-2283.
[68]王玲风,施跃健.城市空巢老人的社会支持及其与心理健康状况的关系[J].中国心理卫生杂志,2008,22(2):118-122.
[69]林婷,黄俊山,姜小鹰.社区老年人生活质量及其社区护理需求调查分析[J].护理学杂志:外科版,2006,21(9):4-7.
[70]张红,覃俊.冠心病患者焦虑抑郁与社会支持的相关性研究[J].陕西医学杂志,2008,37(4):438-439.
[71]叶丽琴.浅谈健康教育投资的经济效益[J].中国热带医学,2006,(03):546-547.
[72]方秀萍,朱敏.87例慢性肾脏病患者用药依从性影响因素调查[J].中医药临床杂志,2007,19(4):349-350.
[73]Stewart DE,Abbey SE,Shnek ZM,et al.Gender differences in health information needs and decisional preferences in patients recovering from an acute ischemic coronary event.[J].Psychosom Med,2004,66(1):42-8.
[74]费翔,吴昭琪,胡欣.冠心病患者健康知识水平及其影响因素的调查[J].解放军护理杂志,2007,24(2):30-31.
[75]叶坤琴,符中明,等.成人高原心脏病97例的心理护理[J].解放军护理杂志,2002,19(5):28-29.
[76]刘艳,罗晓.冠心病中医药治疗进展[J].中国社区医师:综合版,2008,10(15):11-11.
[77]柴云,徐增光,王保郧,等.武当山镇农村居民中医药利用及倾向研究[J].陕西中医学院学报,2005,28(1):67-68.
[78]杨芳,任蔚虹.冠状动脉介入病人应用信息交流袋减轻围术期疾病不确定感的临床研究[J].护理研究:上旬版,2008,22(5):1151-1154.
[79]舒琴,张秋兰.护理健康教育存在的问题与思考[J].时珍国医国药,2007,18(6):1521-1521.
[80]Montgomery DA,Amos RJ.Nutrition information needs during cardiac rehabilitation:perceptions of the cardiac patient and spouse.[J].J Am Diet Assoc,1991,91(9):1078-83.
[81] Day W, Batten L. Cardiac rehabilitation for women: one size does not fit all.[J]. Aust J Adv Nurs, 2006,24(1):21-6.
[82] Cebeci F, Celik SS. Discharge training and counselling increase self-care ability and reduce postdischarge problems in CABG patients.[J]. J Clin Nurs, 2008,17(3):412-20.
[83] Yap TL, Davis LS. Physical activity: the science of health promotion through tailored messages.[J]. Rehabil Nurs, 2008,33(2):55-62.
[84] Becton DE, Bombardier C, Guillemin F, et al. Cross-cultural adaptation of the Roland-Morris questionnaire for German-speaking patients with low back pain[J]. Spine, 1999,24:1099-1103.
[1]林清然.美国医院系统化健康教育的启示[J].广东医学,2008,29(7):1232-1233.
[2]Dodge J.Factors related to patients' perceptions of their cognitive needs[J].Nursing Research,1969,18(6):502-503.
[3]Redman BK.Measurement Tools in Patient Education[M].2nd editioned.New York,NY:Springer Publishing Compan,2003.3-5,15-18.
[4]王海东.美国当代成人学习理论述评[J].中国成人教育,2007,(1):126-128.
[5]Mirka T.Meeting the learning needs of post-myocardial infarction patients[J].Nurs Educ Today,1994,(14):448-456.
[6]舒琴,张秋兰.护理健康教育存在的问题与思考[J].时珍国医国药,2007,18(6):1521-1521.
[7]Killeen MB KIM.Viewpoint:use of King's conceptual system,nursing informatics,and nursing classification systems for global communication.[J].Int J Nurs Terminol Classif,2007,18(4):156.
[8]刘巍,刘玉锦.量性研究和质性研究在护理研究中的综合运用[J].吉林医学,2008,29(14):1147-1148.
[9]Baldie DJ EVA,Davey PG.The information and support needs of patients discharged after a short hospital stay for treatment of low-risk Community Acquired Pneumonia:implications for treatment without admission.[J].BMC Pulm Med.2008 Jul 29;8:11,2008,(8):11.
[10]Pelchat D LH,Levert MJ DC.Information needs of families of children with a disability:the viewpoint of parents and health professionals[J].Rech Soins Infirm.2008 Mar;(92):59-67,2008,(92):59-67.
[11]Smith J,Liles C.Information needs before hospital discharge of myocardial infarction patients:a comparative,descriptive study.[J].J Clin Nurs,2007,16(4):662-71.
[12]Johansson K,Hupli M,Salantera S.Patients' learning needs after hip arthroplasty.[J].J Clin Nurs,2002,11(5):634-9.
[13]黄雪薇,王秀利,张瑛,等.癌症患者的信息需求--信息选择情况及影响因素分析[J].中国心理卫生杂志,2003,17(11):754-756,753.
[14]Bubela N GS,McCay E MA,Nagle L PD,et al.The Patient Learning Needs Scale:reliability and validity[J].J Adv Nurs,1990,15(10):1181-1187.
[15]Jonathan S CL.Information needs before hospital discharge of myocardial infarction patients:a comparative,descriptive study[J].Journal Of Clinical Nursing,2007,16(4):622-671.
[16]Galloway SGJE.Ucertainty,Symptom distress,and information needs after surgery for cacer of the colon[J].Cancer Nursing,1996,19:112-117.
[17]Kheradmand M.SYN,Ali Khani M.HH.Investigating The Learning Needs Of The Mothers Regarding Post Operative Surgery Heart Care Of Their Infants In The Health Centers In Tehran[J].Quarterly Iran Journal Of Nursing,2005,18(43):31-38.
[18]Hyland ME JRC,Hanney KE.The Lung Information Needs Questionnaire:Development,preliminary validation and findings.[J].Respir Med,2006,100(10):1870-16.
[19]Sauro A GA,Greco PL SF,Sirignano AR SD,et al.The COPD Italian Lung Information Needs Questionnaire(LINQ):Development,preliminary validation,and findings.[J].Eur J Gen Pract.2008Sep 27:1-3,2008,(9):1-3.
[20]Gerard PS,Peterson LM.Learning needs of cardiac patients.[J].Cardiovasc Nurs,1984,20(2):7-11.
[21]Frattini E,Lindsay P,Kerr E,et al.Learning needs of congestive heart failure patients.[J].Prog Cardiovasc Nurs,1998,13(2):11-6,33.
[22]Galloway S,Graydon J,Harrison D,et al.Informational needs of women with a recent diagnosis of breast cancer:development and initial testing of a tool.[J].J Adv Nurs,1997,25(6):1175-83.
[23]Templeton HR,Coates VE.Adaptation of an instrument to measure the informational needs of men with prostate cancer.[J].J Adv Nurs,2001,35(3):357-64.
[24]李峥.心肌梗塞患者对健康教育的需求调查[J].中华护理杂志,1998,33(6):355-357.
[25]肖灿华.冠心病介入治疗患者家属健康教育需求的调查分析[J].中华护理杂志,2001,36(7):543-543.
[26]黄雪薇,张瑛,王秀利,等.癌症患者的信息需求--《癌症患者信息选择问卷》的编制与评估[J].中国心理卫生杂志,2003,17(11):750-753.
[27]Davies NJ KG,Thomas RJ BT.Information satisfaction in breast and prostate cancer patients:implications for quality of life.[J].Psychooncology,2008,17(10):1048-52.