自我管理教育课程对社区脑卒中患者的效果
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摘要
目的研究自我管理教育课程对社区脑卒中患者自我管理情况的改善。方法入选2012年1月到2016年12月北京市丰台区方庄社区卫生服务中心脑卒中患者115例,随机数字表法分为研究组57例和对照组58例。对照组接受常规门诊健康教育,研究组听取自我管理教育课程,1次/周,共听6周课,课程结束后比较2组患者慢性病自我效能情况。采用统计软件SPSS 19.0对数据进行分析,组间比较采用t检验或χ2检验。结果相比干预前,研究组患者干预后自我效能得分明显提高,差异具有统计学意义(P<0.05)。研究组干预后相比对照组规律锻炼[(7.89±1.12)vs(6.31±0.53)分],获取疾病信息[(9.09±0.37)vs(5.23±1.93)分],获取社区、家庭和朋友的帮助[(8.28±0.06)vs(5.17±1.61)分],和医生沟通[(9.13±0.78)vs(6.24±0.46)分],疾病总体管理[(8.12±1.77)vs(6.16±0.22)分],做家务[(9.13±0.69)vs(6.18±1.70)分]等方面得分明显提高,差异具有统计学意义(P<0.05)。结论自我管理教育课程可有效改善脑卒中患者自我管理情况。
Objective To assess improvement of the self-management in the stroke patients after attending teaching program.Methods A total of 115 stroke patients were enrolled at Fangzhuang Community Health Service Center from January 2011 to December 2016. The patients were randomly divided into study group( n = 57) and control group( n = 58). The control group were given routine outpatient health education,while the study group attended a self-management course once a week for 6 weeks. A comparison was made using Chronic Diseases Self-efficacy Scale on the completion of the course. SPSS statistics 19. 0 was used for data analysis,and Student's t test or Chi-square test for comparison. Results The self-efficacy scores after intervention were significantly higher in the study group than in the control group( P < 0. 05). Compared with control group after intervention,the study group had higher scores in regular exercise[(7. 89 ± 1. 12) vs(6. 31 ± 0. 53)],geting information on disease[(9. 09 ± 0. 37) vs(5. 23 ± 1. 93)],obtaining help from community,family and friends [( 8. 28 ± 0. 06) vs( 5. 17 ± 1. 61)],communicating with physician [( 9. 13 ± 0. 78) vs(6. 24 ± 0. 46)],managing disease in general [( 8. 12 ± 1. 77) vs( 6. 16 ± 0. 22)]and doing chores [( 9. 13 ± 0. 69) vs(6. 18 ± 1. 70)]. Conclusion Self-management teaching program can effectively improve self-management of the stroke patients.
Objective To assess improvement of the self-management in the stroke patients after attending teaching program.Methods A total of 115 stroke patients were enrolled at Fangzhuang Community Health Service Center from January 2011 to December 2016. The patients were randomly divided into study group( n = 57) and control group( n = 58). The control group were given routine outpatient health education,while the study group attended a self-management course once a week for 6 weeks. A comparison was made using Chronic Diseases Self-efficacy Scale on the completion of the course. SPSS statistics 19. 0 was used for data analysis,and Student's t test or Chi-square test for comparison. Results The self-efficacy scores after intervention were significantly higher in the study group than in the control group( P < 0. 05). Compared with control group after intervention,the study group had higher scores in regular exercise[(7. 89 ± 1. 12) vs(6. 31 ± 0. 53)],geting information on disease[(9. 09 ± 0. 37) vs(5. 23 ± 1. 93)],obtaining help from community,family and friends [( 8. 28 ± 0. 06) vs( 5. 17 ± 1. 61)],communicating with physician [( 9. 13 ± 0. 78) vs(6. 24 ± 0. 46)],managing disease in general [( 8. 12 ± 1. 77) vs( 6. 16 ± 0. 22)]and doing chores [( 9. 13 ± 0. 69) vs(6. 18 ± 1. 70)]. Conclusion Self-management teaching program can effectively improve self-management of the stroke patients.
引文
[1]王文志.中国脑血管病防治研究现状和发展方向[J].中国现代神经疾病杂志,2011,11(2):134-137.DOI:10.3969/j.issn.1672-6731.2011.02.003.Wang WZ.The present status and direction of prevention,treatment and research on cerebrovascular diseases in China[J].Chin J Contemp Neurol Neurosurg,2011,11(2):134-137.DOI:10.3969/j.issn.1672-6731.2011.02.003.
[2]黄慧嫦,蓝艳杏.脑卒中的护理进展[J].中华全科医学,2013,11(2):291-292.DOI:10.16766/j.cnki.issn.1674-4152.2013.02.015.Huang HC,Lan YX.Progress of nursing for stroke patients[J].Chin J Gen Pract,2013,11(2):291-292.DOI:10.16766/j.cnki.issn.1674-4152.2013.02.015.
[3]衡艳林,陈燕.联合家庭心理干预对脑卒中患者生存质量的影响[J].中国医药指南,2012,10(34):120-121.Heng YL,Chen Y.Effect of family psychological intervention on quality of life of stroke patients[J].Guide Chin Med,2012,10(34):120-121.
[4]张森,王维利,赵江.自我管理在癌症病人中的应用研究[J].护理研究,2011,25(8A):1980-1982.DOI:10.3969/j.issn.1009-6493.2011.22.003.Zhang S,Wang WL,Zhao J.Research on applying self-management for patients with cancer[J].Chin Nurse Res,2011,25(8A):1980-1982.DOI:10.3969/j.issn.1009-6493.2011.22.003.
[5]林琳,李颖,迟秀文.冠心病患者自我管理的研究进展[J].当代护士,2013,10:9-10.Lin L,Li Y,Chi XW.Research progress of self-management in patients with coronary heart disease[J].Today Nurs,2013,10:9-10.
[6]Barlow J,Wright C,Sheasby J,et al.Self-management approaches for people with chronic conditions:a review[J].Patient Educ Couns,2002,48(2):177-187.
[7]张丽丽,董建群.慢性病患者自我管理研究进展[J].中国慢性病预防与控制,2010,18(2):207-211.Zhang LL,Dong JQ.Progress in the self-management in patients with chronic diseases[J].Chin J Prev Control Chronic NonCommun Dis,2010,18(2):207-211.
[8]Lo SHS,Chang AM,Chau JPC.Stroke self-management support improves survivors'self-efficacy and outcome expectation of selfmanagement behaviors[J].Stroke,2018,49(3):758-760.DOI:10.1161/STROKEAHA.117.019437.
[9]Bandura A.Self-efficacy:toward a unifying theory of behavioral change[J].Psychol Rev,1977,84(2):191-215.
[10]Lorig KR,Sobel DS,Ritter PL,et al.Effect of a self management program on patients with chronic disease[J].Eff Clin Prac,2001,4(6):256-262.
[11]Williams AM,Bloomfield L,Milthorpe E,et al.Effectiveness of moving on:an Australian designed generic self-management program for people with a chronic illness[J].BMC Health Serv Res,2013,13:90-104.DOI:10.1186/1472-6963-13-90.
[12]Freund T,Gensichen J,Goetz K,et al.Evaluating self-efficacy for managing chronic disease:psychometric properties of the sixitem Self-Efficacy Scale in Germany[J].J Eval Clin Pract,2013,19(1):39-43.DOI:10.1111/j.1365-2753.2011.01764.x.
[13]Bodenheimer T,Lorig K,Holman H.Patient self-mangement of chronic disease in primary care[J].JAMA,2002,288(19):2469-2475.
[2]黄慧嫦,蓝艳杏.脑卒中的护理进展[J].中华全科医学,2013,11(2):291-292.DOI:10.16766/j.cnki.issn.1674-4152.2013.02.015.Huang HC,Lan YX.Progress of nursing for stroke patients[J].Chin J Gen Pract,2013,11(2):291-292.DOI:10.16766/j.cnki.issn.1674-4152.2013.02.015.
[3]衡艳林,陈燕.联合家庭心理干预对脑卒中患者生存质量的影响[J].中国医药指南,2012,10(34):120-121.Heng YL,Chen Y.Effect of family psychological intervention on quality of life of stroke patients[J].Guide Chin Med,2012,10(34):120-121.
[4]张森,王维利,赵江.自我管理在癌症病人中的应用研究[J].护理研究,2011,25(8A):1980-1982.DOI:10.3969/j.issn.1009-6493.2011.22.003.Zhang S,Wang WL,Zhao J.Research on applying self-management for patients with cancer[J].Chin Nurse Res,2011,25(8A):1980-1982.DOI:10.3969/j.issn.1009-6493.2011.22.003.
[5]林琳,李颖,迟秀文.冠心病患者自我管理的研究进展[J].当代护士,2013,10:9-10.Lin L,Li Y,Chi XW.Research progress of self-management in patients with coronary heart disease[J].Today Nurs,2013,10:9-10.
[6]Barlow J,Wright C,Sheasby J,et al.Self-management approaches for people with chronic conditions:a review[J].Patient Educ Couns,2002,48(2):177-187.
[7]张丽丽,董建群.慢性病患者自我管理研究进展[J].中国慢性病预防与控制,2010,18(2):207-211.Zhang LL,Dong JQ.Progress in the self-management in patients with chronic diseases[J].Chin J Prev Control Chronic NonCommun Dis,2010,18(2):207-211.
[8]Lo SHS,Chang AM,Chau JPC.Stroke self-management support improves survivors'self-efficacy and outcome expectation of selfmanagement behaviors[J].Stroke,2018,49(3):758-760.DOI:10.1161/STROKEAHA.117.019437.
[9]Bandura A.Self-efficacy:toward a unifying theory of behavioral change[J].Psychol Rev,1977,84(2):191-215.
[10]Lorig KR,Sobel DS,Ritter PL,et al.Effect of a self management program on patients with chronic disease[J].Eff Clin Prac,2001,4(6):256-262.
[11]Williams AM,Bloomfield L,Milthorpe E,et al.Effectiveness of moving on:an Australian designed generic self-management program for people with a chronic illness[J].BMC Health Serv Res,2013,13:90-104.DOI:10.1186/1472-6963-13-90.
[12]Freund T,Gensichen J,Goetz K,et al.Evaluating self-efficacy for managing chronic disease:psychometric properties of the sixitem Self-Efficacy Scale in Germany[J].J Eval Clin Pract,2013,19(1):39-43.DOI:10.1111/j.1365-2753.2011.01764.x.
[13]Bodenheimer T,Lorig K,Holman H.Patient self-mangement of chronic disease in primary care[J].JAMA,2002,288(19):2469-2475.