老年脑卒中患者健康信念与健康行为的现状调查
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摘要
目的了解老年脑卒中患者健康信念与健康行为的现状,并探讨二者的关系。方法 2017年4～11月在海南医学院第一附属医院,采用一般情况调查表、Champion健康信念量表(CHBMS)及健康促进生活方式量表Ⅱ(HPLPⅡ)对114例住院老年脑卒中患者进行问卷调查,采用单因素分析、Pearson相关系数分析、多重线性回归分析探讨老年脑卒中患者健康信念与健康行为的关系。结果共发放问卷114份,有效回收问卷100份,问卷回收有效率为87.72%。老年脑卒中患者的CHBMS总分为(103.78±12.81)分,各条目均分为(3.05±0.38)分,大于3分,处于中等水平,各维度由高到低分别为感知健康行为的障碍、健康动力、自我效能、感知健康行为的益处、感知疾病易感性、感知疾病严重性;HPLPⅡ总分为(106.89±18.51)分,各条目平均分为(2.05±0.36)分,低于2.5分,处于中等偏低水平,各维度由高到低顺序为压力管理、营养、人际关系、自我实现、健康责任感、运动;健康信念与健康行为的Pearson相关系数为0.438,为中度正相关;多重线性回归分析结果显示,健康动力和感知障碍对健康行为的影响较大(调整后R2=0.313)。结论老年脑卒中患者健康信念与健康行为水平不高,相关性不强,健康感知障碍维度得分最高,健康动力不足,应减轻老年脑卒中患者的心理负担,增强康复信心,使其采纳有利于自身的健康行为,逐步提高生活质量。
Objective To understand the status of health belief and health behavior in elderly stroke patients and to explore the relationship between them. Methods In the First Affiliated Hospital of Hainan Medical University from April 2017 to November 2017, 114 inpatients with senile stroke were investigated with general situation questionnaire, Champion Health Belief Model scale(CHBMS) and Health-Promoting Lifestyle Profile scale Ⅱ(HPLP Ⅱ).One-factor analysis, Pearson correlation coefficient analysis, and multivariate logistic regression analysis were used to investigate the relationship between health belief and health behavior in elderly stroke patients. Results A total of 114 questionnaires were sent out and 100 effective questionnaires were collected with the effective rate of questionnaire recovery of 87.72%. The total score of CHBMS in elderly patients with stroke was 103.78±12.81, and the average score of each item was 3.05±0.38, which was more than 3 and was at the middle level. The items with scores from high to low were as follows: disorder of perceived health behavior, health motivation, self-efficacy, perceived benefits of healthy behavior, susceptibility to disease, and severity of disease. The total score of HPLP Ⅱ was 106.89±18.51, and the average score of each entry was 2.05±0.36, which was lower than 2.5 and was in the middle and low level. The order of each dimension from high to low was stress management, nutrition, interpersonal relationship, self-realization, health responsibility, exercise. The Pearson correlation coefficient between health belief and healthy behavior was 0.438, with moderately positive correlation, and the results of multiple linear regression analysis showed that health motivation and perception disorder had a significant effect on healthy behavior(adjusted R2=0.313). Conclusion The level of health belief and health behavior in elderly patients with stroke is not high, and the correlation is not strong, with the score of health perception disorder the highest and the health motivation insufficient. Therefore, we should alleviate the psychological burden of elderly patients with cerebral apoplexy, enhance the confidence of rehabilitation, enable them to adopt healthy behaviors that are conducive to their own, and gradually improve their quality of life.
Objective To understand the status of health belief and health behavior in elderly stroke patients and to explore the relationship between them. Methods In the First Affiliated Hospital of Hainan Medical University from April 2017 to November 2017, 114 inpatients with senile stroke were investigated with general situation questionnaire, Champion Health Belief Model scale(CHBMS) and Health-Promoting Lifestyle Profile scale Ⅱ(HPLP Ⅱ).One-factor analysis, Pearson correlation coefficient analysis, and multivariate logistic regression analysis were used to investigate the relationship between health belief and health behavior in elderly stroke patients. Results A total of 114 questionnaires were sent out and 100 effective questionnaires were collected with the effective rate of questionnaire recovery of 87.72%. The total score of CHBMS in elderly patients with stroke was 103.78±12.81, and the average score of each item was 3.05±0.38, which was more than 3 and was at the middle level. The items with scores from high to low were as follows: disorder of perceived health behavior, health motivation, self-efficacy, perceived benefits of healthy behavior, susceptibility to disease, and severity of disease. The total score of HPLP Ⅱ was 106.89±18.51, and the average score of each entry was 2.05±0.36, which was lower than 2.5 and was in the middle and low level. The order of each dimension from high to low was stress management, nutrition, interpersonal relationship, self-realization, health responsibility, exercise. The Pearson correlation coefficient between health belief and healthy behavior was 0.438, with moderately positive correlation, and the results of multiple linear regression analysis showed that health motivation and perception disorder had a significant effect on healthy behavior(adjusted R2=0.313). Conclusion The level of health belief and health behavior in elderly patients with stroke is not high, and the correlation is not strong, with the score of health perception disorder the highest and the health motivation insufficient. Therefore, we should alleviate the psychological burden of elderly patients with cerebral apoplexy, enhance the confidence of rehabilitation, enable them to adopt healthy behaviors that are conducive to their own, and gradually improve their quality of life.
引文
[1]江玉棉,陈海莲,简爱华,等.脑卒中患者居家功能锻炼依从性与健康信念的相关性研究[J].中国临床护理, 2015, 7(2):93-96, 102.
[2]徐娟娟,肖爱玲.健康信念模式在脑卒中患者健康教育的应用[J].中西医结合心血管病杂志(电子版), 2018, 6(9):3-4.
[3]中华医学会神经病学分会中华医学会神经病学分会脑血管病学组,刘鸣,蒲传强.中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志, 2015, 48(4):246-257.
[4]彭慧蛟,万丽红,黄月友,等.脑卒中患者健康信念与健康行为的调查研究[J].中华护理杂志, 2012, 47(1):10-13.
[5]崔永菁.脑卒中患者心理障碍的原因分析及护理干预效果[J].临床医药文献杂志(电子版), 2017, 4(17):3254-3255.
[6]周末,林爱翠.脑卒中患者早期康复需求情况的调查研究[J].中国康复医学杂志, 2015, 30(8):820-821.
[7]米雪,于宏丽,张婷婷,等.优质护理服务的延续护理对脑卒中患者康复的影响[J].护士进修杂志, 2015, 30(20):1860-1863.
[8] PHILLIPS LA, TUHRIM S, KRONISH IM, et al. Stroke survivors'endorsement of a“stress belief model”of stroke prevention predicts control of risk factors for recurrent stroke[J]. Psychol Health Med,2014, 19(5):19-24.
[9]刘华玲,时艳霞,朱海萍,等.中青年脑卒中患者健康行为调查及影响因素分析[J].中华护理杂志, 2015, 50(8):981-985.
[10]王云璐,张振香,张秋实,等.脑卒中患者体育运动研究进展[J].中国老年学杂志, 2015, 35(3):829-831.
[11] MILLER KK, PORTER RE, DEBAUN-SPRAGUE E, et al. Exercise after stroke:patient adherence and beliefs after discharge from rehabilitation[J]. Top Stroke Rehabil, 2017, 24(2):142-148.
[12]张惠清.健康教育能够提高老年脑卒中病人康复护理治疗的依从性[J].智慧健康, 2017, 3(6):100-101, 108.
[13]陈丹丹,乔婷婷,郑蔚,等.住院脑卒中患者健康信念调查及影响因素分析[J].中国实用神经疾病杂志, 2015, 18(21):43-44.
[14]戎艳琴.脑卒中患者健康行为现状及影响因素研究[D].保定:河北大学, 2017.
[2]徐娟娟,肖爱玲.健康信念模式在脑卒中患者健康教育的应用[J].中西医结合心血管病杂志(电子版), 2018, 6(9):3-4.
[3]中华医学会神经病学分会中华医学会神经病学分会脑血管病学组,刘鸣,蒲传强.中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志, 2015, 48(4):246-257.
[4]彭慧蛟,万丽红,黄月友,等.脑卒中患者健康信念与健康行为的调查研究[J].中华护理杂志, 2012, 47(1):10-13.
[5]崔永菁.脑卒中患者心理障碍的原因分析及护理干预效果[J].临床医药文献杂志(电子版), 2017, 4(17):3254-3255.
[6]周末,林爱翠.脑卒中患者早期康复需求情况的调查研究[J].中国康复医学杂志, 2015, 30(8):820-821.
[7]米雪,于宏丽,张婷婷,等.优质护理服务的延续护理对脑卒中患者康复的影响[J].护士进修杂志, 2015, 30(20):1860-1863.
[8] PHILLIPS LA, TUHRIM S, KRONISH IM, et al. Stroke survivors'endorsement of a“stress belief model”of stroke prevention predicts control of risk factors for recurrent stroke[J]. Psychol Health Med,2014, 19(5):19-24.
[9]刘华玲,时艳霞,朱海萍,等.中青年脑卒中患者健康行为调查及影响因素分析[J].中华护理杂志, 2015, 50(8):981-985.
[10]王云璐,张振香,张秋实,等.脑卒中患者体育运动研究进展[J].中国老年学杂志, 2015, 35(3):829-831.
[11] MILLER KK, PORTER RE, DEBAUN-SPRAGUE E, et al. Exercise after stroke:patient adherence and beliefs after discharge from rehabilitation[J]. Top Stroke Rehabil, 2017, 24(2):142-148.
[12]张惠清.健康教育能够提高老年脑卒中病人康复护理治疗的依从性[J].智慧健康, 2017, 3(6):100-101, 108.
[13]陈丹丹,乔婷婷,郑蔚,等.住院脑卒中患者健康信念调查及影响因素分析[J].中国实用神经疾病杂志, 2015, 18(21):43-44.
[14]戎艳琴.脑卒中患者健康行为现状及影响因素研究[D].保定:河北大学, 2017.