社区脑卒中自我管理小组教育课程的设计及实施
|
摘要
目的对社区脑卒中自我管理小组教育课程进行设计并探索其实施效果。方法借鉴中国香港康复会长期病自我管理教育相关理论,制定脑卒中自我管理教育课程内容。以2012年1月—2016年12月在北京市丰台区方庄社区卫生服务中心就诊的脑卒中患者115例作为研究对象,采用随机数字表法将研究对象分为研究组57例,对照组58例。监测2组患者入组前后血压,并采用慢性病自我效能量表及自我感受负担量表分别于入组前及课程结束后进行评估,评价课程实施效果。结果初次建立了方庄社区脑卒中自我管理小组,在社区层面设计了脑卒中自我管理教育课程,客观评价了课程的应用效果。完成了研究对象干预前后血压及慢性病自我效能及自我感受负担调查。2组研究对象血压值在干预后差异无统计学意义。采用慢性病自我效能量表分别在入组前对干预组及对照组进行测量,平均得分分别为(196.23±47.29)分、(203.38±54.19)分,差异无统计学意义(P>0.05)。课程结束后平均得分分别为(225.91±43.22)分、(204.83±54.60)分,差异有统计学意义(P<0.05)。采用自我感受负担量表分别在入组前对研究组及对照组进行测量,平均得分分别为(25.42±9.35)分,(24.66±7.58)分,差异无统计学意义(P>0.05)。课程结束后平均得分为(22.80±10.96)分、(24.06±8.03)分,差异有统计学意义(P<0.05)。结论本课程设计合理,适用于社区脑卒中患者;通过该课程的实施,提高了社区脑卒中患者的自我效能水平,降低了自我感受负担。
Objective To design and explore implementation effects of community stroke self-management group education courses. Methods Based on the relevant theories of the long-term self-management education of Hong Kong Rehabilitation Association, the curriculum content of stroke self-management education was developed. A total of 115 stroke patients were randomly selected as study subjects from January 2012 to December 2016, 57 in the study group and 58 in the control group. The blood pressures before and after the two groups of patients were monitored, and the chronic disease self-efficacy scale and self-perception burden scale were evaluated before and after the course of assessment to evaluate the effect of the curriculum implementation. Results The Fangzhuang Community Stroke Self-Management Group was established for the first time, and stroke self-management education curriculum was designed at the community level to objectively evaluate the application effects of the curriculum. A survey of blood pressure and chronic disease self-efficacy and self-perception burden before and after the study subjects' intervention was completed. There was no significant difference in blood pressure values between the two groups of subjects after intervention. The chronic disease self-efficacy scale was used to measure the intervention group and the control group before the entry into the group. The average scores were(196.23±47.29) points and(203.38±54.19) points respectively, P>0.05, and the difference was not statistically significant. After the end of the course, the average scores were:(225.91±43.22) points and(204.83±54.6) points, P<0.05.The difference was statistically significant. The self-perceptual burden scales were used to measure the study group and the control group before the enrollment. The average scores were:(25.42±9.35) points,(24.66±7.58) points, P>0.05, and the difference was not statistically significant. After the end of the course, the average scores were:(22.80±10.96) points,(24.06±8.03) points, P<0.05. The difference was statistically significant. Conclusion This course is designed to be suitable for patients with stroke in the community. Through the implementation of this course, the self-efficacy of stroke patients in the community has been improved, and the burden of self-perception has been reduced.
Objective To design and explore implementation effects of community stroke self-management group education courses. Methods Based on the relevant theories of the long-term self-management education of Hong Kong Rehabilitation Association, the curriculum content of stroke self-management education was developed. A total of 115 stroke patients were randomly selected as study subjects from January 2012 to December 2016, 57 in the study group and 58 in the control group. The blood pressures before and after the two groups of patients were monitored, and the chronic disease self-efficacy scale and self-perception burden scale were evaluated before and after the course of assessment to evaluate the effect of the curriculum implementation. Results The Fangzhuang Community Stroke Self-Management Group was established for the first time, and stroke self-management education curriculum was designed at the community level to objectively evaluate the application effects of the curriculum. A survey of blood pressure and chronic disease self-efficacy and self-perception burden before and after the study subjects' intervention was completed. There was no significant difference in blood pressure values between the two groups of subjects after intervention. The chronic disease self-efficacy scale was used to measure the intervention group and the control group before the entry into the group. The average scores were(196.23±47.29) points and(203.38±54.19) points respectively, P>0.05, and the difference was not statistically significant. After the end of the course, the average scores were:(225.91±43.22) points and(204.83±54.6) points, P<0.05.The difference was statistically significant. The self-perceptual burden scales were used to measure the study group and the control group before the enrollment. The average scores were:(25.42±9.35) points,(24.66±7.58) points, P>0.05, and the difference was not statistically significant. After the end of the course, the average scores were:(22.80±10.96) points,(24.06±8.03) points, P<0.05. The difference was statistically significant. Conclusion This course is designed to be suitable for patients with stroke in the community. Through the implementation of this course, the self-efficacy of stroke patients in the community has been improved, and the burden of self-perception has been reduced.
引文
[1] 刘秀梅,葛彩英,贾鸿雁,等.社区脑卒中患者“家庭医生式”服务模式的探索与实践[J].中华全科医学,2015,13(6):981-983.
[2] 魏霞.早期大剂量阿托伐他汀对缺血性脑卒中患者hs-CRP和ox-LDL的影响[J].中国临床研究,2015,28(1):33-34.
[3] 陈然,丛光燕,严兴亚,等.进展性缺血性脑卒中相关危险因素分析[J].安徽医学,2014,35(10):1398-1400.
[4] 穆景颂,倪朝民.常见病康复诊疗规范(2)——脑卒中分级康复诊疗指南解读[J].安徽医学,2016,37(9):1190-1191.
[5] 席雅曼,郭宏.四肢血压与脑卒中关系研究进展[J].中华实用诊断与治疗杂志,2017,31(2):191-193.
[6] 安秀朋,段永亮.颈动脉粥样硬化性急性缺血性脑卒中的外科治疗现状[J].中华实用诊断与治疗杂志,2014,28(9):833-834.
[7] 任连峰.健康教育与促进对脑卒中患者功能恢复影响研究[J].河北医学,2015,21(9):1527-1528.
[8] 王晓群,冯芳.自我管理健康教育对脑卒中病人自我效能水平的影响[J].全科护理,2017,15(22):2695-2697.
[9] 张朝.自我管理行为干预对脑卒中患者康复效果的影响[J].护理实践与研究,2017,14(2):148-150.
[10] 程玉华.自我管理方案对脑卒中患者康复的应用研究[J].当代护士(上旬刊),2018,25(4):35-37.
[11] 王冠洲,刘静贤,熊建中,等.影响脑卒中患者预后的相关因素分析[J].中国临床研究,2014,27(6):674-676.
[12] 陈鸿芳,吕媛,尹薇,等.协同护理模式对脑卒中患者自我护理能力及生活质量的影响[J].陕西医学杂志,2015,44(8):1101-1102.
[13] 王艳晶.综合性护理干预对慢性心力衰竭患者负性情绪、自我管理及生活质量的影响[J].中国医药指南,2018,16(1):263-264.
[14] 刘秀梅,刘新颖,葛彩英,等.家庭医生式服务模式对社区脑卒中患者生存质量影响研究[J].中华全科医学,2015,13(4):616-618.
[15] 侯艳玲,王小波,张琳娜,等.自我管理教育在手术治疗下肢动脉硬化闭塞症患者康复中的应用[J].河北医学,2015,21(10):1736-1739.
[16] 邱翠竹,王明珠,罗少莊,等.青少年1型糖尿病患者自我管理能力现状及影响因素的调查研究[J].中国医药科学,2018,8(6):10-13,30.
[17] 刘华,宋梅,黄黎,等.慢性阻塞性肺疾病患者自我管理方法研究近况[J].陕西医学杂志,2016,45(5):633-634,640.
[18] 董万里,郑丽娜,王海播,等.集束化干预对阻塞性睡眠呼吸暂停综合征患者自我管理水平的影响[J].中华实用诊断与治疗杂志,2017,31(7):710-711.
[19] 李方方,宋葆云,闫秀文.不同压力滴定技术对重度睡眠呼吸暂停患者自我管理水平的影响[J].中华实用诊断与治疗杂志,2016,30(4):391-392.
[20] 张树军,卢国友.自我管理对社区2型糖尿病患者的影响研究[J].河北医学,2014,20(10):1701-1703.
[2] 魏霞.早期大剂量阿托伐他汀对缺血性脑卒中患者hs-CRP和ox-LDL的影响[J].中国临床研究,2015,28(1):33-34.
[3] 陈然,丛光燕,严兴亚,等.进展性缺血性脑卒中相关危险因素分析[J].安徽医学,2014,35(10):1398-1400.
[4] 穆景颂,倪朝民.常见病康复诊疗规范(2)——脑卒中分级康复诊疗指南解读[J].安徽医学,2016,37(9):1190-1191.
[5] 席雅曼,郭宏.四肢血压与脑卒中关系研究进展[J].中华实用诊断与治疗杂志,2017,31(2):191-193.
[6] 安秀朋,段永亮.颈动脉粥样硬化性急性缺血性脑卒中的外科治疗现状[J].中华实用诊断与治疗杂志,2014,28(9):833-834.
[7] 任连峰.健康教育与促进对脑卒中患者功能恢复影响研究[J].河北医学,2015,21(9):1527-1528.
[8] 王晓群,冯芳.自我管理健康教育对脑卒中病人自我效能水平的影响[J].全科护理,2017,15(22):2695-2697.
[9] 张朝.自我管理行为干预对脑卒中患者康复效果的影响[J].护理实践与研究,2017,14(2):148-150.
[10] 程玉华.自我管理方案对脑卒中患者康复的应用研究[J].当代护士(上旬刊),2018,25(4):35-37.
[11] 王冠洲,刘静贤,熊建中,等.影响脑卒中患者预后的相关因素分析[J].中国临床研究,2014,27(6):674-676.
[12] 陈鸿芳,吕媛,尹薇,等.协同护理模式对脑卒中患者自我护理能力及生活质量的影响[J].陕西医学杂志,2015,44(8):1101-1102.
[13] 王艳晶.综合性护理干预对慢性心力衰竭患者负性情绪、自我管理及生活质量的影响[J].中国医药指南,2018,16(1):263-264.
[14] 刘秀梅,刘新颖,葛彩英,等.家庭医生式服务模式对社区脑卒中患者生存质量影响研究[J].中华全科医学,2015,13(4):616-618.
[15] 侯艳玲,王小波,张琳娜,等.自我管理教育在手术治疗下肢动脉硬化闭塞症患者康复中的应用[J].河北医学,2015,21(10):1736-1739.
[16] 邱翠竹,王明珠,罗少莊,等.青少年1型糖尿病患者自我管理能力现状及影响因素的调查研究[J].中国医药科学,2018,8(6):10-13,30.
[17] 刘华,宋梅,黄黎,等.慢性阻塞性肺疾病患者自我管理方法研究近况[J].陕西医学杂志,2016,45(5):633-634,640.
[18] 董万里,郑丽娜,王海播,等.集束化干预对阻塞性睡眠呼吸暂停综合征患者自我管理水平的影响[J].中华实用诊断与治疗杂志,2017,31(7):710-711.
[19] 李方方,宋葆云,闫秀文.不同压力滴定技术对重度睡眠呼吸暂停患者自我管理水平的影响[J].中华实用诊断与治疗杂志,2016,30(4):391-392.
[20] 张树军,卢国友.自我管理对社区2型糖尿病患者的影响研究[J].河北医学,2014,20(10):1701-1703.