不同健康教育方式对糖尿病住院患者知信行的影响

Effect of different health education methods on knowledge, attitudes and practices among hospitalized patients with diabetes

目的评估多次连续性健康教育与单次完整性健康教育对糖尿病住院患者营养知识-态度-行为（KAP）水平的影响。方法将2010年7月至12月新人住内分泌病房的108例糖尿病患者按入院时间随机分成常规教育组（50例）和强化教育组（58例）；常规教育组采用单次完整性教育，强化教育组采用多次连续性教育；应用自制问卷对两组患者教育前后进行调查，比较两组患者健康教育前后的营养KAP水平。结果无论常规教育组还是强化教育组患者，教育后营养KAP水平均较入院时有提高。对于问卷中“应控制总能量摄入”、“应控制食盐摄入量”以及“食物交换份”3项知识内容，强化教育组改善率[分别为88．4％（38／43）、84．6％（33／39）和60．9％（28／46）]高于常规教育组[分别为71．1％（27／38）、65．6％（21／32）和40．0％（16／40）]，之间的差异有统计学意义（x1^2=4．75，x2^2=4．83，x3^24．37，P〈0．05）；对于“认为健康教育很重要”这项态度内容，强化教育组改善率为95．8％（23／24），也明显高于常规教育组的65．2％（15／23）（x^2=14．90，P〈0．01）；强化教育组治疗饮食改善比例更是达到14／14，显著高于常规教育组的5／13（x^2=44．40，P〈0．01）。结论健康教育是改善糖尿病住院患者营养KAP水平的有效方法，多次连续性的健康教育方式在糖尿病健康教育中具有更加重要的意义。

Objective To assess the effect of ongoing health education compared to a single comprehensive health program on nutritional knowledge, attitudes and practices （KAP） of hospitalized diabetes patients to provide a basis for improving health education for these patients. Methods Newly hospitalized patients with diabetes were randomly classified into Group 1 （ Conventional Education Group ; 50 cases） and Group 2 （Intensive Education Group; 58 cases）. A single comprehensive health program was conducted for Group 1, and an ongoing health program was provided for Group 2. A self-designed questionnaire was administered to the two groups before and after the health education, and nutritional KAP of these patients were compared. Results In both groups, after health education, the nutritional KAP of the newly enrolled inpatients were substantially improved. For ＂control of total energy intake＂, ＂control of salt intake＂ and ＂food exchanges＂, the improvement rates of Group 2 [ 88.4% （ 38/43 ） , 84. 6% （ 33/39 ） , 60. 9% （28/46）, respectively] were higher compared to Group 1 [71.1% （27/38）, 65.6% （21/32）, 40. 0% （ 16/40）, respectively ]. The differences were significant （ X12 = 4. 75, X22 = 4. 83, X23 = 4. 37, respectively, P 〈 0. 05 ）. For ＂importance of health education＂, the improvement rate of Group 2 [ 95.8% （23/24） I was significantly higher than that of Group 1 [ 65.2% （ 15/23 ）, x2 = 14. 90, P 〈 0. 01 ]. For ＂therapeutic diet＂, the improvement rate of Group 2 was 14/14, significantly higher than that of Group 1 （5/13; X2 = 44. 40, P 〈 0. 01 ）. Conclusion Health education is an effective way to improve the nutritional KAP of inpatients with diabetes. An ongoing health program should have a more significant role in health education for these patients than a single program.