哮喘日记个体化健康教育对患儿疾病不确定感和焦虑心理的影响研究

Psychological Effects of An Asthma-diary Educational Intervention in Asthmatic Patients

目的 探讨以哮喘日记为个体化的健康教育对减轻哮喘患儿的疾病不确定感和焦虑心理的影响.方法 选取2007年1月-2011年12月在我院哮喘门诊明确诊断并定时参加哮喘教育活动的7～14岁哮喘患儿129例,分为日记组（n=65）和对照组（n=64）.采用中文版Mishel疾病不确定感量表和焦虑量表分别测量患儿开展健康教育前后疾病不确定感和焦虑程度.采用直观模拟标度尺测定患儿教育后的满意度.结果 对照组2例患儿退出研究.日记组与对照组哮喘患儿在健康教育前均存在严重的疾病不确定感[总分分别为（120.3±10.5）、（118.5±11.7）分]和焦虑心理[（42.4±9.2）、（41.9±8.8）分],不同的健康教育形式均能够明显减轻这两种心理状态[（71.3±9.4）、（83.6±10.1）分和（28.1±7.5）、（36.3±9.8）分],但以哮喘日记为个体化的健康教育效果更佳（F总值分别为58.91、32.47,其中F组内值分别为153.82、20.34,F组间值分别为17.25、10.75;P＜0.05）.健康教育后日记组对哮喘知识获取的满意度高于对照组,差异有统计学意义（P＜0.05）.结论 以哮喘日记为个体化的健康教育是一种减轻患儿疾病不确定感和焦虑心理的有效手段.

Objective To determine whether asthma diary is an effective tool to alleviate illness uncertainty and anxie- ty in asthmatic children. Methods A total of 129 children aged between 7 years and 14 years with a definite diagnosis of asthma and receiving asthma education in our hospital between January 2007 and December 2011 were included in this study. A random- ized controlled trial was applied. The children were divided into diary group （n = 65 ） and control group （n = 64） . The levels of illness uncertainty and anxiety were measured using Chinese version of Mishel Uncertainty in Illness and State Anxiety Invento- ry. And the satisfaction levels of the care and perceived knowledge were measured by Visual Analogue Scale. Results Two patients withdrew from the study in control group. Before the interventions, the levels of illness uncertainty and anxiety in the diary group and in the control group were high [ diary group ： （ 120. 3 ± 10. 5 ）, （ 42. 4± 9. 2 ） ; control group ： （ 118.5 ± 11.7 ）, （41.9 ±8. 8 ） ） , and all of them decreased significantly after the interventions [ diary group ： （ 71.3 ± 9. 4 ）, （ 28. 1 ± 7.5 ） ; control group ： （ 83.6 ± 10. 1 ） , （ 36. 3 ±9. 8 ） ）. However, the effects of individual educational model on illness uncertainty and anxiety in diary group were better than those of the conventional model in control group （illness uncertainty： Ftotal = 58.91, Fwithin group =153.82, Fbetween group =17.25, P 〈0.05; anxiety： Ftotal=32.47, Fwithin group =20.34, F between group =10.75, P〈 0. 05 ） . The satisfaction level of their perceived knowledge were significantly higher in diary group than that in control group after the interventions （ P 〈 0. 05 ） . Conclusion Asthma diary as a individual educational tool is effective in reducing the levels of the illness uncertainty and anxiety in asthmatic patients.