自我效能训练对脊髓损伤患者生活质量的影响

Effect of self-efficacy training on Quality of Life in Spinal Cord Injury patients

目的:探讨自我效能理论在脊髓损伤患者康复中的应用效果。方法:选择2011年7月至2012年12月入住我科治疗的脊髓损伤患者79例,分为观察组和对照组,对照组采取常规护理措施,观察组采用自行设计的5步模式自我效能提升训练。采用一般自我效能感量表(GSES)、改良的Barthel指数(MBI)、生活质量指数评定量表(QOL)、自行设计的遵医行为调查表分别调查两组患者的自我效能、日常生活能力、生活质量及遵医率,于患者入院24小时内、入院1个月、入院3个月各评定1次。结果:两组患者GSES得分、MBI评分、QOL得分的组间差异均有统计学意义(F组间分别为6.67、12.68、5.61,P<0.05),但在时间序列、组间和时间序列的交互效应间均无统计学意义。两组患者遵医行为调查的差异有统计学意义(P<0.05)。结论:自我效能训练增强了脊髓损伤患者的康复信心,消除了负性因素影响,提高了遵医行为,改善了患者生活质量,利于脊髓损伤患者的康复,因此建议对脊髓损伤患者常规开展自我效能提升训练。

Objective： To investigate the effect of self-efficacy theory application on rehabilitation of spinal cord injury patients. Methods： A total of 79 patients with spinal cord injury from July, 2011 to December, 2012 were enrolled in this study. They were divided into observation group （42 cases） and control group （37 cases） according to different wards they stayed in. The observation group got 5-step model self-efifcacy enhancement training while the control group accepted common practice. General self-efifcacy scale （GSES） the Modiifed Barthel Index （MBI） and the quality of life （QOL） scale were used to evaluate their self efficacy, activity of daily living and QOL within 24 hours of admission, 1 month and 3 months after admission, respectively. Results： There was difference on the GSES scores and MBI scores and QOL status evaluation between the two groups （Fgroup=6.67, 12.68, 5.61;P〈0.05）, but no difference on the time sequence or interaction effects between the two groups. The compliance rates also were different between them （P〈0.05）. Conclusion： Self-efifcacy training may enhance the rehabilitation conifdence of spinal cord injury patients, and then increase their compliance behavior to improve their quality of life. It was thus recommended to provide this kind of self efifcacy training to promote rehabilitation in spinal cord injury patients.