同伴教育对银屑病患者社会心理适应的影响

Effect of Peer Education on Social Psychological Adaptation of Patients with Psoriasis

目的探讨同伴教育对银屑病患者社会心理适应的影响。方法招募5例有5年以上银屑病史的志愿者,由皮肤科医师和护士对其进行培训,考核合格后对实验组的患者在出院后,同伴教育者对实验组患者每月实施电话访问1次,干预内容包括:1宣传预防银屑病复发的健康知识;2根据美国心理学家艾理斯的理性-情绪疗法的ABC理论,指导小组成员提高社会心理适应水平。对照组仅由主管医生、责任护士按照档案册,每月对患者电话访问1次,宣教预防银屑病复发的健康知识、解答患者的各种社会心理适应不良问题。在出院前和出院后1年,分别评估两组患者掌握预防银屑病复发知识的程度和社会心理适应水平;根据PASI评估两组银屑病患者病情及复发率。结果干预后1年时,两组患者预防银屑病复发知识的知晓率(包括运动、饮食、心理、药物、预防感染、气候环境6个方面)均达到91.83%以上,两组的差异无统计学意义(P>0.05);但实验组患者社会心理适应水平优于对照组,差异有统计学意义(P<0.01)。而且实验组未复发银屑病的患者(86.67%)明显高于对照组(60.00%),差异也有统计学意义(P<0.05)。结论同伴教育能有效提高银屑病患者社会心理适应水平,并能有效降低银屑病复发。

Objective To evaluate the effect of peer education on social psychological adaptation of patients with psoriasis. Methods Five volunteers with history of psoriasis over five years were recruited and trained by dermatologists and nurses. They became the peer educators after passing the examination. The peer educators implemented telephone interviews on experimental group’s patients monthly after leaving hospital. The interventions included：1 To propaganda the knowledge of preventing the recurrence of psoriasis,2To instruct the panel members to improve their social psychological adaptation level based on the American psychologist Albert Ellis’ s rational- emotive therapy of ABC theory. Telephone interviews were provided only by their doctors and nurses according to the file copies in control group monthly,to propaganda the knowledge of preventing the recurrence of psoriasis and answer patients’ social psychological maladaptive problems. The mastery of knowledge in the prevention of recurrence of psoriasis and social psychological adaptation level of two groups were assessed before and one year after being discharged. The state of illness and recurrence rate of two groups were evaluated according to PASI. Results One year after interventions,two groups’ awareness rate of knowledge in the prevention of recurrence of psoriasis（ including exercise,diet,psychology,medicine,prevention of infection,climate and environment） all reached over 91. 63%,the difference was not statistically significant between two groups（ P 〉 0. 05）,However,the level of social psychological adaptation of the experimental group was better than the control group,the difference was statistically significant（ P 〈 0. 01）. And the no relapse rates in the experimental group（86. 67%） were significantly higher than the control group（60. 00%）,the difference was statistically significant（ P 〈 0. 01）. Conclusion Peer educators has been proved to be feasible and effective for improving social psychological adaptation level of patients with psoriasis,and the recurrence of psoriasis can be effectively reduced.