哮喘日记个体化健康教育对家长焦虑和疾病不确定感的影响

Effects of asthma-diary educational intervention on anxiety and illness uncertainty in the parents of asthmatic patients

目的探讨以哮喘日记为个体化的健康教育手段是否能够减轻哮喘患者家长的焦虑和疾病不确定感的心理。方法将129名哮喘儿童的家长按单双号随机分为日记组(n=65)和对照组(n=64)。对照组采用定期讲座的形式介绍哮喘防治知识,日记组除了采用定期讲座教育以外,同时用哮喘日记记录患儿用药和症状的变化情况,根据日记记录的变化进行个体化教育。用焦虑和Mishel疾病不确定感量表分别测量家长健康教育前后焦虑和疾病不确定感的程度。用直观模拟标度尺确定家长教育后的满意度。结果两组哮喘儿童家长在健康教育前有严重的焦虑[(46.4±8.5)分、(47.6±9.2)分]和疾病不确定感心理[总分分别为(117.9±12.4)分、(120.5±13.2)分],不同的健康教育方法都能有效减轻二种心理状态[(26.3±6.7)分、(37.7±7.0)分和(73.6±8.8)分、(88.7±12.5)分],但以哮喘日记为个体化的健康教育效果明显优于传统的健康教育,实施后日记组和对照组之间焦虑程度比较差异有统计学意义(t=3.385,P<0.001),疾病不确定感总分和4个维度得分比较差异均有统计学意义(P<0.05)。健康教育后日记组家长对哮喘知识获取的满意度为(9.9±1.6)cm,高于对照组的(8.9±1.6)cm,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可以有效降低哮喘儿童家长焦虑和疾病不确定感心理。

Objective To determine whether asthma diary is an effective tool for alleviation of anxiety and illness uncertainty in asthmatic children＇s parents. Methods A total of 129 parents whose children were with a definite diagnosis of asthma and receiving asthma education between January 2007 and December 2011 were included in this study. A randomized controlled trial was used and the parents were divided into diary group（n=65） and control group（n=64）. The control group obtained asthma prevention and control knowledge from regular lectures, while the diary group kept an asthma diary（involving changes in medication and symptoms） plus regular lectures. The levels of illness uncertainty and anxiety were measured by Chinese version of State Anxiety Inventory and Mishel Uncertainty in Illness, respectively. The levels of satisfaction of care and perceived knowledge gain were measured by Visual analogue scale. Results Before the interventions, the levels of anxiety and illness uncertainty in the diary group and control group were high： diary group：（46.4±8.5） and（117.9±12.4）; control group（47.6±9.2） and（120.5±13.2）. All the values decreased significantly after the interventions： diary group：（26.3±6.7） and（73.6±8.8）; control group：（37.7±7.0）and（88.7 ± 12.5）. However, the effects of individual educational model on anxiety and illness uncertainty in diary group were better than those in control group（anxiety： t=3.385,P〈0. 001; illness uncertainty： t values of total and 4subgroups were 2.238, 2.581, 2.397, 2.120, 2.108, respectively, P〈0.05）. The satisfaction level of their perceived knowledge was significantly higher in diary group than that in control group after the interventions：（9.9 ± 1.6） and（8.9±1.6） cm, P=0.039. Conclusion Asthma diary as an individual educational tool is effective for reducing the level of the anxiety and illness uncertainty in asthmatic children＇s parents.