溃疡性结肠炎病人实施自我管理教育的效果

Effect of implement of self management education for patients with ulcerative colitis

[目的]探讨自我管理教育在溃疡性结肠炎(UC)病人中应用的效果。[方法]对32例溃疡性结肠炎病人进行"一对一"自我管理教育,并配合自我监测日志填写,内容包括遵医嘱服药、进食时间、地点,所有进食食物和饮料(包括正餐、点心、零食等)的名称、量、烹饪方法,进食食物和饮料后的消化道反应(如腹痛、腹泻、腹胀等)及出现的时间、复诊时间、用药变化等。实施12个月并对日志内容分析,应用中文版炎症性肠病问卷(IBDQ)、病人依从性调查表、溃疡性结肠炎疾病活动指数(UCDAI)进行测评。[结果]12个月后IBDQ评分:肠道症状(54.5±8.1)分、全身症状(27.9±2.1)分、情感功能(53.5±6.4)分、社会功能(35.3±3.1)分,与入组时比较差异有统计学意义(P<0.05);12个月后治疗有效率为96.8%,UCDAI总分(3.4分±1.2分),与入组时,UCDAI总分为(5.3分±1.6分)比较差异有统计学意义(P<0.05)。[结论]自我监测日志填写使自我管理教育更精细化,在设计上符合病人的健康需求,实施起来简单易行,所需费用低,可以由病人接受训练后自己组织实施。

Objective： To probe Into the application effect of self management education for patients with ulcera-tive colitis. Methods： A total of 32 patients with ulcerative colitis received the＊“ ne to one^self management edu-cation and self monitoring log fill, th e content rncluded： taking medicine according to the doctor＇s advice, eating time and place^the name？quantity and cooking method of all food and beverage（including meals？ re fre shm ents, snacks and so on）,the digestive tract reaction（such as abdominal p a in, dia rrhe a , abdominal distension and so on） after eating food and beverage and the appearance time , return time ,medication changes and so on. The educa-tion was implemented for 12 months and analyzed the log contents, and then the evaluationusing the IBDQ,he patient compliance questionnaire, and UCDAI. Results： After 12 m o n th s, the IBDQ scores： the intestinal symptoms score was （54. 5 ± 8.1）, systemic symptoms scorewas （27. 9±2.1） , emotional func-tion scorewas （53. 5 ± 6. 4）, social function sco rew a s （35. 3 ± 3.1 ） , comparing with those before the educa-tion the difference had statistical significance （P〈0.05）; after 1.2 months of treatment , the effective rate was 96.8%,the total score of UCDAI was （3. 4±1.2）, and before the tre a tment, the effective ra tew a s 62.5% , thetotal score of UCDAI was （5.3±1.6） ？the difference was statistically significant （P 0. 05）. Conclusion： Self monitoring log fill can make self management more refined,and meet the health needs of patients in the design. The implementation was simple and low cost. It can be organized and implemented by patients themselves after training