健康信念指导下的护理干预提高胃癌高危人群胃镜依从性的效果研究

Research on effects of nursing intervention under the guidance of health belief on gastroscope compliance of gastric carcinoma high-risk population

目的探讨健康信念指导下的护理干预对提高胃癌高危人群胃镜检查依从性的干预效果。方法随机选取陕西省安康市和广东省深圳市4个社区初筛已明确为胃癌高危且尚未完成胃镜检查的人群,将其随机分为干预组和对照组,每组各280人。干预组接受以健康信念模式为指导的为期1年的护理干预,对照组按照常规胃癌筛查进行健康教育。比较两组人群对筛查、胃镜和高危因素三个维度的认知水平及在易感性、严重性、益处、障碍、自我效能五个维度方面的得分。结果干预后两组人群对筛查、胃镜和高危因素三个维度的认知水平差异有统计学意义(P<0.05);干预后,干预组的健康信念在易感性、严重性、益处、障碍、自我效能五个维度方面的得分显著高于对照组,差异有统计学差异(P<0.05);干预组完成胃镜筛查率和胃癌阳性检出率明显高于对照组,差异有统计学差异(P<0.05)。结论以健康信念模式为指导的护理干预为胃癌高危人群树立了健康信念,提高了胃镜筛查的参与率和胃癌的阳性检出率,值得推广应用。

Objective To study the effects of nursing intervention under the guidance of health belief on gastroscope compliance of gastric carcinoma high-risk population in order to provide the scientific basis for clinic.Methods People who was clearly identified as gastric carcinoma high-risk population,but had not finished gastroscope,during preliminary screening in 4 communities in Ankang city of Shaanxi province and Shenzhen city of Guangdong province were selected and randomly divided into intervention group and control group,280 people in each group.People in control group was simply received regular propaganda and education about gastric carcinoma screening,people in intervention group was received nursing intervention with guidance of the health belief model for a year.Results After intervention,there were significant differences between two groups on cognitive levels in respect of three dimensions including screening,gastroscope and high-risk factors respectively（P〈0.05）.for five dimensions of health belief including susceptibility,ponderance,benefits,barriers and self-efficacy,scores of the intervened group were significantly higher than those of the control group respectively（P〈0.05）.The number of subjects,who finished gastroscope screening,in the intervened group was significantly higher than that of the control group（P〈0.05）.Conclusion The nursing intervention under the guidance of health belief can help gastric carcinoma at high-risk population to establish health belief,enhance participation rates of gastroscope screening.and had important significance to positive rates of early gastric carcinoma.