健康信念模式健康教育对直肠癌肠造口患者自护能力及生活质量的影响

Influence of health belief model of health education on self-care ability of patients with colostomy for rectal cancer and quality of life

目的探讨健康信念模式健康教育对直肠癌肠造口患者自护能力及生活质量的影响。方法回顾性分析120例接受直肠癌造口术的直肠癌患者的临床资料,根据护理方法的不同将患者分为对照组和观察组,每组60例,对照组患者接受常规的健康教育,观察组患者接受健康信念模式健康教育。比较两组患者术后3个月的并发症发生率,采用自我护理能力测定量表评定两组患者出院第1天和出院6个月后的自护能力,采用健康调查简表(SF-36)评价两组患者治疗前后的生活质量。结果术后3个月,观察组患者的并发症总发生率为13.33%,明显低于对照组的41.67%,差异有统计学意义(P<0.01)。出院第1天和出院6个月后,观察组患者的自我效能、自护知识和自护技能评分均明显高于对照组,差异均有统计学意义(P<0.01)。治疗后,观察组患者的生理职能、身体疼痛、精神健康、生理功能、情感职能、社会职能、一般健康状况和活力评分均高于对照组,差异均有统计学意义(P<0.05)。结论健康信念模式健康教育可减少直肠癌肠造口患者的术后并发症发生率,增强患者的自护能力,改善患者的生活质量,值得临床推广应用。

Objective To explore the influence of health belief model （HBM） of health education on self-care ability of patients with colostomy for rectal cancer and the effect on quality of life （QOL）. Method A retrospective analysis of 120 patients with rectal cancer who underwent colostomy was performed. These patients were given basic health care （control group）, or HBM-based health education （study group）, with 60 cases in each group. The incidence of complications in 3 months after surgery were compared, and the self-care ability on the first day and in 6 months after discharge and QOL of these patients before and after treatment were evaluated using self-care ability scale and SF-36, respectively. Result In 3 months after surgery, the overall incidence of complications in study group was 13.33%, and was significantly lower than that in control group at 41.67%, the difference was statistically significant （P〈0.01）. On the first day and in 6 months after discharge, the self-efficacy, self-care knowledge and self-care skills scores were significantly higher in study group than in control group （P〈0.01）. After treatment, the physical function, body pain, mental health, physiological function, emotional function, social function, general health mad activity scores were higher in patients of study group than those in control group, and the differences were statistically significant （P〈0.05）.Conclusion For rectal cancer patients that received ostomy, HBM-based health education can effectively enhance the self-care ability, and improve the QOL.