健康教育处方对类风湿性关节炎患者自我管理能力的影响

Effect of health education prescription in chronic disease outpatient clinic on the self-management ability of patients with rheumatoid arthritis

目的探讨健康教育处方对类风湿性关节炎(rheumatoid arthitis,RA)患者自我管理能力的影响。方法以我院风湿免疫科慢病管理门诊110例类风湿关节炎患者为研究对象,根据随机数字表分为对照组与观察组,患者均予类风湿关节炎常规治疗,对照组予以常规健康宣教,观察组予类风湿关节炎健康教育处方管理,两组均干预6个月,干预后分别采用慢性病自我效能量表(CDSES)及一般自我效能感量表(GSES)共同评估患者自我效能,采用健康促进生活方式量表II(HPLP II)评估其健康行为改善情况,并采用简易生活质量量表SF-36评估生活质量、服药依从性,同时评估其关节功能。结果干预后对照组CDSES、GSES评分依次为(67.7±10.6)和(29.2±4.1)分,均显著低于观察组的(79.8±11.8)和(32.7±4.8)分(P<0.05);干预后观察组各项健康行为指标及总评分均显著高于对照组(P<0.05);干预后两组关节严重程度均有显著改善(P<0.05),但组间差异无统计学意义(P>0.05)。结论类风湿关节炎健康教育处方管理可显著提升RA患者自我效能感,改善其健康行为,继而提高生活质量,改善患者预后。

Objective To explore the effect of health education prescription on the self-management ability of patients with rheumatoid arthritis(RA).Methods 110 patients with RA in chronic disease outpatient clinic of the hospital were selected as subjects,and they were divided into the control group and the observation group by the random number table method.All patients were given routine treatment for RA.The control group was given conventional health education while the observation group was given RA health education prescription management.The two groups were given 6 months of intervention.After the intervention,the self-efficacy of patients was evaluated by the Chronic Disease Self Efficacy Scale(CDSES)and the General Self Efficacy Scale(GSES).The improvement of health behaviors,quality of life and medication compliance were evaluated with the Health Promoting Lifestyle Profile II(HPLP II)and short-form of quality of life(SF-36),respectively,and the joint function was also evaluated.Results After the intervention,scores of CDSES and GSES in the control group[(67.7±10.6)and(29.2±4.1)]were significantly lower than those in the observation group[(79.8±11.8)and(32.7±4.8)](P<0.05).After the intervention,scores of health behavior indexes and the total score in observation group were significantly higher than those in the control group(P<0.05).After intervention,the joint function in the two groups was significantly improved(P<0.05),without significant difference between the two groups(P>0.05).Conclusion The health education prescription management of rheumatoid arthritis can significantly improve the self-efficacy of patients with RA and improve their healthy behavior,thus improving their quality of life and the prognosis.