回馈教学法对糖尿病高危足患者足部护理知识及足部自我护理行为的影响

Effects of teach-back method on foot self-care knowledge and behaviors in high-risk diabetic foot patients

目的探讨回馈教学法对糖尿病高危足患者足部护理知识及足部自我护理行为的影响,为糖尿病高危足患者的健康教育提供循证依据。方法将114例糖尿病高危足患者采用简单随机数字表法随机分为对照组60例与试验组54例。对照组患者采用常规教育方法,试验组患者采用回馈教学法进行健康教育。比较两组患者入院时、出院时足部护理知识得分和足部自我护理行为得分,及出院后1个月两组患者足部自我护理行为得分。结果入院时两组患者足部护理知识总分及6个维度得分比较,差异均无统计学意义(均P>0.05),出院时试验组患者足部护理知识总分和“足部日常护理”“足部指甲修剪”“足部问题治疗”3个维度得分均高于对照组,两组比较,差异具有统计学意义(均P<0.05)。入院时、出院时、出院后1个月两组患者足部自我护理行为得分重复测量结果显示,总分和条目“检查鞋”“洗脚”“泡脚”“擦干脚趾间隙”在组间和时间有交互效应(均P<0.05),而且出院时、出院后1个月试验组得分均高于对照组(均P<0.05)。结论应用回馈教学法对糖尿病高危足患者行健康教育,可以有效提高患者足部护理知识,有效改善患者足部自我护理行为。

Objective To explore the effects of teach-back method on foot self-care knowledge and behaviors in high-risk patients with diabetic foot.Methods A total of 114 patients with high-risk diabetic foot were randomly divided into the control group(n=60)and the trial group(n=54)by the random number table.The patients in the control group were treated with the conventional education and those in the trial group received the teach-back method for health education.The score of foot self-care knowledge and behaviors were compared between the two groups at admission and discharge.We would follow-up the score of foot self-care behaviors at the first month after discharge.Results There was no statistically significant differences between the two groups in the scores of total score as well as its 6 dimension scores of foot self-care knowledge at admission(all P>0.05).At discharge,the total score of foot self-care knowledge,daily foot care,manicure foot nails,treatment of foot problems of patients in the trial group were all superior to the control group,with statistically significant differences(P<0.05).Repeated measures ANOVA showed the differences of total score of foot self-care behaviors,washing the feet,soaking the feet,drying the space between toes were statistically significant within the group by time interaction(P<0.05)at admission,discharge and the first month after discharge.At discharge,the first month after discharge,the total score of foot self-care behaviors,checking the shoes,soaking the feet,drying the space between toes in the trial group were all superior to the control group(P<0.05).Conclusion The application of teach-back method to health education for high-risk diabetic foot patients can effectively improve the patients'foot self-care knowledge and behaviors.