回馈教育模式在永久性肠造口患者中的应用

Application of teach-back education model in patients with permanent enterostomy

目的:探讨回馈教育模式在永久性肠造口患者中的应用效果及对患者健康素养、自我护理能力、心理韧性的影响。方法:采用便利抽样法,选取2019年1—10月滨州医学院烟台附院胃肠外科收治的70例直肠癌术后永久性肠造口患者为研究对象,于患者入院、术前、术后、出院和造口门诊阶段实施回馈教育模式的造口宣教。干预前后分别采用健康素养调查表(HLMS)、自我护理能力测评表(ESCA)、心理韧性量表(CD-RISC)对患者的健康素养、自我护理能力、心理韧性进行评价。结果:干预后患者的HLMS信息获取能力、经济支持意愿、交流互动能力、改善健康意愿维度得分均高于干预前,干预前后比较差异有统计学意义(P<0.05)。干预后患者ESCA的自我护理技能、自我责任感、自我概念、健康知识水平维度得分高于干预前,干预前后比较差异有统计学意义(P<0.05)。干预后患者CD-RISC的坚韧性、力量性、乐观性维度得分高于干预前,干预前后比较差异有统计学意义(P<0.05)。结论:对永久性肠造口患者实施回馈教育,能提高患者的健康素养和自我护理能力,改善患者心理韧性。

Objective To explore the application effect of teach-back education model on patients with permanent enterostomy and its impact on patients'health literacy,self-care ability and psychological toughness.Methods By convenient sampling,a total of 70 patients with permanent enterostomy after rectal cancer surgery,who were admitted to Department of Gastrointestinal Surgery,Yantai Affiliated Hospital of Binzhou Medical University from January to October 2019 were selected as research subjects.An enterostomy education program according to teach-back education model was performed on the patient's admission,before and after surgery,at discharge and on enterostomy outpatient.Before and after the intervention,Health Literacy Management Scale(HLMS),Exercise of Self-Care Agency Scale(ESCA),and Connor Davidson Resilience Scale(CD-RISC)were used to evaluate patients'health literacy,self-care ability,and psychological toughness.Results In terms of health literacy,the HLMS dimensions scores of willingness to financial support,ability to communicate and interact,and willingness to improve health were higher than those before intervention with significant statistical difference(P<0.05).The ESCA dimensions scores of patients'self-care skills,self-responsibility,self-concept,and health knowledge level after intervention were significantly higher than those before intervention(P<0.05).The CD-RISC dimensions scores of the patients'toughness,strength and optimism after intervention were higher than those before intervention with significant statistical difference(P<0.05).Conclusions The implementation of teach-back education for patients with permanent enterostomy can significantly improve the health literacy and self-care ability of patients,and improve their psychological toughness.