健康信念模式为基础的饮食指导对老年消化道出血患者管理能力及依从性影响

Effect of dietary guidance based on health belief model on management ability and compliance of elderly patients with gastrointestinal bleeding

目的探究健康信念模式为基础的饮食指导对老年消化道出血患者自我管理能力、饮食管理依从性和营养影响。方法选择2017年1月-2019年12月于华西医院消化内科收治的老年消化道出血患者120例,随机分为观察组(n=60)和对照组(n=60)。对照组按科室护理常规行饮食干预,观察组予以基于健康信念模式的饮食指导。评估并比较2组干预前后自我管理能力(AHSMSRS评分)、饮食管理依从性和营养指标;随访3个月,记录并比较2组不良事件发生情况。结果干预后,2组AHSMSRS各项评分、饮食管理依从性和营养指标(Hb、Alb、TRF和PAB)水平均较同组干预前明显升高(P<0.05),且观察组上述指标均显著高于对照组(P<0.05);随访3个月期间,观察组不良事件总发生率明显低于对照组(P<0.05)。结论老年消化道出血患者采取基于健康信念模式的饮食指导,可提高患者自我管理能力及饮食管理依从性,有利于增强患者的营养,减少不良事件的发生。

Objective To explore the effects of dietary guidance based on health belief model on self-management ability,dietary management compliance and nutrition of elderly patients with gastrointestinal bleeding.Methods A total of 120 elderly patients with gastrointestinal bleeding treated in Department of Gastroenterology of West China Hospital were enrolled between January 2017 and December 2019 and were randomly divided into observation group(n=60)and control group(n=60).The control group received dietary guidance according to the routine nursing care of gastrointestinal bleeding,and observation group received dietary guidance based on health belief model.The self-management ability(AHSMSRS score),dietary management compliance,and nutritional indexes were compared between the two groups.The incidence of adverse events was recorded and compared between the two groups during 3 months of follow-up.Results After intervention,the levels of AHSMSRS scores,dietary management compliance and nutritional indexes(Hb,Alb,TRF,PAB)of the two groups were significantly higher than those of the same group before intervention(P<0.05),and the above indexes of the observation group were significantly higher than those of the control group(P<0.05).During the follow-up of 3 months,the total incidence of adverse events in the observation group was significantly lower than that in the control group(P<0.05).Conclusion Dietary guidance based on health belief model in elderly patients with gastrointestinal bleeding can improve the self-management ability and dietary management compliance of patients,enhance the nutrition of patients and reduce the occurrence of adverse events.