基于TTM的健康宣教对缺血性脑卒中恢复期患者康复锻炼依从性及护理工作满意度的影响

Influence of TTM-based Health Education on Rehabilitation Exercise Compliance and Nursing Job Satisfaction of Patients in Convalescent Period of Ischemic Stroke

目的探讨基于跨理论模型(TTM)的健康宣教对缺血性脑卒中恢复期患者康复锻炼依从性及护理工作满意度的影响。方法选取郑州大学第一附属医院缺血性脑卒中恢复期患者110例,依据入院时间分组,2018年1月至2019年4月采取常规护理的55例患者作为常规组,2019年5月至2020年8月在常规护理基础上采取基于TTM的健康宣教的55例患者作为TTM组。比较两组康复锻炼依从性、护理工作满意度及干预前后健康知识掌握度评分、日常生活能力(Barthel)评分、一般自我效能感量表(GSES)评分、脑卒中自我管理能力量表(SSSMQ)评分及医学应对方式问卷评分(MCMQ)评分。结果TTM组康复锻炼依从性优良率98.18%(54/55)高于常规组78.18%(43/55),差异有统计学意义(P<0.05);干预后TTM组健康知识掌握度评分及Barthel评分高于常规组,差异有统计学意义(P<0.05);TTM组护理工作满意度96.36%(53/55)高于常规组74.55%(41/55),差异有统计学意义(P<0.05);TTM组干预后GSES评分、SSSMQ评分高于常规组,差异有统计学意义(P<0.05);TTM组干预后MCMQ量表回避、屈服评分低于常规组,面对评分高于常规组,差异有统计学意义(P<0.05)。结论TTM的健康宣教能提高缺血性脑卒中恢复期患者康复锻炼依从性及日常生活能力,同时还能增强患者认知、自我效能及自我管理能力,提升护理工作满意度,改善应对方式。

Objective To investigate the effect of TTM-based health education on rehabilitation exercise compliance and nursing job satisfaction of patients in convalescent period of ischemic stroke.Methods A total of 110 patients with ischemic stroke convalescent in our hospital were selected and grouped according to the time of admission.Fifty-five patients who received routine care from January 2018 to April 2019 were selected as the routine group.On the basis of routine care,Fifty-five patients who took TTM-based health education were selected as the TTM group.Rehabilitation exercise compliance,nursing job satisfaction,health knowledge mastery,daily living ability(Barthel),General self-efficacy ScaleGSES,the Southampton Stroke self-management Questionnaire,SSSMQ and Medical Coping Modes Questionnaire(MCMQ)before and after intervention were compared between the two groups.Results The excellent and good rate of rehabilitation exercise compliance in TTM group was 98.18%(54/55)higher than 78.18%(43/55)in routine group(P<0.05);After intervention,the scores of health knowledge mastery and Barthel in TTM group were higher than those in routine group(P<0.05);nursing job satisfaction in the TTM group was 96.36%(53/55)higher than that in the routine group 74.55%(41/55)(P<0.05);After intervention,THE GSES score and SSSMQ score of TTM group were higher than those of conventional group,and the differences were statistically significant(P<0.05).After intervention,the MCMQ scale avoidance and yield scores of TTM group were lower than those of the conventional group,and the face score was higher than that of the conventional group,the differences were statistically significant(P<0.05).Conclusion TTM health education can improve rehabilitation exercise compliance and daily living ability of patients in the convalescent stage of ischemic stroke,and also enhance patients'cognition,self-efficacy and self-management ability,improve nursing work satisfaction and improve coping styles.