结构化教育在中青年缺血性脑卒中患者中的应用

Application of a structured health education program in self-management of young and middle-aged patients with ischemic stroke

目的探讨基于结构化的健康教育方案在中青年缺血性脑卒中患者自我管理中的应用效果。方法选取2021年8月—12月在湖南省某三级甲等医院神经内科2个病室住院的中青年缺血性脑卒中患者作为研究对象,分别设为试验组(n=30)和对照组(n=28)。试验组实施中青年缺血性脑卒中患者结构化健康教育方案,结合患者手册、小视频、挂图等工具,开展以认识脑卒中、如何建立健康生活方式、用药指导与定期随访为主题的健康教育,对照组实施神经内科常规健康教育方案,包括院内指导与每周1次的健康教育宣传会。入院时、出院后1个月、出院后3个月,采用中风自我管理行为评定量表对患者进行调查。结果两组自我管理行为组间与时间有交互效应(F=28.520,P<0.001),简单效应分析显示,出院后3个月试验组自我管理水平高于对照组(P<0.05)。两组患者疾病管理维度(F=13.290,P<0.001)、安全用药管理维度(F=4.073,P=0.022)、饮食管理维度(F=9.656,P<0.001)、康复锻炼管理维度(F=5.204,P=0.009)组间与时间有交互效应,简单效应分析显示,出院后1个月、3个月,试验组饮食管理得分均高于对照组(P<0.05),出院后3个月试验组在疾病管理、安全用药管理、康复锻炼管理方面得分高于对照组(P<0.05)。结论对中青年脑卒中患者实施结构化教育能够改善其自我管理行为,提高其对疾病、安全用药、饮食、康复锻炼等方面的管理。

Objective To explore the effect of a structured health education program in self-management of young and middle-aged patients with ischemic stroke.Methods From August to December 2021,young and middle-aged ischemic stroke patients hospitalized in two wards of the Department of Neurology,a tertiary care hospital in Hunan Province were recuited as the participants and divided into the experimental group(n=30)and the control group(n=28).A structured health education program for young and middle-aged ischemic stroke patients was implemented in the experimental group,including health education content on the theme of understanding stroke,how to establish a healthy lifestyle,medication guidance and regular follow-up combined with patient brochures,small videos,wall charts and other tools.Meanwhile,the routine health education program in neurology was implemented for the control group,including in-hospital guidance and weekly health education advocacy session.participats’admission,one and three months after discharge,the stroke self-management behavior rating scale was used to evaluate the effect.Results There was an interaction effect between self-management behavior groups and time in both groups(F=28.520,P<0.001),and simple effect analysis showed that the self-management level in the experimental group was significantly higher than that in the control group three months after discharge(P<0.05).There were interaction effects between groups and time in the dimension of disease management(F=13.290,P<0.001),safe medication management(F=4.073,P=0.022),diet management(F=9.656,P<0.001),and rehabilitation exercise management(F=5.204,P=0.009)in both groups.Besides,simple effect analysis showed that the diet management scores of the experimental group were higher than those of the control group at one and three months after discharge(P<0.05),and the disease management,safe medication management and rehabilitation exercise management scores of the experimental group were higher than those of the control group at three months after discharge(P<0.05).Conclusion The structured education program applied to young and middle-aged stroke patients can improve their selfmanagement behaviors and promote their management of diseases,safe medication,diet,and rehabilitation exercises.