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基于行为改变理论和健康信念模式的健康管理对首发缺血性脑卒中的防控研究

Effects of health management on prevention and control of first-episode ischemic stroke based on BCW theory and health belief model
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摘要 目的:探讨基于行为改变理论(BCW)和健康信念模式(HBM)的健康管理对首发缺血性脑卒中(IS)的防控作用。方法:选取2019年1月至2021年12月在徐州市第一人民医院神经内科住院治疗的首发IS患者248例,采用随机数字表法分为对照组和观察组,每组124例。对照组接受神经内科常规护理及随访,观察组在此基础上接受基于BCW和HBM模式的健康管理。于干预前和干预后采用脑卒中患者自我管理行为量表评估自我管理能力,采用自拟疾病认知情况调查问卷评估IS认知水平,采用《HPLP-II健康促进生活方式量表中文版》评估健康行为,采用美国国立卫生研究院卒中量表(NIHSS)评分评估患者神经功能缺损情况。于出院后6个月设计《脑卒中患者治疗依从性调查量表》调查治疗依从性及卒中复发率。结果:干预前两组自我管理行为量表评分、脑卒中认知水平和健康行为评分对比差异均无统计学意义(P>0.05),干预后观察组自我管理行为量表各维度、脑卒中认知水平和健康行为评分均高于干预前和同期对照组(P<0.05)。观察组干预后的NIHSS评分低于对照组(P<0.05)。观察组治疗依从率高于对照组(P<0.05)。观察组卒中复发率则低于对照组(P<0.05)。结论:基于BCW理论和HBM的健康管理可提高首发IS患者自我管理能力、脑卒中认知水平,规范健康行为,提高治疗依从性,减少卒中复发,利于患者健康和疾病控制。 Objective To investigate the effects of health management based on behavior change wheel(BCW)and health belief model on prevention and control of first-episode ischemic stroke(IS).Methods A total of 248 first-time IS patients who were hospitalized in the Department of Neurology at the First People's Hospital of Xuzhou from January 2019 to December 2021 were selected and randomly divided into a control group and an observation group using a random number table method,with 124 patients in each group.The control group received routine nursing care and follow-up in neurology,while the observation group received health management based on BCW and HBM models on this basis.Before and after intervention,the self-management ability of stroke patients was evaluated using the self management behavior scale,the cognitive level of IS was evaluated using a self-designed disease cognition survey questionnaire,the health behavior was evaluated using the Chinese version of the HPLP-II Health Promotion Lifestyle Scale,and the neurological deficits of patients were evaluated using the National Institutes of Health Stroke Scale(NIHSS)score.A stroke patient treatment compliance survey scale was designed 6 months after discharge to investigate treatment compliance and stroke recurrence rate.Results There was no statistically significant difference in the scores of the self-management behavior scale,stroke cognitive level,and health behavior score between the two groups before intervention(P>0.05).After intervention,the dimensions of the self-management behavior scale,stroke cognitive level,and health behavior score in the observation group were higher than those before intervention and the control group during the same period(P<0.05).The NIHSS score of the observation group after intervention was lower than that of the control group(P<0.05).The treatment compliance rate of the observation group was higher than that of the control group(P<0.05).The recurrence rate of stroke in the observation group was lower than that in the control group.Conclusion Health management based on BCW theory and HBM can improve the self-management ability and stroke cognition level of first-onset IS patients,regulate health behavior,improve treatment compliance,reduce stroke recurrence,and benefit patient health and disease control.
作者 郭文娟 王暖 曹苇 王建玉 管章蒙 Gao Wenjuan;Wang Nuan;Cao Wei;Wang Jianyu;Guan Zhangmeng(Department of Neurology,Xuzhou First People’s Hospital,Xuzhou 221000,China)
出处 《中华卫生应急电子杂志》 2023年第6期348-353,共6页 Chinese Journal of Hygiene Rescue(Electronic Edition)
基金 "六大人才高峰"高层次人才科研项目(YY-146)。
关键词 行为改变理论 健康信念模式 健康管理 缺血性脑卒中 自我管理能力 健康行为 Behavior change wheel Health belief model Health management Ischemic stroke Self-management ability Health behavior
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