基于赋能理论模式护理干预对继发性癫痫患者自我管理及生活质量的影响

Effect of nursing intervention based on the empowerment theory model on self-management and quality of life in patients with secondary epilepsy

目的探究基于赋能理论模式的护理干预对促进继发性癫痫患者自我管理能力和改善其生活质量的有效性。方法该研究为随机对照试验。将咸阳市中心医院2021年6月至2023年6月收治的84例继发性癫痫患者按随机数字表法分为两组,各42例。参照组:男28例,女14例,年龄32~64(41.63±5.37)岁;发作类型:单纯型部分发作21例、复杂型部分发作12例、全身性发作9例;采用常规护理措施。试验组:男23例,女19例,年龄36~66(41.06±5.24)岁;发作类型:单纯型部分发作23例、复杂型部分发作11例、全身性发作8例;采用基于赋能理论模式的护理干预。两组均干预3个月。观察并比较两组患者干预前、后的自我管理能力[癫痫患者自我管理量表(ESMS)]、神经功能改善情况[美国国立卫生研究院卒中量表(NIHSS)]、疾病不确定感[Mishel疾病不确定感量表(MUIS)]和生活质量[中文版癫痫患者生活质量评定量-31(QOLIE-31)],统计两组患者3个月内继发性癫痫发生情况。采用t检验、χ^(2)检验进行统计分析。结果干预后,试验组ESMS、QOLIE-31评分均高于参照组[(155.21±19.87)分比(121.17±17.63)分、(73.14±8.32)分比(62.29±7.38)分],差异均有统计学意义(t=8.31、6.32,均P<0.05);试验组NIHSS、MUIS评分均低于参照组[(21.07±3.08)分比(25.81±3.36)分、(62.48±7.51)分比(72.04±7.36)分],差异均有统计学意义(t=6.74、5.89,均P<0.05)。试验组3个月内继发性癫痫发作率低于参照组[11.90%(5/42)比38.10%(16/42)],差异有统计学意义(χ^(2)=7.68,P<0.05)。结论采用基于赋能理论模式的护理干预可有效增强继发性癫痫患者自我管理能力,改善生活质量,减少疾病复发,对提升神经功能亦具有正面影响。

Objective To evaluate the effect of nursing intervention based on the empowerment theory model on self-management capability and quality of life in patients with secondary epilepsy.Methods This study was a randomized controlled trial.A total of 84 patients with secondary epilepsy admitted to Xianyang Central Hospital from June 2021 to June 2023 were divided into two groups according to the random number table method,with 42 cases in each group.In the reference group,there were 28 males and 14 females,aged 32-64(41.63±5.37)years,and the types of seizures included simple partial seizures in 21 cases,complex partial seizures in 12 cases,and generalized seizures in 9 cases.In the experimental group,there were 23 males and 19 females,aged 36-66(41.06±5.24)years,and the types of seizures included simple partial seizures in 23 cases,complex partial seizures in 11 cases,and generalized seizures in 8 cases.The reference group received routine nursing measures,the experimental group received nursing intervention based on the empowerment theory model,and both groups were intervened for 3 months.The self-management ability[Epilepsy Self-Management Scale(ESMS)],neurological function improvement[National Institutes of Health Stroke Scale(NIHSS)],disease uncertainty[Mishel Uncertainty in Illness Scale(MUIS)],and quality of life[Chinese version of the Quality of Life in Epilepsy Inventory-31(QOLIE-31)]were observed and compared between the two groups before and after intervention,and the occurrence of secondary epilepsy within 3 months in the two groups was also evaluated.Statistical methods used were t test and χ^(2) test.Results After intervention,the scores of ESMS and QOLIE-31 in the experimental group were higher than those in the reference group[(155.21±19.87)points vs.(121.17±17.63)points,(73.14±8.32)points vs.(62.29±7.38)points],with statistically significant differences(t=8.31 and 6.32,both P<0.05);the scores of NIHSS and MUIS in the experimental groups were lower than those in the reference group[(21.07±3.08)points vs.(25.81±3.36)points,(62.48±7.51)points vs.(72.04±7.36)points],with statistically significant differences(t=6.74 and 5.89,both P<0.05).The incidence of secondary epilepsy seizures within 3 months in the experimental group was lower than that in the reference group[11.90%(5/42)vs.38.10%(16/42)],with a statistically significant difference(χ^(2)=7.68,P<0.05).Conclusion The nursing intervention based on the empowerment theory model can effectively enhance the self-management in patients with secondary epilepsy,improve the quality of life,reduce the disease recurrence,and has a positive impact on improving neurological function.