社区脑卒中自我管理小组教育课程的设计及实施

Education curriculum design and Implementation of community stroke self-management group

目的对社区脑卒中自我管理小组教育课程进行设计并探索其实施效果。方法借鉴中国香港康复会长期病自我管理教育相关理论,制定脑卒中自我管理教育课程内容。以2012年1月—2016年12月在北京市丰台区方庄社区卫生服务中心就诊的脑卒中患者115例作为研究对象,采用随机数字表法将研究对象分为研究组57例,对照组58例。监测2组患者入组前后血压,并采用慢性病自我效能量表及自我感受负担量表分别于入组前及课程结束后进行评估,评价课程实施效果。结果初次建立了方庄社区脑卒中自我管理小组,在社区层面设计了脑卒中自我管理教育课程,客观评价了课程的应用效果。完成了研究对象干预前后血压及慢性病自我效能及自我感受负担调查。2组研究对象血压值在干预后差异无统计学意义。采用慢性病自我效能量表分别在入组前对干预组及对照组进行测量,平均得分分别为(196.23±47.29)分、(203.38±54.19)分,差异无统计学意义(P>0.05)。课程结束后平均得分分别为(225.91±43.22)分、(204.83±54.60)分,差异有统计学意义(P<0.05)。采用自我感受负担量表分别在入组前对研究组及对照组进行测量,平均得分分别为(25.42±9.35)分,(24.66±7.58)分,差异无统计学意义(P>0.05)。课程结束后平均得分为(22.80±10.96)分、(24.06±8.03)分,差异有统计学意义(P<0.05)。结论本课程设计合理,适用于社区脑卒中患者;通过该课程的实施,提高了社区脑卒中患者的自我效能水平,降低了自我感受负担。

Objective To design and explore implementation effects of community stroke self-management group education courses. Methods Based on the relevant theories of the long-term self-management education of Hong Kong Rehabilitation Association, the curriculum content of stroke self-management education was developed. A total of 115 stroke patients were randomly selected as study subjects from January 2012 to December 2016, 57 in the study group and 58 in the control group. The blood pressures before and after the two groups of patients were monitored, and the chronic disease self-efficacy scale and self-perception burden scale were evaluated before and after the course of assessment to evaluate the effect of the curriculum implementation. Results The Fangzhuang Community Stroke Self-Management Group was established for the first time, and stroke self-management education curriculum was designed at the community level to objectively evaluate the application effects of the curriculum. A survey of blood pressure and chronic disease self-efficacy and self-perception burden before and after the study subjects’ intervention was completed. There was no significant difference in blood pressure values between the two groups of subjects after intervention. The chronic disease self-efficacy scale was used to measure the intervention group and the control group before the entry into the group. The average scores were(196.23±47.29) points and(203.38±54.19) points respectively, P>0.05, and the difference was not statistically significant. After the end of the course, the average scores were:(225.91±43.22) points and(204.83±54.6) points, P<0.05.The difference was statistically significant. The self-perceptual burden scales were used to measure the study group and the control group before the enrollment. The average scores were:(25.42±9.35) points,(24.66±7.58) points, P>0.05, and the difference was not statistically significant. After the end of the course, the average scores were:(22.80±10.96) points,(24.06±8.03) points, P<0.05. The difference was statistically significant. Conclusion This course is designed to be suitable for patients with stroke in the community. Through the implementation of this course, the self-efficacy of stroke patients in the community has been improved, and the burden of self-perception has been reduced.