本文選題：院外壓瘡 + 照顧者　； 參考：《華北理工大學》2017年碩士論文

【摘要】：目的比較常規(guī)健康教育與基于知信行理論模式的健康教育對院外壓瘡患者主要照顧者認知和行為及其疾病結(jié)局的干預效果。方法選取2015年5月~2016年6月北京某三級醫(yī)院院外壓瘡住院患者主要照顧者60例作為研究對象,按入院順序進行排序,奇數(shù)入對照組,偶數(shù)入干預組,各組30例。對照組接受常規(guī)的健康教育,包括講解壓瘡的原因、分期和傷口的護理,演示正確翻身技能等。干預組在常規(guī)健康教育基礎之上加用知信行理論模式下的健康教育,健康教育時間為每次45min,2次/周,共3個月。知信行理論模式(Knowledge,Attitude and practice,KAP)是為了改變健康行為的一種模式,它由獲取知識、產(chǎn)生信念和形成行為三個連續(xù)的過程組成,照顧者只有先獲得了壓瘡相關知識,并對壓瘡知識進行積極的思考,才能逐步形成信念及正確的態(tài)度。知識上升為信念,照顧者才能采取積極的態(tài)度去改善照顧行為[1]。本研究依據(jù)理論的三個階段進行干預設計并實施干預。于干預前、干預后1個月和干預后3個月,采用壓瘡知識問卷、一般自我效能問卷(GSES)和照顧行為問卷對兩組照顧者進行測評,評價知信行理論模式下的健康教育的干預效果。使用SPSS17.0統(tǒng)計軟件進行分析,計量資料以均數(shù)±標準差(`x±S)表示;兩組間數(shù)據(jù)比較采用兩獨立樣本t檢驗,干預前后數(shù)據(jù)采用配對樣本t檢驗,計數(shù)資料用頻數(shù)表示,采用x2檢驗,對照顧者進行的干預隨時間推移的變化用重復測量方差分析,以P0.05表示差異有統(tǒng)計學意義。結(jié)果兩組壓瘡患者照顧者壓瘡知識比較:在干預前兩組壓瘡患者照顧者壓瘡知識比較,差異無統(tǒng)計學意義(P0.05);在干預1個月時,干預組照顧者壓瘡知識得分較對照組有提高,差異有統(tǒng)計學意義(P0.05);干預3個月,干預組照顧者壓瘡知識得分較對照組有顯著性提高,差異有統(tǒng)計學意義(P0.05)。兩組壓瘡患者照顧者一般自我效能比較:在干預前兩組壓瘡患者照顧者一般自我效能比較,差異無統(tǒng)計學意義(P0.05);干預1個月時,干預組照顧者自我效能得分較對照組有提高,差異有統(tǒng)計學意義(P0.05);干預3個月,干預組照顧者自我效能得分較對照組有顯著性提高,差異有統(tǒng)計學意義(P0.05)。兩組壓瘡患者照顧者照顧行為比較:在干預前兩組壓瘡患者照顧者照顧行為比較,差異無統(tǒng)計學意義(P0.05);在干預1個月時,干預組照顧者照顧行為較對照組有提高,差異有統(tǒng)計學意義(P0.05);干預3個月,干預組照顧者照顧行為得分較對照組有顯著性提高,差異有統(tǒng)計學意義(P0.05)。兩組壓瘡患者照顧者翻身技能比較:在干預前兩組壓瘡患者照顧者翻身技能比較,差異無統(tǒng)計學意義(P0.05);在干預1個月時,干預組照顧者翻身技能較對照組有提高,差異有統(tǒng)計學意義(P0.05);干預3個月,干預組照顧者翻身技能較對照組有顯著性提高,差異有統(tǒng)計學意義(P0.05)。兩組壓瘡患者壓瘡再發(fā)生率比較:對照組31例中再發(fā)生壓瘡例數(shù)15例占48.3%;干預組29例中再發(fā)生例數(shù)3例占10.3%,干預組較對照組壓瘡再發(fā)生率的差異有統(tǒng)計學意義(P0.05)。結(jié)論知信行理論模式下的健康教育可以改善院外帶入壓瘡照顧者行為,其方法簡便易行,可在臨床廣泛推廣使用。
[Abstract]:Objective to compare the effect of health education and knowledge based health education on the cognition and behavior of the main caregivers of patients with pressure sore and the outcome of the disease. Methods to select 60 main caregivers of the hospitalized patients in the outside pressure sore in a three grade three hospital in Beijing in May 2015, as the research object, according to the order of admission. In the control group, the control group received routine health education, including explaining the causes of pressure sores, staging and wound care, demonstrating the correct turn over skills, etc. the intervention group added health education on the basis of conventional health education on the basis of the knowledge and letter theory model on the basis of the routine health education, and the health education time was 45min each time, the control group received the routine health education. 2 / week, 3 months. Knowledge (Attitude and practice, KAP) is a pattern for changing healthy behavior. It consists of three continuous processes of acquiring knowledge, generating beliefs and forming behavior. The caregivers can only get the knowledge of pressure sores first, and think positively about pressure sore knowledge. Belief and correct attitude. Knowledge is rising to belief, the caregiver can take a positive attitude to improve the behavior of care [1].. This study is based on the three stages of the theory of intervention design and intervention. Before intervention, 1 months after intervention and 3 months after intervention, the knowledge of pressure ulcer, general self-efficacy questionnaire (GSES) and care behavior are adopted. The questionnaire was used to evaluate the two groups of caregivers, to evaluate the intervention effect of health education under the theory of knowledge and credit theory. The data were analyzed with SPSS17.0 statistical software, and the measurement data were expressed with mean standard deviation (`x + S). The data of the two groups were compared with two independent samples of t test, and the data were measured by paired sample t test and the number of data used in frequency. It was indicated that the x2 test was used to compare the intervention of the caregivers with the change of time with the repeated measurement of variance analysis, and the difference was statistically significant by P0.05. Results the pressure sore knowledge of the two groups of pressure sore caregivers was compared: there was no significant difference between the two groups of pressure sores before the intervention (P0.05), and the intervention for 1 months was not significant. In the intervention group, the score of pressure sore knowledge in the intervention group was higher than that in the control group (P0.05). The intervention group was significantly higher than the control group in the intervention group for 3 months, and the difference was statistically significant (P0.05). The two groups of pressure sore caregivers were compared with those in the two groups of pressure sore patients before the intervention. General self-efficacy comparison, the difference was not statistically significant (P0.05); when intervention 1 months, the intervention group's self-efficacy score was higher than the control group, the difference was statistically significant (P0.05); the intervention group was significantly higher than the control group in the intervention group for 3 months, the difference was statistically significant (P0.05). Two groups of pressure sore patients were compared. There was no significant difference between the care behavior of the two groups of pressure sores before the intervention (P0.05), and the care behavior of the caregivers in the intervention group was higher than the control group at 1 months. The difference was statistically significant (P0.05), and the intervention group was significantly higher than the control group for 3 months. The difference was statistically significant (P0.05). Comparison of the turn over skills of the two groups of pressure sore caregivers: there was no statistical difference between the two groups of pressure sore caregivers before the intervention (P0.05); in the 1 month intervention, the caregivers of the intervention group were higher than the control group (P0.05), and the intervention group was intervened for 3 months. There was significant improvement in the turnover skill of the customers compared with the control group, the difference was statistically significant (P0.05). The rate of pressure ulcers in the two groups of pressure sore patients was compared: the number of pressure sore cases in the control group was 48.3% in 15 cases and 3 in 29 cases in the intervention group, 10.3% in 3 cases, and the difference between the intervention group and the control group was statistically significant (P0.05). Health education based on KAP theory can improve the behavior of pressure sore caregivers outside the hospital. The method is simple and feasible, and can be widely used in clinical practice.
【學位授予單位】：華北理工大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R473

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