健康教练技术对首发脑卒中患者知识水平及自我管理行为的效果评价

doi:10.3761/j.issn.1672-9234.2022.01.014

摘要/Abstract

摘要：

目的探究健康教练技术对首发脑卒中患者脑卒中知识水平和脑卒中自我管理行为的效果。方法将在邵阳市某三级甲等医院住院的70例首发脑卒中患者按照随机数字表分为对照组和试验组(各35例),对照组采用常规的健康教育方法,试验组实施健康教练技术,该技术主要包括接触、观察、强化、澄清、帮助、鼓励、教育和引导。干预6个月后,比较两组脑卒中知识、自我管理行为得分。结果干预6个月后,试验组脑卒中知识、自我管理行为得分分别为(32.0±3.1)分、(172.9±14.5)分,对照组为(25.9±4.7)分、(154.9±19.1)分,两组比较差异均有统计学意义(t=6.380、4.433,P<0.001)。结论实施健康教练技术能有效提高首发脑卒中患者脑卒中知识水平和脑卒中自我管理行为。

关键词: 卒中, 健康教育, 健康教练技术, 自我管理

Abstract:

Objective To explore the effects of the health coaching on knowledge level and self-management of patients with first stroke. Methods Seventy patients who experienced stoke the first time in a tertiary hospital in Shaoyang were randomly divided into the control group and the experimental group,with 35 cases in each group. Patients in the control group received regular education. Patients in the experimental group received health coaching including contact,observe,affirm,clarify,help,inspire,nurture,and guide. The scores of stroke knowledge and self-management behavior were compared before and after 6 months of the intervention. Results After 6 months of the intervention,the scores of stroke knowledge and self-management behavior of patients in the experimental group were(32.0±3.1) and (172.9±14.5) respectively,both of which were higher than those of patients in the control group(25.9±4.7) and (154.9±19.1),respectively(t=6.380,4.433,P<0.001). Conclusion Heath coaching can effectively improve the knowledge level and self-management behavior of patients with first stroke.

Key words: Stroke, Health Education, Health coaching, Self-management

周欣欣, 黄雅莲, 方艳春, 颜梅芳, 林施施, 欧阳娟. 健康教练技术对首发脑卒中患者知识水平及自我管理行为的效果评价[J]. 中华护理教育, 2022, 19(1): 81-85.

ZHOU Xin-xin, HUANG Ya-lian, FANG Yan-chun, YAN Mei-fang, LIN Shi-shi, OUYANG Juan. Effects of the heath coaching on knowledge level and self-management of patients with first stroke[J]. Chinese Journal of Nursing Education, 2022, 19(1): 81-85.

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参考文献 16

[1]	尤黎明, 吴瑛. 内科护理学[M]. 6版. 北京: 人民卫生出版社, 2018: 832.
	You LM, Wu Y. Internal medicine nursing[M]. 6th ed. Beijing: People’s Medical Publishing House, 2018: 832.
[2]	《中国脑卒中防治报告》编写组. 《中国脑卒中防治报告2019》概要[J]. 中国脑血管病杂志, 2020, 17(5):272-281.
	Prevention ROS, Group TICW. Brief report on stroke prevention and treatment in China,2019[J]. Chin J Cerebrovasc Dis, 2020, 17(5):272-281.
[3]	Riegel B, Moser DK, Buck HG, et al. Self-care for the prevention and management of cardiovascular disease and stroke[J]. J Am Heart Assoc, 2017, 6(9):e006997.
[4]	王者凤, 张玉爱. 脑卒中患者自我管理行为在神经功能缺损与健康状况间的中介作用[J]. 中华行为医学与脑科学杂志, 2017, 26(7):624-627.
	Wang ZF, Zhang YA. Mediating effect of self-management behavior between nervous functional defects and health condition in patients with stroke[J]. Chin J behav Med and Brain Sci, 2017, 26(7):624-627.
[5]	谭小雪, 徐敏. 首发脑卒中患者自我管理水平变异曲线规律分析[J]. 中华现代护理杂志, 2019, 25(21):2679-2683.
	Tan XX, Xu M. A study on the variation curve of self-management level in patients with first onset stroke[J]. Chin J Mod Nurs, 2019, 25(21):2679-2683.
[6]	Hayes E, Kalmakis KA. From the sidelines:coaching as a nurse practitioner strategy for improving health outcomes[J]. J Am Acad Nurse Pract, 2007, 19(11):555-562. doi: 10.1111/jaan.2007.19.issue-11
[7]	Oostingh EC, Ophuis RH, Koster MP, et al. Mobile health coa-ching on nutrition and lifestyle behaviors for subfertile couples using the smarter pregnancy program:model-based cost-effectiveness analysis[J]. JMIR Mhealth Uhealth, 2019, 7(10):e13935.
[8]	Tiede M, Dwinger S, Herbarth L, et al. Long-term effectiveness of telephone-based health coaching for heart failure patients:a post-only randomised controlled trial[J]. J Telemedicine Telecare, 2017, 23(8):716-724. doi: 10.1177/1357633X16668436
[9]	李奎成, 唐丹, 刘晓艳, 等. 国内Barthel指数和改良Barthel指数应用的回顾性研究[J]. 中国康复医学杂志, 2009, 24(8):737-740.
	Li KC, Tang D, Liu XY, et al. Renew of the application of Barthel Index and Modified Barthel Index in Mainland China[J]. Chin J Rehabil Med, 2009, 24(8):737-740.
[10]	江虹, 丁福, 朱跃平, 等. E-Coach慢病管理模式在高血压控制中的应用研究[J]. 护理学杂志, 2019, 34(10):30-33.
	Jiang H, Ding F, Zhu YP, et al. Effects of E-Coach technology-based intervention on blood pressure control in outpatients with hypertension[J]. J Nurs Sci, 2019, 34(10):30-33.
[11]	王陇德. 健康管理师基础知识[M]. 2版. 北京: 人民卫生出版社, 2019.
	Wang DL. Basic knowledge of health manager[M]. 2nd ed. Beijing: People’s Medical Publishing House, 2019.
[12]	张小培. 出院后脑卒中患者的健康行为与生活质量的相关性研究[D]. 广州:中山大学, 2009.
	Zhang XP. The relationship between health behavior and quality of life after stroke[D]. Guangzhou:Sun Yat-sen Univer-sity, 2009.
[13]	王艳桥. 中风自我管理项目的构建与应用研究[D]. 成都:成都中医药大学, 2012.
	Wang YQ. Construction and application of self-management intervention project for patients after stroke[D]. Chengdu:Chengdu University of TCM, 2012.
[14]	周兰. 网络互动式健康教育对中青年脑卒中高危人群的干预研究[D]. 衡阳:南华大学, 2019.
	Zhou L. Study on the intervention of network interactive health education to young and middle-aged people at high risk of stroke[D]. Hengyang:University of South China, 2019.
[15]	Park YH, Moon SH, Ha JY, et al. The long-term effects of the health coaching self-management program for nursing-home residents[J]. Clin Interv Aging, 2017, 12:1079-1088. doi: 10.2147/CIA
[16]	Miyamoto S, Henderson S, Fazio S, et al. Empowering diabetes self-management through technology and nurse health coaching[J]. Diabetes Educ, 2019, 45(6):586-595. doi: 10.1177/0145721719879421