目的 制订“线下讲堂+线上督导”的健康教育方案,并探讨其在肠造口患者家庭护理中的应用效果。方法 采取便利抽样法,选取某医院2019年5月—2020年5月入院的92例患者为试验组,在院期间组织患者参加线下健康大讲堂,出院后通过线上平台督导其家庭护理行为。选取2018年4月—2019年4月入院的103例患者为对照组,给予传统健康教育。评价两组的出院指导质量,以及入院时、出院时、出院后1个月、出院后3个月的自我护理能力,并统计出院后3个月造口相关并发症的发生率。结果 出院指导质量结果显示,两组需要内容维度得分差异无统计学意义（P>0.05）,试验组获得内容维度得分（51.08±2.94）分、指导技巧及效果（100.37±6.41）分和出院指导质量总得分（152.01±7.96）分均高于对照组（P<0.05）。患者自我护理能力组间和时间存在交互效应（F=6.53,P<0.001）,简单效应分析显示,出院时、出院后1个月、出院后3个月,试验组自我护理能力得分均高于对照组（P<0.05）。试验组出院后3个月造口相关并发症发生率（9.78%）较对照组（63.11%）低,差异有统计学意义（P<0.05）。结论 “线下讲堂+线上督导”的健康教育方案能有效提高出院指导质量、患者居家自我护理能力,降低肠造口并发症发生率,保障患者安全。

Objective To develop a health education program with “offline lecture + online supervision” and to examine the effects of the program. Methods A total of 92 patients admitted from May 2019 to May 2020 were recruited and assigned to the experimental group. The offline lectures were provided to the patients in the experimental group during their hospitalization. After discharge,the online supervision was provided to supervise the home care. Another 103 patients who were admitted to the hospital from April 2018 to April 2019 were recruited and assigned to the control group and traditional health education was given to them. The quality of discharge education and self-care ability of patients at admission,discharge,1 month after discharge,and 3 months after discharge in the two groups were compared. Besides,the incidence of stoma-related complications within 3 months after discharge was recorded. Results There was no statistically significant difference in the dimensional score of discharge knowledge need contents between the two groups（P>0.05）. The knowledge acquisition dimension score（51.08±2.94）,the teaching skills and effects dimension score（100.37±6.41）,and the education quality total score（152.01±7.96） of patients in the experimental group were higher than those in the control group（P<0.05）. There was an interaction effect between the patient’s self-care ability and time,and the simple effect analysis showed that at the times of discharge,1 month after discharge,3 months after discharge,the self-care ability scores between the two groups were statistically different（P<0.05）. Complications within 3 months after discharge of patients in the experimental group（9.78%） was lower than that of the control group（63.11%）（P<0.05）. Conclusion The “offline lecture + online supervision” can improve self-care ability when patients are at home,reduce the incidence of adverse events in patients with enterostomy,and ensure patient safety effectively.