慢性病患者健康相关行为领域问题的居家访视效果  

Problems in health related behaviors domain in patients with chronic diseases:effect of home visiting service by nurse

作　　者：谭晓青 朱金萍 曾丽 刘雪琴[3] 

机构地区：[1]深圳市南山区蛇口人民医院肾内内分泌科,广东深圳518067 [2]清新县人民医院太和镇社区卫生服务中心 [3]南方医科大学珠江医院临床护理教研室

出　　处：《护理学杂志》2013年第11期73-76,共4页

基　　金：广东省清远市科技计划项目(2010B42)

摘　　要：目的探讨居家访视护理对社区慢性病患者健康相关行为领域问题的访视效果,为社区居家访视的发展提供依据。方法引进奥马哈系统(Omaha System)构建居家访视评估表,随机选择60例居家慢性病患者(脑卒中、高血压、糖尿病患者各20例,最终完成研究58例)进行3次访视,对最常见的3大问题进行干预。结果47例(81.0%)慢性病患者存在营养问题,比例最高,其次是药物治疗方案问题[44例(75.9%)]和健康照顾督导问题[27例(46.6%)];物质滥用问题所占比例最少,为13.8%(8例)。患者或家属营养、药物治疗方案和健康照顾督导问题的认知、行为、状况评分(K-B-S评分)都随着访视次数的增加而提升,访视前后各方面的评分改变差异有统计学意义(均P<0.05),通过3次访视后,只有高血压患者组的营养问题认知评分和糖尿病患者组的药物治疗方案问题的认知和行为评分达到4分。结论居家访视能提高慢性病患者的营养、药物治疗方案和健康照顾督导问题的K-B-S评分,逐渐改变慢性病患者不良的健康相关行为习惯,但是需要更长时间的跟踪干预,才能帮助慢性病患者建立健康的行为模式。Objective To evaluate the effectiveness of home visits by nurses on problems in health related behaviors domain in patients with chronic diseases, and to provide references for development of home visiting service. Methods We employed the Omaha System to develop a home visiting assessment form in terms of patients＇ knowledge, behaviors, and status, and then provided home visi- ting service for 60 patients with stroke, hypertension, or diabetes （each disease having 20 participants）. Finally 58 cases completed the study and each received 3 visits from researchers who took interventions against top 3 problems. Results Specifically, 47（81.0%）patients had problems in nutrition, 44（75. 9%） had problems in medication regimen, 27（46. 6%）had problems in health care supervision, with the least number of patients having problems in substance use（8 cases, 13.8%）. The scores of pa- tientsr knowledge, behaviors and status concerning problems in nutrition,medication regimen, and in health care supervision, in- creased significantly with home visiting service （P〈0.05 for all）. But only the scores of knowledge concerning nutrition in hyper- tension patients, and the scores of knowledge,and behaviors concerning medication regimen in diabetes patients, averaged 4 points after 3 visits. Conclusion Home visiting service could improve patients＇ scores in knowledge, behaviors and status concerning prob- lems in nutrition, medication regimen, and health care supervision. The practice helps patients change bad habits in health related behaviors, although long-term service is needed to help patients form health Dromoting behaviors.

关 键 词：社区护理 慢性疾病 居家访视 奥马哈系统 健康相关行为 

分 类 号：R473.2[医药卫生—护理学]