行为分阶段转变理论在维持性血液透析患者手卫生健康教育中的应用  

Application of the trans-theoretical model and stages of change in health education of hand hygiene in maintenance hemodialysis patients

作　　者：顾美红[1] 夏虹[1] 张耀全[2] 

机构地区：[1]东南大学医学院附属江阴市人民医院血液净化中心,214400 [2]东南大学医学院附属江阴市人民医院肾内科,214400

出　　处：《中华现代护理杂志》2013年第28期3475-3478,共4页Chinese Journal of Modern Nursing

摘　　要：目的 应用行为分阶段转变理论模型,探讨血液透析患者手卫生的健康教育方法,促进患者建立科学的行为方式,提高自我管理能力,从而减少感染等并发症的发生.方法 选择100例血液透析患者为研究对象,采用行为分阶段转变理论模型进行干预,评价干预前后患者手卫生状况.结果 本组血液透析患者干预前手卫生认知得分为（54.7±5.7）分,干预后为（84.9±4.6）分,干预前后比较差异有统计学意义（t=-13.855,P＜0.01）；干预后患者手卫生执行率从46.8％提高到85.7％,洗手正确率从5.2％提高到80.9％,干预前后比较差异均有统计学意义（x2值分别为84.064,99.762;P ＜0.01）.干预后MHD患者手部细菌培养平均菌落数为（5.62±3.6）cfu/cm2,明显少于干预前（112.0±12.4） cfu/cm2,干预前后比较,差异有统计学意义（t=16.96,P＜0.05）.结论 运用行为分阶段转变理论能有效改善维持性血液透析患者手卫生状况.Objective Application of the trans-theoretical model and stages of change,to discuss the health education method of hand hygiene in hemodialysis patients,to help patients establish scientific behavior,to improve the ability of self-management and reduce the incidence of infection and other complications.Methods One hundred patients with maintenance hemodialysis （MHD） were chosen,and received the transtheoretical model and stages of change.The hand hygiene in hemodialysis patients was evaluated before and after the intervention.Results Before and after intervention,the total score of cognition of hand hygiene was （54.7 ±5.7） vs （84.9 ± 4.6）,and the difference was statistically significant （t =-13.855,P ＜ 0.01）.The execution rate of hand hygiene was 46.8％ vs 85.7％,the correct rate of hand-washing was 5.2％ vs 80.9％,and the differences were statistically significant （x2 =84.064,99.762,respectively; P ＜ 0.01）.The hand bacteria colonies was （112 ± 12.4） vs （5.62 ± 3.6） cfu/cm2 before and after intervention,and the difference was statistically significant （t =16.96,P ＜ 0.01） ; the qualification rate was increased,and the difference was statistically significant （P ＜ 0.01）.Conclusions Application of the trans-theoretical model and stages of change could ameliorate MHD patients hand hygiene status.

关 键 词：肾透析 手卫生 健康教育 行为分阶段转变理论 

分 类 号：R473.5[医药卫生—护理学]