自我管理模式对强直性脊柱炎患者疾病相关知识、关节功能和生活质量的影响  

Self-management mode on disease-related knowledge,joint function and quality of life in patients with ankylosing spondylitis

作　　者：张萍萍[1,2] 牟一坤[1] 戈兰[2] 古洁若[2] 

机构地区：[1]中山大学附属第三医院儿科,广州510630 [2]中山大学附属第三医院风湿科,广州在读博士生510630

出　　处：《新医学》2015年第12期812-815,共4页Journal of New Medicine

基　　金：中山大学临床医学研究5010计划项目(2007023)

摘　　要：目的评价自我管理模式对强直性脊柱炎(AS)患者疾病相关知识、关节功能和生活质量的影响。方法采取俱乐部、病友会的自我管理形式对84例AS患者进行心理指导、疼痛指导、饮食指导、生活指导,于治疗前及治疗后6个月以AS健康管理问卷、毕氏AS功能指数(BASFI)对84例患者的疾病知识水平、关节功能、心理质量和生活质量进行评定。结果与参与前比较,84例AS患者在参与自我管理模式半年后的疾病相关知识得分从(58.1±11.6)分增加至(74.8±10.2)分,BASFI评分从(5.25±1.93)分改善至(3.90±1.87)分,参与前后比较差异均有统计学意义(P均<0.001);悲观绝望认为自己将来无法像正常人一样工作的患者减少,相信疾病可以控制、愿意配合医生治疗、勇于面对生活的患者比例上升,因为害怕药物不良反应而不愿长期药物治疗的患者比例下降,戒烟、戒酒,饮食合理的患者增多(P均<0.05),对健康教育的满意度提高到从73%提高至100%(P<0.001)。结论 AS患者俱乐部、病友会可充分调动患者的主观能动性,从而积极配合治疗和护理,提高了患者全面的健康知识,改善了关节功能,同时也增加了患者自我管理的能力和战胜疾病的信心,有利于提高患者的生活质量。Objective To evaluate the effect of self-management mode upon disease-related knowledge,joint function and quality of life in patients with ankylosing spondylitis（ AS）. Methods Eighty four AS patients received guidance in the aspects of psychology,pain,diet and life through self-management mode in the pattern of AS patient club or gathering. Before and six months after treatment,disease-related knowledge,compliance,joint function,psychological quality and life quality were evaluated by questionnaire of AS health management and Bath AS Function Index（ BASFI）. Results The questionnaire score of disease-related knowledge in AS patients was significantly increased from（ 58. 14 ± 11. 62） to（ 74. 77 ± 10. 16） and the BASFI score was considerably improved from（ 5. 25 ± 1. 93） to（ 3. 90 ± 1. 87） after self-management for half a year（ both P 0. 001）. The percentage of patients who felt desperate about conducting normal work was significantly increased（ P 0. 05）. The proportion of patients who were confident in controlling disease,willing to cooperate with doctors and face life actively was dramatically increased（ P 0. 05）. The percentage of patients unwilling to receive long-term drug therapy for fear of side effects significantly declined（ P 0. 05）. The proportion of patients who quit smoking and drinking and pursued reasonable diet rose significantly（ all P 0. 05）.The satisfaction degree on health education was significantly increased from 73% to 100%（ P 0. 001）. Conclusions Patient club and gathering could fully mobilize patients＇ initiative to cooperate actively with the treatment and nursing,which enhances the understanding of AS patients regarding AS-related knowledge,improves the joint function,makes them more confident about recovery,enhances patients＇ ability of self-management and improves their life quality.

关 键 词：强直性脊柱炎 自我管理模式 关节功能 生活质量 

分 类 号：R473.5[医药卫生—护理学]