赋能教育理念在乙型肝炎肝硬化失代偿患者健康教育中的应用  

Application of empowerment education concept in the health education for decompensated patientswith hepatitis B cirrhosis

作　　者：黄慧懿[1] 钱湘云[2] 陈璇[1] 季永香 季媛 Huang Huiyi;Qian Xiangyun;Chen Xuan;Ji Yongxiang;Ji Yuan(Hepatology Department,Nantong Third Hospital Affiliated to Nantong University,Nantong 226006,Chin;Nursing Department,Nantong Third Hospital Affiliated to Nantong University,Nantong 226006,China)

机构地区：[1]南通大学附属南通第三医院肝病科,南通226006 [2]南通大学附属南通第三医院护理部,南通226006

出　　处：《中华现代护理杂志》2018年第29期3527-3531,共5页Chinese Journal of Modern Nursing

基　　金：江苏省青年医学人才依托课题（QNRC2016399）;南通市市级科技计划（指导性）项目（HS149018）;南通市市级科技计划项目（HS2016002）

摘　　要：目的探讨赋能教育在乙型肝炎肝硬化失代偿患者健康教育中的应用效果。方法采用便利抽样法，选取南通市某三级甲等传染病专科医院2017年l-5月住院的乙型肝炎肝硬化失代偿患者100例为研究对象。采用随机数字表法随机分为观察组和对照组，每组各50例。对照组实施临床路径常规健康指导，观察组在常规教育的基础上采用赋能教育理念进行健康教育。分别对两组患者干预前、干预后的自我管理行为、肝硬化并发症发生例数、护理工作满意度进行比较。结果干预过程中观察组l例死亡，对照组2例因经济困难住院3d出院，最终观察组49例，对照组48例。干预后观察组自我管理行为中的饮食管理、日常生活管理、用药管理、病情监测管理得分均高于对照组，差异有统计学意义（t值分别为-4．047、-3．635、-3．437、-3．831；P〈0．05）。护理工作满意度中的服务态度、沟通能力、人文关怀、理论指导均优于对照组，差异有统计学意义（χ2值分别为7．789、6．804、6．557、6．239；P〈0．05）。肝硬化并发症中肝性脑病、电解质紊乱的发生例数低于对照组，差异有统计学意义（χ2值分别为4．549、4．401；P〈0．05）。结论赋能教育模式可以提高乙型肝炎肝硬化失代偿患者自我管理行为，提高满意度，减少并发症。Objective To explore the empowerment education application effect on the healthy education for patients with hepatitis B cirrhosis. Methods A total of 100 cases of hepatitis B cirrhosis decompensation were selected from January to May 2017 in a Class m Grade A infectious disease specialist hospital in Nantong with convenience sampling method. All the research subjects were divided into observation group and control group by random number table method, with 50 cases in each group. Routine health guidance of clinical pathway was conducted for the control group, and empowerment education based on routine education was carried out for the observation group. Before and after the intervention, self-management behaviors, the incidence rate of cirrhosis complications and nursing job satisfaction in the two groups were compared respectively. Results There were 1 death case in the observation group and 2 cases discharged after 3 days in the control group during the intervention. Finally, there were 49 cases in the observation group and 48 cases in the control group. The evaluation scores of self-management behaviors which includes diet management, daily life management, medication administration, disease monitoring management were higher than those in the control group. The differences were statistically significant（t=-4,047, -3.635, -3.437, -3.831; P 〈 0.05）. Satisfaction with nursing service which includes service attitude, communication ability, humanisticcare and theoretical guidance in the observation group was significantly higher than that in the control group. The differences were statistically significant （χ2=7.789, 6.804, 6.557, 6.239 ; P 〈 0.05）. The incidence rate of cirrhosis complications which includes hepatic encephalopathy and electrolyte disorder was lower than that in the control group, and the differences were statistically significant （χ2=4.549, 4.401 ; P 〈 0.05）. Conclusions Empowerment education can improve self-management behavior of patients with hepatitis B cirrhosis and satisf

关 键 词：肝炎  乙型 肝硬化 健康教育 失代偿期 赋能教育 

分 类 号：R473.5[医药卫生—护理学]