综合提醒系统对脑卒中患者出院6个月知信行和临床结局的效果  

Effect of Comprehensive Reminder System on Health Knowledge,Belief and Behaviors,and Clinical Outcomes for Stroke Patients Six Months after Discharge

作　　者：沈梦杰 王霄 谭菊香[2] 王少洲[3] 张迎梅[4] 万丽红[1] SHEN Meng-jie;WANG Xiao;TAN Ju-xiang;WANG Shao-zhou;ZHANG Ying-mei;WAN Li-hong(School of Nursing,Sun Yat-sen University,Guangzhou,Guangdong 510089,China;The Third Affiliated Hospital of Sun Yat-sen University-Lingnan Hospital,Guangzhou,Guangdong 510530,China;Department of Neurology,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou,Guangdong 510630,China;Guangdong Traditional Chinese Medical Hospital,Guangzhou,Guangdong 510120,China)

机构地区：[1]中山大学护理学院,广东广州市510089 [2]中山大学附属第三医院岭南医院,广东广州市510530 [3]中山大学附属第三医院神经内科,广东广州市510630 [4]广东省中医院,广东广州市510120

出　　处：《中国康复理论与实践》2020年第7期856-862,共7页Chinese Journal of Rehabilitation Theory and Practice

基　　金：广州市科普专项(No.201609010050);广东省科技发展专项(No.2016A020215039)。

摘　　要：目的探讨健康信念综合提醒系统对脑卒中患者出院后6个月健康知识、信念、行为、卫生服务利用情况及临床结局的效果。方法 2015年2月至2016年3月,方便抽样广州市3家综合医院高血压并发缺血性脑卒中出院患者174例,分为对照组(n=87)和干预组(n=87)。对照组予常规健康教育;干预组在此基础上采用"基于健康信念模式的综合提醒系统"进行健康教育和延续护理。出院6个月后,采用脑卒中健康知识问卷(SKQ)、脑卒中患者健康信念简表(SF-HBMS-SP)和脑卒中健康行为量表(HBS-SP)进行调查,并记录临床结局(急诊就诊、再住院、复发和死亡)。结果对照组75例、干预组76例完成调查。干预组SKQ (U=903.000)、SF-HBMS-SP (t=-9.099)和HBS-SP(t=-7.786)总分均显著高于对照组(P <0.001)。干预组门诊复诊率(97.37%)显著高于对照组(76.00%)(P <0.001);两组急诊就诊数和再住院数无显著性差异(P> 0.05),死亡和复发率无显著性差异(P> 0.05)。结论健康信念综合提醒系统能提高脑卒中患者出院后健康知识、信念、行为和门诊复诊率,但尚未对临床结局产生明显效果。Objective To investigate the effect of Comprehensive Reminder System Based on Health Belief Model(CRS-HBM)on health knowledge,belief,behaviors,utilization of health services and clinical outcomes in stroke patients after discharge.Methods From February,2015 to March,2016,174 stroke patients with hypertension were divided into control group(n=87)and intervention group(n=87).The control group received routine stroke health education,and the intervention group received the CRS-HBM program in addition.They were investigated with Stroke Knowledge Questionnaire(SKQ),Short Form Health Belief Model Scale for Stroke Patients(SF-HBMS-SP),Health Behavior Scale for Stroke Patients(HBS-SP),and the utilization of health services and clinical outcomes(emergency,re-hospitalization,recrudescence and death)were recorded six months after discharge.Results A total of 75 cases in the control group and 76 in the intervention group finished the research.The total scores of SKQ(U=903.000),SF-HBMS-SP(t=-9.099)and HBS-SP(t=-7.786)were more in the intervention group than in the control group(P<0.001).The outpatient re-visit rate was more in the intervention group(97.37%)than in the control group(76.00%)(P<0.001).The incidence of emergency,re-hospitalization,recrudescence and death were not significantly different between the two groups(P>0.05).Conclusion The application of CRS-HBM can improve the health knowledge,belief,behaviors for stroke patients after discharge,but there are not enough effects on clinical outcomes.

关 键 词：脑卒中 健康信念综合提醒系统 健康教育 知识 信念 行为 

分 类 号：R743.3[医药卫生—神经病学与精神病学]