格林模式在中青年腰椎间盘突出症患者健康教育中的应用  

Application of PRECEDE-PROCEED model in health education for young and middle-aged patients with lumbar disc herniation

作　　者：何丽芳 吴梦雯 吴秀清[3] 肖春秀[4] 甘香[5] 陈君玉[6] HE Li-fang;WU Meng-wen;WU Xiu-qing;XIAO Chun-xiu;GAN Xiang;CHEN Jun-yu

机构地区：[1]莆田学院护理学院,莆田市351100 [2]福建医科大学护理学院 [3]福建医科大学附属协和医院骨科 [4]福建医科大学附属协和医院护理部 [5]莆田学院附属医院护理部 [6]莆田学院附属医院骨科

出　　处：《中华护理教育》2020年第9期817-822,共6页Chinese Journal of Nursing Education

基　　金：2018年莆田学院研究生专项项目(2018053)。

摘　　要：目的探究格林模式健康教育对中青年腰椎间盘突出症患者疾病认知水平、腰椎间盘自护行为水平及功能障碍的影响。方法采取临床随机对照试验方法,将福州市和莆田市某2所三级甲等医院骨科门诊就诊的205例非手术中青年腰椎间盘突出症患者随机分为试验组(n=103)和对照组(n=102)。两组在院内都接受思维导图联合微视频的健康教育,在此基础上,试验组实施院外格林模式健康教育,即分别针对倾向因素、促进因素和强化因素进行干预;对照组利用微信群进行常规团体辅导。比较两组干预前及第2、4、6个月末患者疾病认知水平、腰椎间盘自护行为水平和Oswestry功能障碍指数。结果两组疾病认知水平、腰椎间盘自护行为水平、功能障碍改善程度均得到提高,试验组干预效果优于对照组(P<0.001)。结论思维导图联合微视频健康教育能够提高中青年腰椎间盘突出症患者疾病认知水平和腰椎间盘自护行为水平,改善其功能障碍程度,同时在此基础上应用格林模式进行干预效果更佳。Objective To explore the influence of PRECEDE-PROCEED model health management on the level of knowledge,self-care behavior and dysfunction in young and middle-aged patients with lumbar disc herniation(LDH).Methods A total of 205 nonsurgical young and middle-aged patients with LDH from the orthopaedic clinic in two tertiary hospitals in Fuzhou and Putian were divided into the interventional group(n=103)and the control group(n=102).Patients in both groups received the health education by using mind map combined with micro-video during hospitalization.Besides,patients in the interventional group received PRECEDE-PROCEED model health management intervention provided by the research team after dischareged,that is to intervene separately for tendency factors,promoting factors and strengthening factors,while patients in the control group received WeChat communication for routine counseling.The knowledge of LDH score,level of self-care behavior score and Oswestry Disability Index were compared before the intervention,and 2 months,4 months,and 6 months.Results Patients'disease cognition level,self-care behavior of lumbar disc level,and the dysfunction were improved in both groups.However,those effects in the interventional group were significantly better than those in the control group(P<0.001).Conclusion Mind map combined with micro-video health education can enhance the disease cognition level of young and middle-aged patients with LDH,improve their self-care behavior of lumbar disc level,and promote their dysfunction recovery.Besides,the effect will be better by combining out-of-hospital PRECEDE-PROCEED model health management intervention.

关 键 词：椎间盘移位 健康教育 格林模式 自护行为 疾病认知 功能障碍 

分 类 号：R473.6[医药卫生—护理学]