行为转变理论为基础的饮食指导对肝硬化患者的影响  

The Influence of Dietary Guidance Based on the Transtheoretical Model and Stages of Change(TTM)on Patients with Cirrhosis

作　　者：赵聪 韩芳芳 袁利娜[1] 申丽香[1] Zhao Cong;Han Fangfang;Yuan Lina(Henan Provincial People′s Hospital,Zhengzhou Henan 450000,China)

机构地区：[1]河南省人民医院,河南郑州450000

出　　处：《齐鲁护理杂志》2020年第21期1-5,共5页Journal of Qilu Nursing

摘　　要：目的:探讨行为转变理论(TTM)为基础的饮食指导对肝硬化患者的影响。方法:选取2018年9月1日~2019年9月1日收治的肝硬化患者92例,依据患者入院编号进行分组,编号为奇数的46例纳入对照组,编号为偶数的46例纳入研究组,对照组给予常规护理,研究组在常规护理基础上给予TTM为基础的饮食指导;比较两组干预前和干预6个月后饮食依从性、自我管理能力[采用成年人健康自我管理能力测评量表(AHSMSRS)]、自我效能[采用一般自我效能量表(GSES)]、营养状况[包括上臂肌围(AMC)、肱三头肌皮皱厚度(TSF)、体质指数(BMI)、血清白蛋白(ALB)、前白蛋白(PA)、总胆固醇(TC)、三酰甘油(TG)]、情绪状态[采用汉密顿焦虑量表(HAMA)、汉密顿抑郁量表(HAMD)]及生活质量[采用生活质量测定表(QOL)]。结果:干预后,研究组饮食依从性优于对照组(P<0.05);干预后,两组AHSMSRS中自我管理行为、自我管理环境、自我管理认知得分和GSES评分均高于干预前(P<0.05),且研究组高于对照组(P<0.01);干预后,两组AMC、TSF、BMI、ALB、PA、TC、TG高于干预前(P<0.05),且研究组高于对照组(P<0.01,P<0.05);干预后,两组HAMA、HAMD评分低于干预前(P<0.05),且研究组低于对照组(P<0.01);干预后,两组QOL中环境领域、生理领域、心理领域、社会关系领域得分高于干预前(P<0.05),且研究组高于对照组(P<0.01)。结论:TTM为基础的饮食指导应用于肝硬化患者中,能提高患者饮食依从性、自我管理能力、自我效能、生活质量,改善其营养状态,缓解负性情绪。Objective:To explore the influence of dietary guidance based on the transtheoretical model and stages of change(TTM)on patients with cirrhosis.Methods:From September 1,2018 to September 1,2019,a total of 92 cases of patients with liver cirrhosis were selected.They were grouped according to their admission Numbers.Forty-six patients numbered odd were included in the control group,and 46 patients numbered even were included in the study group.The control group was given routine nursing care,and TTM-based dietary guidance was given to the study group on the basis of routine nursing.Diet compliance,self-management ability[using adult health self-management self-rating scale(AHSMSRS)],self-efficacy[the general self-efficacy scale(GSES)],the nutritional status[including upper arm muscle circumference(AMC),triceps skinfold thickness(TSF),body mass index(BMI),serum albumin(ALB)and prealbumin(PA),total cholesterol(TC),three acyl glycerin(TG)],emotional state(HAMA And HAMD),and quality of life(QOL)were compared between the two groups before intervention and 6 months after intervention.Results:After intervention,dietary compliance of the study group was better than that of the control group(P<0.05).After intervention,the AHSMSRS scores of self-management behavior,self-management environment,self-management cognition and GSES score in the two groups were all higher than those in the control group(P<0.05),and the study group was higher than the control group(P<0.01).After intervention,AMC,TSF,BMI,ALB,PA,TC,and TG in the two groups were higher than those before intervention(P<0.05),and the study group was higher than the control group(P<0.01,P<0.05).After intervention,HAMA and HAMD scores in both groups were lower than those before intervention(P<0.05),and those in the study group were lower than those in the control group(P<0.01).After intervention,the scores of environmental field,physiological field,psychological field and social relation field in QOL of the two groups were higher than those before intervention(P<0.05),and

关 键 词：行为转变理论 饮食指导 肝硬化 管理能力 饮食依从性 

分 类 号：R473.57[医药卫生—护理学]