失能老人照护者多平台延续教育模式的构建及效果分析  

The construction and effect analysis of multi-platform continuing education model for the elderly caretakers with disabilities

作　　者：张婷婷 李丽金 黄斌英[3] 钟艳平 唐瑛 赵霞 蒋文中[1] Zhang Tingting;Li Lijin;Huang Binying;Zhong Yanping;Tang Ying;Zhao Xia;Jiang Wenzhong(Occupational Medicine,Guangzhou 12th People's Hospital,510620,China;Comprehensive Ward,Guangzhou Yuexiu District Zhuguang Street Community Health Service Center,510110,China;Otorhinolaryngology Department,Guangzhou 12th People's Hospital,510620,China;Yuexiu District Huanghuagang Street Community Health Service Center,510095,China)

机构地区：[1]广州市第十二人民医院职业病科,510620 [2]广州市越秀区珠光街社区卫生服务中心综合病房,510110 [3]广州市第十二人民医院耳鼻喉科,510620 [4]越秀区黄花岗街社区卫生服务中心,510095

出　　处：《国际护理学杂志》2020年第23期4223-4230,共8页international journal of nursing

基　　金：2018年广州护理学会"长期护理服务体系"主题研究课题(SH20180326);广州市卫生健康委临床重点专科(穗卫函[2019]1555号);广东省医学科研基金项目(A2016429);广东省中医药局基金项目(20191267)。

摘　　要：目的构建失能老人照护者多平台延续教育模式,探讨该模式是否能够提高照护者知识水平和提升出院后以照护者为主导的失能老人居家健康行为的依从性。方法构建"医院-社区-家庭"失能老人照护者多平台延续教育模式,选取广州市2家医院和2家社区出院的广州城区失能老人及其照护者为研究对象,建立延续性护理服务档案数据库,采用多中心随机对照方法随机分为对照组和干预组,对照组仅接受常规出院健康知识宣教,干预组在此基础上增加多平台协作的延续教育,即通过理论授课、面对面指导、上门服务、多媒体平台等教育模式提高照护者在失能老人生活护理、疾病护理、安全护理、心理护理等方面的照护能力。在出院前三天内、干预第12周和第24周分别通过陪护者理论测试问卷和健康行为依从性问卷评价照护者的照护知识水平和健康行为的依从性。结果共有168例患者及其陪护完成出院24 w的全部资料的收集,其中对照组87例,干预组81例。干预组在干预后各时间点的陪护理论测试成绩和健康行为依从性均有明显提高,差异有统计学意义(均P<0.05),且得分均高于同期的对照组,差异有统计学意义(均P<0.05)。结论长期护理保险制度下构建失能老人多平台延续教育模式能够提高失能老人照护者的照护水平,从而提升出院后以照护者为主导的失能老人居家健康行为依从性。Objective To construct a multi-platform continuing education model for caregivers of disabled elderly,and to explore whether this model can improve the knowledge level of caregivers and enhance the compliance of caregivers'health behaviors at home after discharge.Methods The multi-platform continuing education model of disabled elderly in"Hospital-Community-Family"was established.The disabled elderly and their caregivers discharged from 2 hospitals and 2 communities in urban areas of Guangzhou were selected as research objects to establish a database of continuous nursing service archives.Multi-center randomized control method was used to randomly divide the patients into control group and intervention group.The control group only accepted conventional discharge health knowledge education.On this basis,the intervention group added multi-platform collaborative continuing education,that is,through theoretical teaching,face-to-face guidance,door-to-door service,multimedia platform and other educational models to improve the caregiver's ability in life care,disease care,safety care,psychological care and other aspects of the disabled elderly care.Caregivers'level of care knowledge and health behavior compliance were evaluated by the companion theory test questionnaire and the health behavior compliance questionnaire at week 12 and 24,respectively,three days before discharge.Results A total of 168 disabled elders and their caregivers completed 24 weeks'data collection,including 87 cases in the control group and 81 cases in the intervention group.The theory test scores and health behavior compliance of the intervention group were significantly improved at each time point after intervention with a statistical difference(P<0.05).The score of intervention group was higher than that in control group with a statistical difference(P<0.05).Conclusions The establishment of a multi-platform continuing education model for the disabled elderly under the long-term care insurance system can improve the level of care for the disable

关 键 词：失能老人 照护 延续教育 依从性 

分 类 号：R473.5[医药卫生—护理学]