信息框架对居民脑卒中就医延迟行为意向的影响研究  

Effect of Message Framing on Stroke Pre-hospital Delay Behavior Intention in Residents

作　　者：王芬 张绮珊 孙兴兰 秦凤银 黄奕敏 韩郭茵 赖锦佳 张小培[2] 谭益冰[1] WANG Fen;ZHANG Qishan;SUN Xinglan;QIN Fengyin;HUANG Yimin;HAN Guoyin;LAI Jinjia;ZHANG Xiaopei;TAN Yibing(School of Nursing,Guangzhou University of Chinese Medicine,Guangzhou 510006,China;No.1 Department of Encephalopathy,the Second Affiliated Hospital of Guangdong Provincial Hospital of Chinese Medicine,Guangzhou 510120,China)

机构地区：[1]广州中医药大学护理学院,广东省广州市510006 [2]广东省中医院第二附属医院脑病一科,广东省广州市510120

出　　处：《中国全科医学》2023年第1期64-73,共10页Chinese General Practice

基　　金：广东省哲学社会科学“十三五”规划2020年度学科共建项目(GD20XGL02)——框架效应视域下中风就医延迟的干预策略研究;广东省医学科研基金项目(A2022289)——基于证据生态系统的社区“中风120”健康教育方案的构建与应用研究。

摘　　要：背景 信息框架(收益框架和损失框架)理论在健康教育中起着重要作用,但目前其在公众脑卒中认知教育中的应用效果尚不明确。目的 探讨基于“中风120”的收益与损失框架信息对居民脑卒中院前延迟行为意向影响的差异。方法 2021年1—9月,通过脚本撰写、视频制作、视频评价3个步骤,形成基于“中风120”的收益框架视频和损失框架视频。于2021年10—11月,采用便利抽样法,选取81例广东省广州市35~80岁的居民为研究对象。采用随机数字表法,按照1∶1的比例,将其随机分为收益框架视频干预组(n=40)和损失框架视频干预组(n=41),邀请收益框架视频干预组居民观看收益框架视频,邀请损失框架视频干预组居民观看损失框架视频。在观看视频前后,采用脑卒中先兆症状识别和应对调查问卷、脑卒中院前延迟行为意向量表(SPDBI)对居民进行调查。比较两组居民干预前后对各脑卒中先兆症状的正确识别与应对情况,以及SPDBI总得分及各维度得分。结果 最终共纳入75例居民,其中收益框架视频干预组37例,损失框架视频干预组38例。干预前,两组居民对各脑卒中先兆症状的正确识别率、应对率比较,差异无统计学意义(P>0.05);两组居民SPDBI总得分及各维度得分比较,差异无统计学意义(P>0.05)。干预后,收益框架视频干预组居民对各脑卒中先兆症状的正确识别率、应对率较干预前提高,差异有统计学意义(P<0.05);SPDBI总得分及除不就医行为合理化维度外的其他维度得分较干预前降低,差异有统计学意义(P<0.05)。损失框架视频干预组居民对各脑卒中先兆症状的正确识别率较干预前提高,差异有统计学意义(P<0.05);对除口角歪斜外的其他脑卒中先兆症状的正确应对率较干预前提高,差异有统计学意义(P<0.05);SPDBI总得分及各维度得分较干预前降低,差异有统计学意义(P<0.05)。损失框架视频干预�Background Message framing(gain-framed message vs loss-framed message)plays a major role in health education,but its significance in public stroke education is still unclear.Objective To compare the impact of gain-and loss-framed messages about "Stroke 1-2-0"(a kind of stroke educational video)on residents’ intention to delay seeking care in the situation of identifying pre-stroke symptoms.Methods From January to September 2021,the gain-framed message video and loss-frame message video based on "Stroke 1-2-0" were developed through three steps:script writing,video production,and video evaluation.Then during October to November 2021,81 residents aged 35-80 selected by convenience sampling from Guangzhou,Guangdong Province were randomized into a gain-framed message video intervention group(n=40)and a loss-framed message video intervention group(n=41),to watch the gain-framed message video and loss-framed message video,respectively.The impact of the intervention was appraised by comparing pre-and post-intervention status of correct recognition and management of pre-stroke symptoms assessed using a self-developed Pre-stroke Symptom Recognition and Management Questionnaire,and pre-and post-intervention total score and domains scores of the Stroke Pre-hospital Delay Behavior Intention(SPDBI)scale.Results A total of 75 cases(37 in the gain-framed message video intervention group and 38 in the loss-framed message video intervention group)who completed the study were finally included.Two groups had no significant differences in pre-intervention rates of correct recognition and management of pre-stroke symptoms(P>0.05).There were no significant intergroup differences in mean pre-intervention total score and each domain score of the SPDBI scale(P>0.05).After intervention,significantly increased rates of correct recognition and management of various pre-stroke symptoms,and significantly lowered mean total score and domain scores(except the non-treatment justification)of the SPDBI scale were found in the gain-framed message

关 键 词：信息框架 卒中 院前延迟 就医延迟 行为意向 视频干预 中风120 

分 类 号：R743[医药卫生—神经病学与精神病学]