基于跨理论模型的健康教育对青年慢性乙型肝炎患者自我管理的影响  

Effects of health education based on the trans-theoretical model on self-management in young patients with chronic hepatitis B

作　　者：游心雯 吴荣珍[1] 陆俊雯 蔡前敏 徐燊华 王佳薇 毛怡 邹迪 YOU Xinwen;WU Rongzhen;LU Junwen;CAI Qianmin;XU Shenhua;WANG Jiawei;MAO Yi;ZOU Di(Suzhou Fifth People's Hospital,Suzhou 215000,China)

机构地区：[1]苏州市第五人民医院,江苏省苏州市215000

出　　处：《护理实践与研究》2024年第8期1184-1192,共9页Nursing Practice and Research

基　　金：苏州市护理学会科研项目(编号:SZHL-B-202209)。

摘　　要：目的探讨基于跨理论模型的健康教育对接受抗病毒治疗的青年慢性乙型肝炎患者自我管理能力、自我效能、生命质量及肝功能恢复的影响。方法选取2022年6—8月80例青年慢性乙型肝炎抗病毒治疗患者为研究对象,按照组间基线资料具有可比性的原则将其分为对照组和观察组,每组40例。对照组实施常规健康教育,即入院宣教、专病护理、出院宣教。观察组在常规健康教育基础上实施跨理论模型的健康教育方案,根据患者所处行为改变阶段予以干预,干预形式主要以个体化指导为主,辅以集体讲座、小组讨论、观看视频、微信平台等形式,在整个阶段性教育过程中,适时评价,循环渐进,前一阶段目标完成后再进入下一阶段的健康教育。比较两组患者干预前、干预后6个月的自我管理、自我效能感、生命质量改善情况及肝功能指标、乙型肝炎病毒基因滴度的变化情况。结果干预前,两组患者自我管理、自我效能感、生命质量得分及肝功能指标、乙型肝炎病毒基因滴度的比较,差异均无统计学意义(P>0.05)。干预6个月后,观察组患者的自我管理得分、自我效能感得分、生命质量得分高于对照组,差异具有统计学意义(P<0.05);观察组患者肝功能指标低于对照组,差异有统计学意义(P<0.05);乙型肝炎病毒基因数值两组比较差异无统计学意义(P>0.05)。结论基于跨理论模型的健康教育能够提高青年慢性乙型肝炎抗病毒治疗患者的自我管理能力、自我效能感及生命质量,促进肝功能恢复,但对乙型肝炎病毒基因滴度的变化水平还没有产生一定的影响,有待进一步研究。Objective To explore the impact of health education based on the trans-theoretical model on self-management ability,self-efficacy,quality of life and liver function recovery in young patients with chronic hepatitis B receiving antiviral therapy.Methods A total of 80 young patients with chronic hepatitis B undergoing antiviral therapy from June to August 2022 were selected as the research subjects.They were divided into a control group and an observation group,with 40 cases in each group,based on the principle of comparable baseline data between the groups.The control group implemented routine health education,including admission education,specialized nursing care,and discharge education.The observation group implemented a health education program based on the trans-theoretical model in addition to routine health education.Interventions were given according to the stage of behavior change the patients were in.The intervention primarily involved individualized guidance,supplemented by group lectures,group discussions,video presentations,use of the WeChat platform,etc.Throughout the phased education process,timely assessments were conducted,with a progressive approach where goals for each stage were achieved before moving on to the next phase of health education.The differences in selfmanagement,self-efficacy,and quality of life improvement were compared between the two groups of patients before and after a 6-month intervention.Changes in liver function indicators and hepatitis B virus gene titers were also assessed.Results Before the intervention,there was no statistically significant difference in self-management scores,self-efficacy scores,quality of life scores,liver function indicators,and hepatitis B virus gene titers between the two groups(P>0.05).After 6 months of intervention,the self-management,self-efficacy,and quality of life scores of patients in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05);the liver function indicator in the ob

关 键 词：跨理论模型 青年患者 慢性乙型肝炎 抗病毒治疗 自我管理 

分 类 号：R473.51[医药卫生—护理学]