Cox健康行为互动模式对反流性咽喉炎患者自护能力、嗓音声学变化的影响  

Effects of Cox's Interaction Model of Client Health Behavior on self-care ability and acoustic changes of voice in patients with laryngopharyngeal reflux

作　　者：杨亚萍 曹丽俐 陆晓梅 杨玺 汤洁 YANG Ya-ping;CAO Li-li;LU Xiao-mei;YANG Xi;TANG Jie(Department of Pharyngology,Head and Neck Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan,CHINA)

机构地区：[1]郑州大学第一附属医院咽喉头颈外科,河南郑州450000

出　　处：《海南医学》2024年第23期3492-3496,共5页Hainan Medical Journal

基　　金：河南省医学科技攻关计划项目(编号:222102310584)。

摘　　要：目的探究Cox健康行为互动(IMCHB)护理模式对反流性咽喉炎(LPR)患者自护能力、嗓音声学变化的影响。方法前瞻性选取2022年1月至2023年10月就诊于郑州大学第一附属医院的102例LPR患者作为研究对象,按随机数表法分为观察组和对照组各51例。对照组患者予以常规护理,观察组患者于对照组基础上予以IMCHB护理模式,干预时间均为3个月。比较两组患者干预前后的嗓音声学指标[振幅微扰、基频微扰、噪音障碍指数(DSI)、最长发音时间(MPT)]和自护能力表(ESCA)、抑郁-焦虑-压力自评量表(DASS-21)、生存质量简表(WHOQOL-BREF)评分的变化。结果干预后,观察组患者的振幅微扰、基频微扰分别为(1.52±0.43)%、(0.24±0.11)%,明显低于对照组的(1.83±0.52)%、(0.53±0.16)%,DSI、MPT分别为2.92±0.75、(22.62±3.02)s,明显高于对照组的2.41±0.68、(18.96±2.18)s,差异均有统计学意义(P<0.05);干预后,观察组患者ESCA中的自我概念、自我责任感、自我护理技能、健康知识评分分别为(23.72±2.58)分、(18.02±1.36)分、(39.86±4.31)分、(56.37±4.24)分,明显高于对照组的(18.14±3.20)分、(15.54±2.03)分、(28.59±3.75)分、(49.03±3.89)分,差异均有统计学意义(P<0.05);干预后,观察组患者DASS-21量表中的焦虑、抑郁、压力评分分别为(8.32±1.14)分、(10.25±1.05)分、(7.55±1.25)分,明显低于对照组的(11.18±1.68)分、(13.21±1.27)分、(11.28±1.36)分,差异均有统计学意义(P<0.05);干预后,观察组患者WHOQOL-BREF量表中的生理领域、心理领域、社会关系领域评分分别为(26.51±2.96)分、(23.12±3.74)分、(11.78±2.12)分,明显高于对照组的(22.14±3.35)分、(18.67±4.59)分、(8.84±1.57)分,差异均有统计学意义(P<0.05)。结论IMCHB护理模式可纠正LPR患者精神心理状态,增强自护能力,改善异常嗓音,提升生活质量水平,值得临床推广应用。Objective To explore the effects of Cox's Interaction Model of Client Health Behavior(IMCHB)on self-care ability and acoustic changes of voice in patients with laryngopharyngeal reflux(LPR).Methods A total of 102 LPR patients treated in the First Affiliated Hospital of Zhengzhou University from January 2022 to October 2023 were prospectively selected and divided into an observation group and a control group according to random number table,with 51 patients in each group.The patients in the control group were given routine nursing,and those in the observation group were given IMCHB.The intervention lasted for 3 months.The acoustic parameters of voice(amplitude perturba-tion,fundamental frequency perturbation,dysphonia severity index[DSI],maximum phonation time[MPT]),exercise of self-care agency(ESCA),Depression,Anxiety and Stress Scale-21 Items(DASS-21),and World Health Organization's Quality of Life Questionnaire-Brief Version(WHOQOL-BREF)before and after intervention were compared between the two groups.Results After intervention,the amplitude perturbations and fundamental frequency perturbations in the obser-vation group were(1.52±0.43)%and(0.24±0.11)%,respectively,which were significantly lower than(1.83±0.52)%and(0.53±0.16)%in the control group,while the DSI and MPT were(2.92±0.75)s and(22.62±3.02)s,respectively,significant-ly higher than(2.41±0.68)s and(18.96±2.18)s in the control group,with statistically significant differences(P<0.05).After intervention,the scores of self-concept,self-responsibility,self-care skills,and health knowledge in the ESCA scale of pa-tients in the observation group were(23.72±2.58)points,(18.02±1.36)points,(39.86±4.31)points,and(56.37±4.24)points,respectively,which were significantly higher than(18.14±3.20)points,(15.54±2.03)points,(28.59±3.75)points,and(49.03±3.89)points in the control group(P<0.05).After intervention,the scores of anxiety,depression,and stress in the DASS-21 scale in the observation group were(8.32±1.14)points,(10.25±1.05)points,and(7.55±1.25

关 键 词：Cox健康行为互动 反流性咽喉炎 嗓音声学 自护能力 生活质量 

分 类 号：R473.76[医药卫生—护理学]