综合提醒系统对脑卒中患者出院6个月知信行和临床结局的效果

doi:10.3969/j.issn.1006-9771.2020.07.023

Abstract

Abstract:

Objective To investigate the effect of Comprehensive Reminder System Based on Health Belief Model (CRS-HBM) on health knowledge, belief, behaviors, utilization of health services and clinical outcomes in stroke patients after discharge. Methods From February, 2015 to March, 2016, 174 stroke patients with hypertension were divided into control group (n = 87) and intervention group (n = 87). The control group received routine stroke health education, and the intervention group received the CRS-HBM program in addition. They were investigated with Stroke Knowledge Questionnaire (SKQ), Short Form Health Belief Model Scale for Stroke Patients (SF-HBMS-SP), Health Behavior Scale for Stroke Patients (HBS-SP), and the utilization of health services and clinical outcomes (emergency, re-hospitalization, recrudescence and death) were recorded six months after discharge.Results A total of 75 cases in the control group and 76 in the intervention group finished the research. The total scores of SKQ (U = 903.000), SF-HBMS-SP (t = -9.099) and HBS-SP (t = -7.786) were more in the intervention group than in the control group (P< 0.001). The outpatient re-visit rate was more in the intervention group (97.37%) than in the control group (76.00%) (P< 0.001). The incidence of emergency, re-hospitalization, recrudescence and death were not significantly different between the two groups (P > 0.05). Conclusion The application of CRS-HBM can improve the health knowledge, belief, behaviors for stroke patients after discharge, but there are not enough effects on clinical outcomes.

Key words: stroke, Comprehensive Reminder System Based on Health Belief Model, health education, knowledge, belief, behavior

CLC Number:

R743.3

SHEN Meng-jie,WANG Xiao,TAN Ju-xiang,WANG Shao-zhou,ZHANG Ying-mei,WAN Li-hong. Effect of Comprehensive Reminder System on Health Knowledge, Belief and Behaviors, and Clinical Outcomes for Stroke Patients Six Months after Discharge[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2020, 26(7): 856-862.

Figures/Tables 3

References 32

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项目		对照组(n = 75)	干预组(n = 76)	χ²值	P值
性别	男	50	50	0.013	0.909
	女	25	26
年龄(岁)	35~44	5	2	2.571	0.261
	45~59	30	25
	60~86	40	49
文化程度	小学及以下	12	12	6.801	0.079
	初中	20	29
	高中及中专	33	19
	大专及以上	10	16
首发/复发	首发	59	49	3.733	0.053
	复发	16	27
病程(年)	0~< 1	61	53	3.301¹⁾	0.196
	1~< 2	2	6
	2~26	12	17
mRS评分	0	33	34	2.799	0.247
	1	33	26
	2~3	9	16
高血压病程(年)	0~< 1	23	10	7.283	0.122
	1~< 5	18	25
	5~< 10	8	10
	10~< 15	13	13
	15~45	13	18

项目	对照组(n= 75)	干预组(n= 76)	U/t值	P值
SKQ^a
总分	69.17±21.81	72.21±20.46	2643.00	0.440
运动锻炼	73.33±44.52	72.37±45.01	2822.50	0.894
营养	67.33±39.84	75.66±35.11	2551.00	0.206
低盐饮食	52.00±50.30	67.11±47.30	2419.50	0.059
戒烟	73.33±44.52	71.05±45.65	2785.00	0.755
限酒	84.00±36.91	80.26±40.07	2743.50	0.550
服药	54.67±40.51	57.46±40.59	2738.00	0.664
血压监测	74.00±32.22	76.32±31.06	2748.00	0.664
脑卒中危险因素	67.87±27.82	70.00±27.81	2692.50	0.554
脑卒中先兆	84.44±28.65	88.60±24.07	2671.50	0.390
脑卒中处理	68.00±46.96	72.37±45.01	2725.50	0.559
SF-HBMS-SP
总分	4.01±0.52	4.15±0.42	-1.872	0.063
易感性	3.97±0.65	4.18±0.72	-1.956	0.052
严重性	3.97±0.89	4.22±0.71	-1.915	0.057
健康动力	4.52±0.77	4.69±0.47	-1.615	0.108
自我效能	4.29±0.75	4.38±0.60	-0.837	0.404
益处	4.43±0.72	4.48±0.55	-0.481	0.631
障碍^b	2.92±0.95	3.06±1.04	-0.839	0.403
HBS-SP
总分	2.50±0.42	2.53±0.52	-0.374	0.709
HPLPⅡ运动锻炼	1.79±0.63	1.96±0.63	-1.677	0.096
HPLPⅡ营养	2.56±0.55	2.61±0.63	-0.517	0.606
低盐饮食	2.84±1.12	2.84±1.12	-0.012	0.991
血压监测	2.28±1.13	2.41±1.28	-0.650	0.516
戒烟^b	3.25±1.21	3.24±1.24	0.083	0.934
限酒^b	3.73±0.58	3.71±0.73	0.213	0.831
服药^b	3.26±0.86	2.96±0.99	1.985	0.050

项目	对照组(n = 75)	干预组(n = 76)	U/t值	P值
SKQ^a
总分	79.08±16.74	92.98± 7.04	903.000	< 0.001
运动锻炼	80.33±40.08	98.46±12.40	1623.000	0.001
营养	77.87±37.11	98.46± 8.70	1449.500	< 0.001
低盐饮食	60.66±49.26	96.92±17.40	1263.500	< 0.001
戒烟	83.61±37.33	100.00±0.00	1657.500	0.001
限酒	90.16±30.03	100.00±0.00	1787.500	0.010
服药	69.40±35.64	99.49± 4.13	996.500	< 0.001
血压监测	81.97±25.87	97.69±10.57	1390.000	< 0.001
脑卒中危险因素	77.21±20.91	85.23±15.82	1493.500	0.015
脑卒中先兆	91.80±20.78	95.90±15.03	1786.000	0.097
脑卒中处理	86.89±34.04	98.46±12.40	1753.000	0.012
SF-HBMS-SP
总分	3.90±0.52	4.59±0.30	-9.099	< 0.001
易感性	3.98±0.62	4.67±0.47	-6.969	< 0.001
严重性	3.77±0.72	4.62±0.51	-7.628	< 0.001
健康动力	4.25±0.73	4.83±0.36	-5.670	< 0.001
自我效能	4.18±0.66	4.70±0.45	-5.173	< 0.001
益处	4.28±0.74	4.77±0.41	-4.539	< 0.001
障碍^b	3.01±0.86	4.00±0.73	-6.997	< 0.001
HBS-SP
总分	2.75±0.40	3.23±0.35	-7.786	< 0.001
HPLPⅡ运动锻炼	2.00±0.58	2.77±0.57	-8.294	< 0.001
HPLPⅡ营养	2.87±0.52	3.12±0.46	-3.069	0.003
低盐饮食	3.15±0.93	3.68±0.70	-4.035	< 0.001
血压监测	3.20±1.07	3.59±0.75	-2.610	0.010
戒烟^b	3.40±1.13	3.75±0.64	-2.347	0.021
限酒^b	3.91±0.34	3.91±0.41	-0.020	0.984
服药^b	3.34±0.81	3.87±0.39	-5.063	< 0.001

Effect of Comprehensive Reminder System on Health Knowledge, Belief and Behaviors, and Clinical Outcomes for Stroke Patients Six Months after Discharge

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