Application of PRECEDE-PROCEED mode health education in the family of children with febrile seizures
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摘要:
目的 探讨前处理模式(PRECEDE-PROCEED)健康教育对热性惊厥患儿家属健康认识认知度、负性情绪及护理满意度的影响。 方法 选取2016年1月—2018年7月广元市第一人民医院86例热性惊厥患儿，按照入院顺序分为观察组与对照组，每组43例。对照组家属实施常规健康教育，观察组家属在此基础上施以PRECEDE-PROCEED模式健康教育。对比2组患儿家属健康知识掌握情况、干预前后负性情绪[焦虑自评量表(self-rating anxiety scale, SAS)、抑郁自评量表(self-rating depression scale，SDS)]变化、配合情况、患儿转归情况及护理满意度。 结果 干预后观察组患儿家属疾病认知、治疗认知、护理认知及健康态度与行为评分高于对照组，2组患儿家属SAS、SDS评分均较干预前降低，且观察组SAS、SDS评分低于对照组，配合度高于对照组，差异均具有统计学意义(均P < 0.05)；2组患儿退热、止惊时间比较，差异无统计学意义(均P>0.05)，但观察组患儿复发次数少于对照组，观察组患儿家属护理满意度高于对照组，差异有统计学意义(均P < 0.05)。 结论 对热性惊厥患儿家属进行PRECEDE-PROCEED模式健康教育，可有效提高其对相关健康知识认知度，缓解负性情绪，有利于保证家属配合临床相关工作顺利进行，护理满意度高，且可降低惊厥复发率。 Abstract:Objective To explore the influence of precede-proceed model (pretreatment model) health education on the health cognition, negative emotion and nursing satisfaction of the family members of patients with febric convulsion. Methods Eighty-six children with febrile seizures from January 2016 to July 2018 were enrolled from The First People's Hospital of Guangyuan City.The patients were divided into observation group and control group according to the admission time, with 43 cases in each group. The family members of the control group were given regular health education, and the family members of the observation group were given the PRECEDE-PROCEED model health education and regular health education. The health knowledge, negative emotions before and after the intervention [anxiety (self-rating anxiety scale, SAS), depression (self-rating depression scale, SDS)], coordination, patients outcome and nursing satisfaction of the two groups were compared. Results After intervention, the scores of disease cognition, treatment cognition, nursing cognition, health attitude and behavior of the family members of the observation group were higher than those of the control group, the SAS and SDS scores in both groups were lower than those before intervention, and SAS and SDS scores in the observation group were lower than those in the control group, the coordination degree of the observation group was higher than that in the control group and the difference were statistically significant (all P < 0.05). There was no statistically significant difference in the time of antipyretic and anticonvulsant between the two groups (all P>0.05). But the recurrence times in the observation group was less than that in the control group, and the nursing satisfaction of the observation group was higher than that of the control group, with statistically significant difference (all P < 0.05). Conclusion The PRECEDE-PROCEED model health education for the family members of patients with febric convulsion could effectively improve their recognition of related health knowledge, relieve negative emotions, ensure the family members to carry out clinical related work smoothly, have high nursing satisfaction, and reduce the recurrence rate of convulsion. -
表 1 2组热性惊厥患儿临床资料比较[例(%)]
组别 例数 性别 年龄(x±s，岁) 病情严重程度 家属身份 家属年龄(x±s，岁) 家属受教育程度 男 女 轻度 中度 重度 母亲 父亲 初中及以下 高中及专科 本科及以上 观察组 43 22(51.16) 21(48.84) 3.67±1.22 11(25.58) 24(55.81) 8(18.60) 32(74.42) 11(25.58) 36.69±5.46 12(27.91) 17(39.53) 14(32.56) 对照组 43 24(55.81) 19(44.19) 3.73±1.18 10(23.26) 26(60.47) 7(16.28) 30(69.77) 13(30.23) 35.37±6.11 13(30.23) 19(44.19) 11(25.58) 统计量 0.187a 0.232b 0.194c 0.231a 1.056b 0.511a P值 0.665 0.817 0.907 0.631 0.294 0.774 注：a为χ2值，b为t值，c为U值。 
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表 2 2组热性惊厥患儿家属干预后健康知识掌握情况比较(x ±s，分)
组别 例数 疾病认知 治疗认知 护理认知 健康态度与行为 观察组 43 18.14±1.21 17.55±1.46 17.63±1.51 18.74±1.02 对照组 43 15.23±1.32 14.87±1.29 13.22±1.18 15.46±1.14 t值 10.656 9.020 15.090 14.060 P值 < 0.001 < 0.001 < 0.001 < 0.001
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表 3 2组热性惊厥患儿家属干预前后SAS、SDS评分比较(x ±s，分)
组别 例数 SAS SDS 干预前 干预后 干预前 干预后 观察组 43 63.26±5.38 43.44±7.37 62.47±6.61 44.85±6.54 对照组 43 62.27±6.26 49.86±8.59 61.88±5.79 48.35±7.19 t值 0.787 -3.720 0.440 -2.361 P值 0.434 <0.001 0.661 0.021
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表 4 2组热性惊厥患儿家属配合情况比较[例(%)]
组别 例数 完全配合 基本配合 不配合 配合度 观察组 43 28(65.12) 12(27.91) 3(6.98) 40(93.02) 对照组 43 22(51.16) 11(25.58) 10(23.26) 33(76.74) 注：2组配合度比较，χ2=4.440，P=0.035。
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表 5 2组热性惊厥患儿退热、止惊时间及复发情况比较(x ±s)
组别 例数 退热时间(d) 止惊时间(h) 复发次数(次) 观察组 43 1.28±0.41 4.36±0.59 2.48±0.86 对照组 43 1.32±0.37 4.41±0.61 4.53±1.07 t值 -0.475 -0.386 -9.792 P值 0.636 0.700 < 0.001
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表 6 2组热性惊厥患儿家属护理满意度比较[例(%)]
组别 例数 不满意 较满意 非常满意 总满意度 观察组 43 2(4.65) 10(23.26) 31(72.09) 41(95.35) 对照组 43 11(25.58) 11(25.58) 21(48.84) 32(74.42) 注：2组总满意度比较，χ2=7.340，P=0.007。
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