基于理性行为理论的家属同步健康教育在肾移植围手术期中的应用

张融冰; 武小强; 王小青; 李晶; 张玲玲

doi:10.16766/j.cnki.issn.1674-4152.002733

基于理性行为理论的家属同步健康教育在肾移植围手术期中的应用

doi: 10.16766/j.cnki.issn.1674-4152.002733

1.
河南省人民医院日间手术管理中心，河南郑州 450000
2.
河南省人民医院泌尿外科

基金项目:

河南省医学科技攻关计划项目 LHGJ20200046

详细信息

通讯作者:
张玲玲, E-mail: 390663723@qq.com

中图分类号: R193 R699.2
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- 被引次数: 0
出版历程
- 收稿日期: 2022-04-20
- 网络出版日期: 2022-12-30

Application of synchronous health education of family members based on rational behavior theory in perioperative period of renal transplantation

1.
Management Center of Day Surgery, Henan Provincial People's Hospital, Zhengzhou, Henan 450000, China

摘要

摘要: 目的探讨基于理性行为理论的家属同步健康教育在肾移植围术期中的应用效果。方法选择2017年3月—2020年5月河南省人民医院收治的120例肾移植术患者，按随机数字表法分组。对照组(60例)接受围术期常规护理，研究组(60例)实施围术期常规护理+基于理性行为理论的家属同步健康教育。比较2组患者治疗依从性，观察2组患者干预前后健康行为、疾病不确定感、社会心理适应性能力、生活质量及家属照顾负担、希望水平的变化。结果干预后，研究组治疗行为、饮食行为、社会心理行为、躯体活动行为及总分均高于对照组(P＜0.05)；研究组总治疗依从性(96.67%)高于对照组(83.33%，P＜0.05)。干预后，研究组Mishel疾病不确定感量表(MUIS-A)评分低于对照组，社会心理适应性能力、肾移植患者生活质量相关评定量表(QOL-RT)评分高于对照组(P＜0.05)；研究组Zarit照顾者负担量表(ZBI)评分低于对照组，Herth希望指数(HHI)评分高于对照组(P＜0.05)。结论基于理性行为理论的家属同步健康教育用于肾移植围术期中效果明显，不仅可改善患者健康行为、生活质量，提高治疗依从性、社会心理适应性能力，减轻疾病不确定感，且利于降低家属照顾负担，提升希望水平。
- 肾移植术 /
- 理性行为理论 /
- 家属同步健康教育 /
- 健康行为
Abstract: Objective To explore the effect of synchronous health education for family members based on rational behavior theory in kidney transplantation. Methods Total 120 renal transplant patients admitted to Henan Provincial People's Hospital from March 2017 to May 2020 were selected and grouped according to the principle of matching basic characteristics between groups. The control group (60 cases) received perioperative routine care, and the study group (60 cases) received perioperative routine care plus synchronous health education of family members based on rational behavior theory. The treatment compliance of the two groups of patients was compared. The changes of health behavior, disease uncertainty, social psychological adaptability, quality of life, family care burden and hope were observed before and after intervention. Results After the intervention, the treatment behavior, eating behavior, social psychological behavior, physical activity behavior and total scores of the study group were higher than those of the control group (P < 0.05), and the total treatment compliance of the study group (96.67%) was higher than that of the control group (83.33%, P < 0.05). After intervention, the scores of Mishel uncertainty in illness scale-adult (MUIS-A) in the study group were lower than those in the control group, while the scores of psychosocial adaptability and quality of life scale for patients of renal transplantation (QOL-RT) in renal transplant patients were higher than those in the control group (P < 0.05). The score of Zarit burden scale (ZBI) in the study group was lower than that in the control group, while the score of Herth hope index (HHI) was higher than that in the control group (P < 0.05). Conclusion The effect of family members' synchronous health education based on rational behavior theory in the perioperative period of renal transplantation is obvious. It can not only improve patients' health behavior and quality of life, improve treatment compliance and psychosocial adaptability, reduce the uncertainty of disease, but also reduce the care burden of family members and improve the level of hope.
- Renal transplantation /
- Rational behavior theory /
- Synchronous health education for family members /
- Health behavior

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表 1 2组肾移植术患者一般资料比较

Table 1. Comparison of general data of two groups of renal transplant patients

组别	例数	性别(例)		年龄(x±s，岁)	术前透析时间(x±s，年)	文化程度(例)
组别	例数	男性	女性	年龄(x±s，岁)	术前透析时间(x±s，年)	小学	初中或高中	大专及以上
对照组	60	31	29	50.68±3.84	3.15±1.48	18	32	10
研究组	60	28	32	49.75±3.34	3.44±1.37	17	29	14
统计量		0.300^a		1.415^b	1.114^b	0.626^c
P值		0.584		0.160	0.268	0.531
注：^a为χ²值，^b为t值，^c为Z值。

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表 2 2组肾移植术患者健康行为评分比较(x±s，分)

Table 2. Comparison of health behavior scores of renal transplant patients between the two groups (x±s, points)

组别	例数	治疗行为		饮食行为		社会心理行为		躯体活动行为		总分
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后
对照组	60	12.65±3.68	20.98±4.02^a	5.63±1.74	7.18±2.34^a	8.63±1.46	11.54±2.28^a	5.74±2.29	7.87±1.69^a	32.65±5.25	47.57±6.34^a
研究组	60	12.84±4.69	25.76±3.75^a	5.15±1.32	9.04±0.24^a	8.57±2.37	13.98±1.28^a	5.72±1.38	9.02±0.39^a	33.04±5.16	56.39±7.19^a
t值		0.247	6.735	1.702	6.125	1.002	7.228	0.058	5.136	0.410	7.127
P值		0.805	＜0.001	0.091	＜0.001	0.318	＜0.001	0.954	＜0.001	0.683	＜0.001
注：与同组干预前比较，^aP＜0.05。

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表 3 2组肾移植术患者治疗依从性比较[例(%)]

Table 3. Comparison of treatment compliance of renal transplant patients between the two groups [cases(%)]

组别	例数	完全依从	部分依从	不依从	总依从
对照组	60	18(30.00)	32(53.33)	10(16.67)	50(83.33)
研究组	60	21(35.00)	37(61.67)	2(3.33)	58(96.67)
统计量			1.449^a		5.926^b
P值			0.147		0.015
注：^a为Z值，^b为χ²值。

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表 4 2组肾移植术患者MUIS-A、社会心理适应性能力、QOL-RT评分比较(x±s，分)

Table 4. Comparison of MUIS-A, psychosocial adaptability, and QOL-RT scores of renal transplant patients between the two groups (x±s, points)

组别	例数	MUIS-A		社会心理适应能力		QOL-RT
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后
对照组	60	95.59±6.45	79.96±5.42^a	46.62±4.45	61.18±5.58^a	102.69±12.46	129.75±21.15^a
研究组	60	96.48±5.58	62.98±4.43^a	46.98±5.21	69.74±4.67^a	101.76±13.34	143.96±24.74^a
t值		0.808	18.789	0.407	9.112	0.395	3.382
P值		0.421	＜0.001	0.685	＜0.001	0.694	0.001
注：与同组干预前比较，^aP＜0.05。

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表 5 2组肾移植术患者家属ZBI、HHI评分比较(x±s，分)

Table 5. Comparison of ZBI and HHI scores of family members of the two groups (x±s, points)

组别	人数	ZBI		HHI
组别	人数	干预前	干预后	干预前	干预后
对照组	60	40.86±5.25	33.65±4.47^a	21.65±3.78	29.78±5.54^a
研究组	60	41.69±4.87	24.87±3.96^a	22.06±4.84	34.96±4.78^a
t值		0.898	11.388	0.517	5.484
P值		0.371	＜0.001	0.606	＜0.001
注：与同组干预前比较，^aP＜0.05。

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