Investigation on the status quo of health literacy and health education needs of caregivers of patients with dysphagia after new stroke before discharge
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摘要:
目的 调查新发脑卒中后吞咽障碍(PSD)患者照顾者出院前健康素养现状和健康教育需求，并分析相关影响因素。 方法 采用便利抽样法，选取2023年2月—2024年8月浙江省人民医院淳安分院收治的105例PSD患者及其照顾者。采用一般资料量表、健康素养量表、健康教育需求量表对PSD患者照顾者进行问卷调查，通过多重线性回归分析PSD患者照顾者健康素养及健康教育需求的影响因素。 结果 共发放调查问卷105份，最终收回有效问卷98份(93.33%)。98例PSD患者照顾者的健康素养量表总分为(48.75±9.20)分，健康教育需求量表总分为(204.16±10.36)分。不同年龄、文化水平、工作状态及与患者关系之间的PSD患者照顾者健康素养量表得分比较，差异有统计学意义(P < 0.05)；不同文化水平、患者带胃管与否、患者每日进餐频次及住院时间之间的PSD患者照顾者健康教育需求量表得分比较，差异有统计学意义(P < 0.05)。多重线性回归分析显示：年龄、文化水平及工作状态是PSD患者照顾者健康素养的影响因素(P < 0.05)，患者带胃管与否、患者每日进餐频次及患者住院时间均为PSD患者照顾者健康教育需求的影响因素(P < 0.05)。 结论 新发PSD患者照顾者出院前的健康素养处于中下等水平，年龄、文化水平及工作状态是相关影响因素；健康教育需求处于高等水平，患者带胃管与否、患者每日进餐频次及患者住院时间是相关的影响因素。 Abstract:Objective To investigate the status quo of health literacy and health education needs of caregivers of patients with dysphagia (PSD) after a new stroke before discharge, and analyze the related influencing factors. Methods A total of 105 PSD patients and their caregivers admitted to Chun ' an Branch of Zhejiang Provincial People ' s Hospital from February 2023 to August 2024 were selected by convenient sampling method. The general data scale, health literacy scale, and health education demand scale were selected to conduct a questionnaire survey on caregivers of PSD patients, and the influencing factors of health literacy and health education demand of caregivers of PSD patients were analyzed by multiple linear regression. Results A total of 105 questionnaires were distributed and 98 valid questionnaires were finally recovered (93.33%). The total score of the health literacy scale for caregivers of 98 PSD patients was (48.75±9.20) points, and the total score of the health education demand scale for caregivers was (204.16±10.36) points. The scores of caregivers of PSD patients with different ages, education levels, working status, and relationships with patients were compared, and the difference was statistically significant (P 0.05). There were significant differences in the scores of PSD caregivers ' health education demand scale among different educational levels, patients with or without gastric tubes, patients ' daily meal frequency, and hospitalization time (P < 0.05). Multiple linear regression analysis showed that age, education level, and working status were the influencing factors of health literacy of caregivers of PSD patients (P < 0.05), and whether patients wore gastric tubes, daily meal frequency and hospitalization time were the influencing factors of health education needs of caregivers of PSD patients (P < 0.05). Conclusion The health literacy of caregivers of newly diagnosed PSD patients before discharge is in the lower-middle level, and age, educational level, and working status are related factors. The demand for health education is at a high level, and whether the patient has a gastric tube, the daily meal frequency of the patient, and the hospitalization time of the patient are related factors. -
Key words:
- Stroke /
- Dysphagia /
- Caregiver /
- Health literacy /
- Health education
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表 1 98例PSD患者照顾者健康素养量表得分情况
Table 1. Scores of health literacy scale for caregivers of 98 PSD patients
项目 分值(分) 得分(x ±s，分) 得分率(%) 排序 基本技能 5~25 10.22±3.17 40.88 3 基本知识与理念 6~30 17.36±3.54 57.87 1 健康生活方式与行为 9~45 21.17±2.49 47.04 2 总分 20~100 48.75±9.20 48.75 
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表 2 98例PSD患者照顾者健康教育需求量表得分情况
Table 2. Scores of health education demand scale for caregivers of 98 PSD patients
项目 分值(分) 得分(x ±s，分) 得分率(%) 排序 吞咽障碍知识 5~25 20.70±1.38 82.80 3 管饲知识 17~85 65.26±4.83 76.78 5 吞咽训练方法 5~25 21.03±1.96 84.12 2 经口进食知识 13~65 59.16±2.54 91.02 1 营养知识 5~25 19.22±1.02 76.88 4 并发症护理 5~25 19.19±1.14 76.76 6 总分 50~250 204.16±10.36 81.60
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表 3 PSD患者照顾者健康素养及健康教育需求的单因素分析(x ±s，分)
Table 3. Univariate analysis of health literacy and health education needs for caregivers of PSD patients (x ±s, points)
项目 例数 健康素养 健康教育需求 量表得分 统计量 P值 量表得分 统计量 P值 年龄(岁) 9.814a < 0.001 0.169a 0.845 ＜45 24 43.26±8.39 203.12±12.57 45~59 57 52.18±9.04 204.35±12.38 ≥60 17 46.15±8.25 205.38±12.95 性别 0.619b 0.538 0.783b 0.435 男性 46 47.89±8.95 203.59±12.18 女性 52 49.02±9.11 205.58±12.96 文化水平 4.280a 0.017 3.250a 0.043 小学及以下 12 44.45±8.42 209.36±12.84 初高中 45 47.88±8.74 205.14±12.52 专科及以上 41 52.05±9.26 200.19±11.87 工作状态 3.735b < 0.001 0.568b 0.571 在职 43 47.28±8.79 205.16±12.42 退休/离职 55 54.16±9.37 203.74±12.08 患者卒中类型 0.518b 0.606 0.220b 0.826 脑出血 56 48.10±9.18 204.57±12.48 脑梗死 42 49.08±9.34 204.03±11.67 患者带胃管 0.475b 0.636 3.220b 0.002 是 61 48.22±9.20 201.18±12.14 否 37 49.14±9.35 209.57±13.08 患者医保类型 0.581a 0.561 0.448a 0.640 职工 29 51.23±9.29 202.36±12.47 新农合/社保 55 50.33±9.14 204.05±12.32 自费 14 48.02±9.07 206.12±12.91 患者每日进餐频次(次) 0.161a 0.852 3.941a 0.023 ＜3 10 49.26±9.31 210.15±13.04 3~5 73 48.71±9.24 204.15±12.28 ＞5 11 50.38±9.47 195.34±12.08 住院时间(d) 0.178a 0.837 4.141a 0.019 ＜7 41 48.85±9.17 207.84±13.27 7~14 18 49.22±9.28 203.46±13.05 ＞14 39 50.07±9.30 199.78±11.46 与患者关系 4.388a 0.015 0.876a 0.420 夫妻 56 54.07±9.33 207.09±13.14 父母或子女 24 49.21±9.17 205.11±12.75 其他 14 47.16±9.05 202.13±12.34 注：a为F值，b为t值。
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表 4 PSD患者照顾者健康素养及健康教育需求的多重线性回归分析
Table 4. Multiple linear regression analysis of health literacy and health education needs for caregivers of PSD patients
变量 β SE β' t值 P值 健康素养量表得分 年龄 5.416 1.628 0.381 3.327 0.001 文化水平 8.511 2.170 0.706 3.922 < 0.001 工作状态 5.255 2.014 0.285 3.327 0.011 与患者关系 -2.099 2.455 -0.167 -0.855 0.395 健康教育需求量表得分 文化水平 4.593 5.082 0.185 0.904 0.368 患者带胃管与否 14.403 5.234 0.339 2.752 0.007 患者每日进餐频次 16.302 5.006 0.570 3.257 0.002 患者住院时间 20.238 3.798 0.813 5.328 < 0.001
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