基于症状管理策略的健康教育在高血压脑出血患者中的应用

doi:10.3760/cma.j.issn.1007-1245.2024.08.033

摘要/Abstract

摘要：

目的　分析基于症状管理策略的健康教育在高血压脑出血患者中的应用效果。方法　本研究为随机对照试验，对2021年1月至2022年1月期间商丘市中心医院的116例高血压脑出血患者进行随机数字表法分组，两组各58例。对照组中男性34例，女性24例，年龄为33～64（47.13±6.34）岁，发病至就诊时间为1～18（11.32±1.30）h。观察组中男性32例，女性26例，年龄为31～65（46.65±6.20）岁，发病至就诊时间为1～19（11.44±1.13）h。对照组给予常规临床干预，观察组给予基于症状管理策略的健康教育干预，共干预6个月。比较两组患者干预实施前3 d和干预完成后3 d内负性情绪评分、心理弹性评分、健康相关行为评分、希望水平评分及干预完成后3 d内症状困扰程度。采用独立样本t检验、χ²检验、秩和检验。结果　干预后观察组的焦虑自评量表（SAS）［（36.45±4.41）分］、抑郁自评量表（SDS）评分［（35.78±3.98）分］均低于对照组［（46.38±5.12）分、（49.38±1.69）分］（均P<0.05），干预后观察组的坚韧［（44.16±5.56）分］、自强［（26.85±4.23）分］、乐观评分［（13.64±1.31）分］及心理弹性总分［（84.65±10.21）分］均高于对照组［（39.25±5.32）分、（23.52±4.16）分、（11.05±1.24）分、（73.82±9.45）分］（均P<0.05），干预后观察组的情绪控制［（8.45±0.94）分］、遵医用药［（12.65±1.34）分］、饮食管理［（16.32±2.45）分］、运动管理［（16.06±2.41）分］、自我监测评分［（9.55±0.75）分］及健康相关行为总分［（63.03±7.12）分］均高于对照组［（7.21±1.12）分、（9.34±1.52）分、（13.74±1.56）分、（14.49±2.12）分、（7.36±1.25）分、（52.14±7.25）分］（均P<0.05），干预后观察组的积极态度［（11.89±2.15）分］、积极行动［（11.74±2.46）分］、亲密关系评分［（12.47±2.42）分］及希望水平总分［（35.71±4.14）分］均高于对照组［（9.45±3.07）分、（10.08±2.54）分、（10.84±3.26）分、（32.65±4.28）分］（均P<0.05）。结论　基于症状管理策略的健康教育干预能够在一定程度上改善高血压脑出血患者的负性情绪，提升心理弹性，改善健康相关行为和希望水平，缓解症状困扰。

关键词:

高血压脑出血, 健康教育, 症状管理策略

Abstract:

Objective　To analyze the application effect of health education based on symptom management strategies in patients with hypertensive cerebral hemorrhage. Methods　This study was a randomized controlled trial. A total of 116 patients with hypertensive cerebral hemorrhage in Shangqiu Central Hospital from January 2021 to January 2022 were divided into two groups by the random number table method with 58 cases in each group. In the control group, there were 34 males and 24 females, aged 33-64 (47.13±6.34) years, and the time from onset to treatment was 1-18 (11.32±1.30) h. In the observation group, there were 32 males and 26 females, aged 31-65 (46.65±6.20) years, and the time from onset to treatment was 1-19 (11.44±1.13) h. The control group was given routine clinical intervention, and the observation group was given health education intervention based on symptom management strategies for a total of 6 months. The negative emotion scores, psychological resilience scores, health-related behavior scores, and hope level scores 3 days before intervention and within 3 days after intervention and symptom distress level within 3 days after intervention were compared between the two groups. Independent sample t test, χ² test, and rank sum test were used. Results　After intervention, the scores of Self-rating Anxiety Scale (SAS) [(36.45±4.41) points] and Self-rating Depression Scale (SDS) [(35.78±3.98) points] of the observation group were lower than those of the control group [(46.38±5.12) points and (49.38±1.69) points] (both P<0.05). After intervention, the scores of toughness [(44.16±5.56) points], self-reliance [(26.85±4.23) points], and optimism [(13.64±1.31) points] and total score of psychological resilience [(84.65±10.21) points] of the observation group were higher than those of the control group [(39.25±5.32) points, (23.52±4.16) points, (11.05±1.24) points, and (73.82±9.45) points] (all P<0.05). After intervention, the scores of emotional control [(8.45±0.94) points], medication adherence [(12.65±1.34) points], dietary management [(16.32±2.45) points], exercise management [(16.06±2.41) points], and self-monitoring [(9.55±0.75) points] and total score of health-related behaviors of the observation group [(63.03±7.12) points] were higher than those of the control group [(7.21±1.12) points, (9.34±1.52) points, (13.74±1.56) points, (14.49±2.12) points, (7.36±1.25) points, and (52.14±7.25) points] (all P<0.05). After intervention, the scores of positive attitudes [(11.89±2.15) points], positive actions [(11.74±2.46) points], and intimate relationships [(12.47±2.42) points] and total score of hope level of the observation group [(35.71±4.14) points] were higher than those of the control group [(9.45±3.07) points, (10.08±2.54) points, (10.84±3.26) points, and (32.65±4.28) points] (all P<0.05). Conclusion　Health education intervention based on symptom management strategies can improve the negative emotions of hypertensive intracerebral hemorrhage patients, enhance their psychological resilience, improve the health related behaviors and hope level, and alleviate the symptoms.

Key words:

Hypertensive intracerebral hemorrhage, Health education, Symptom management strategies

马瑞张燕陈笑笑王朝刚.

基于症状管理策略的健康教育在高血压脑出血患者中的应用 [J]. 国际医药卫生导报, 2024, 30(8): 1387-1391.

Ma Rui, Zhang Yan, Chen Xiaoxiao, Wang Chaogang.

Application of health education based on symptom management strategies in patients with hypertensive cerebral hemorrhage [J]. International Medicine and Health Guidance News, 2024, 30(8): 1387-1391.

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