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目的探讨行动导向教学法对直肠癌造口患者健康教育效果的影响。方法选取2012年6月至2015月12月间苏州大学附属第二医院收治的108例直肠癌行结肠造口患者,采用随机数字表法分为观察组与对照组,每组54例。观察组患者给予行动导向教学法的健康教育模式,对照组患者给予常规健康教育模式。6个月后,对两组患者的焦虑和抑郁情况、自我护理能力、并发症及满意度进行对比。结果干预前,两组患者焦虑和抑郁评分,差异均无统计学意义。干预后,两组患者焦虑和抑郁评分均比干预前降低,差异均有统计学意义(均P<0.05);且观察组患者焦虑评分(39.1±5.9)分和抑郁评分(40.3±5.1)分,均显著低于对照组患者的(49.5±6.6)分和(47.6±5.8)分,两组比较,差异均有统计学意义(均P<0.05)。观察组患者自我护理技能(35.9±4.9)分、自我责任感(27.8±5.9)分、自我概念(22.4±3.4)分、健康知识水平(47.4±5.4)分及总分(133.5±7.2)分均显著高于对照组患者的(29.7±4.7)分、(20.5±4.6)分、(17.9±3.0)分、(36.5±7.4)分及(104.6±6.9)分,两组比较,差异均有统计学意义(均P<0.05)。观察组患者并发症发生4例,显著低于对照组的29例,观察组患者满意度为96.3%(52/54),显著高于对照组患者的83.3%(45/54),两组比较,差异均有统计学意义(均P<0.05)。结论将行动导向教学法应用于直肠癌造口患者的健康教育中,可有效缓解患者的焦虑和抑郁情绪,提升自我护理能力和满意度,降低并发症,值得临床推广。
Objective To explore the effect of action-oriented pedagogy on health education in patients with rectal cancer. Methods A total of 108 patients with colorectal cancer who underwent colostomy were enrolled in the Second Affiliated Hospital of Soochow University from June 2012 to December 2015. The patients were divided into observation group and control group with 54 cases in each group. Patients in the observation group were given a health education mode of action-oriented pedagogy, while those in the control group were given conventional health education mode. Six months later, anxiety and depression, self-care ability, complication and satisfaction were compared between the two groups. Results Before intervention, there was no significant difference in anxiety and depression score between the two groups. After intervention, the scores of anxiety and depression in both groups were significantly lower than those before intervention (all P <0.05); and anxiety score (39.1 ± 5.9) and depression score (40.3 ± 5.1) in the observation group (49.5 ± 6.6) and (47.6 ± 5.8) points in the control group, respectively. There were significant differences between the two groups (all P <0.05). Self-care skills (35.9 ± 4.9), self-responsibility (27.8 ± 5.9), self-concept (22.4 ± 3.4), health knowledge level (47.4 ± 5.4) and total score (133.5 ± 7.2) (29.7 ± 4.7), (20.5 ± 4.6) points, (17.9 ± 3.0) points, (36.5 ± 7.4) points and (104.6 ± 6.9) points in the control group, the differences were statistically Significance (both P <0.05). In the observation group, 4 cases of complications occurred, which was significantly lower than that of the control group (29 cases). The satisfaction rate of the observation group was 96.3% (52/54), significantly higher than that of the control group (83.3%, 45/54) , The differences were statistically significant (all P <0.05). Conclusion The application of action-oriented pedagogy in the health education of rectal cancer patients can effectively relieve anxiety and depression of patients, enhance self-care ability and satisfaction, reduce complications and deserve clinical promotion.