IKAP模式健康教育提高血液净化患者血管通路建立后遵医行为和生活质量的效果观察

目的 观察信息-知识-信念-行为(IKAP)模式健康教育对提高血液净化患者血管通路建立后遵医行为和生活质量的临床效果。 方法 2018年5月—2019年2月郑州大学第一附属医院120例定期接受血液净化治疗患者依据健康教育方法分为IKAP组78例与对照组42例,对照组实施常规健康宣教,IKAP组除了对照组宣教措施以外,重点进行IKAP模式健康教育。干预后通过自拟调查问卷、自护能力测定量表(ESCA)、健康状况调查问卷(SF-36)评估患者遵医行为、自护能力与生活质量,并统计并发症发生率。 结果 IKAP组患者干预后自我保暖、不负重不受压、遵守治疗方案、定期健手操、定时测血压、保护血管通路6项遵医行为配合度优于对照组,ESCA量表的自我概念、自护责任感、自护技能和健康知识水平4个维度评分明显高于对照组,差异均有统计学意义(P<0.05)。IKAP组患者干预后6个月内并发症发生率(8.97%)明显低于对照组(23.81%),干预后6个月SF-36问卷中的生理职能、躯体疼痛、活力、社会功能、情感职能、精神健康6各维度评分明显高于对照组,差异均有统计学意义(P<0.05)。 结论 对于血液净化患者而言,开展IKAP模式健康教育可有效改善血管通路建立后遵医行为、提高自护能力、降低并发症发生率及提升生活质量。 

Effects of IKAP mode health education on improving treatment compliance and quality of life in patients undergoing blood purification after vascular access establishment

Objective To observe clinical effects of information-knowledge-attitude-practice(IKAP) mode health education on improving treatment compliance and quality of life in patients undergoing blood purification after vascular access establishment. Methods Total 120 patients who underwent regular blood purification in the hospital from May 2018 to February 2019 were divided into IKAP group(78 cases) and control group(42 cases) according to different health education methods. The control group underwent routine health education. On this basis, IKAP group underwent IKAP mode health education. After intervention, self-designed questionnaire, exercise of self-care agency scale(ESCA) and short-form-36 health survey(SF-36) were applied to assess treatment compliance, self-care ability and quality of life. The incidence of complications was statistically analyzed. Results After intervention, the cooperation degree of treatment compliance such as self-warming, no weight-bearing and no oppression, complying with treatment regimen, regular hand care exercises, timed blood pressure measuring and protecting vascular access of the IKAP group was better than that of the control group, and the scores of self-concept, self-care responsibility, self-care skills and health knowledge level of ESCA in the IKAP group were significantly higher than those in the control group(all P<0.05). Within 6 months after intervention, the incidence of complications in the IKAP group was significantly lower than that in the control group(8.97% vs. 23.81%). At 6 months after intervention, the scores of physiological function, physical pain, vitality, social function, emotional function and mental health in SF-36 questionnaire in the IKAP group were significantly higher than those in the control group(all P<0.05). Conclusion For patients undergoing blood purification, IKAP mode health education can effectively improve treatment compliance after vascular access establishment, improve self-care ability, reduce incidence of complications and improve quality of life.