递进互动式健康教育对脑卒中后鼻饲患者家庭照护水平的影响

目的探讨递进互动式健康教育模式在提高卒中后鼻饲患者家庭照护水平上的有效性。方法选择卒中后伴吞咽功能缺损接受鼻饲护理患者的主要家庭照护者60名，随机分为实验组（n=30）和对照组（n=30）。实验组为递进互动式健康教育组，患者人院1～5d内护士讲解鼻饲相关知识和演示操作过程；6～10d讲解操作注意事项，主要照顾者演示操作过程；11—15d由主要照顾者讲解操作注意事项并在护士辅助下完成操作过程。对照组为常规健康教育组。分别在留置胃管后第15d评价两组主要家庭照护者的鼻饲技术、鼻饲相关护理知识、护理满意度，在患者出院后28d内电话随访胃管留置情况。结果实验组主要照顾者鼻饲护理知识（8．23±1．01）分，对照组（5．73±0．98）分，差异有统计学意义（t=9．75，P〈0．01）；实验组鼻饲护理技术掌握评分（38．07±2．63）分，对照组（24．53±3．40）分，差异有统计学意义（t=17．25，P〈0．01）；出院28d内胃管留置情况电话随访结果实验组优于对照组（P〈0．01）；两组护理满意度总分比较差异有统计学意义（P〈0．01）。结论递进互动式健康教育可以提高鼻饲患者主要照顾者的护理技能，改善护理技术和流程的满意度。

Effect of step-by-step interactional health education model on the quality of home care in tube feeding patients after stroke

Objective To evaluate the benefits of step-by-step interactional health education model in improving the home care quality in tube feeding patients after stroke. Methods Totals of 60 main home care givers of patients who received tube feeding after stroke were randomly divided into 2 groups. The test group was given step-by-step interactional health education model, which main home care givers received the health education about the relevant knowledge and demonstration operation process in the 1st ± 5th day, operation notes and exercise in 6th-10th day, demonstrated the notes and finished the operation under the help of nurses in 11 th ± 15th day; while the control group was given standard health education model. Then, the skill of tube feeding, overall nursing knowledge, and patients＇ satisfaction on the nursing of two groups were observed on the 15th day, and the situation of tube indwelling was observed during 28 days after discharge by phone. Results The scores of nursing knowledge and tube feeding skills of test group were （ 8.23 ± 1.01 ） and（ 38.07 ± 2.63 ） , and those of the control group were （5.73 ± 0.98 ） and （24.53 ± 3.40 ）, and the difference was statistically significant（ t = 9.75, 17.25, respectively; P 〈 0. 01 ）. The situation of tube indwelling of test group during 28 days after discharge by phone was significantly better than that of control group （ P 〈 0. 01 ）. Conclusions The step-by- step interactional health education model can improve the quality of home care in tube feeding patients after stroke, promote the patients satisfaction of nursing skills and procedures.