基于行为转变理论的护理模式对老年膝骨性关节炎患者疾病相关知识及自我管理行为的影响-现代医学

基于行为转变理论的护理模式对老年膝骨性关节炎患者疾病相关知识及自我管理行为的影响

单位：南京医科大学附属南京医院, 江苏南京 210000

分类号：R473.6

出版年·卷·期（页码）：2017·36·第十一期（1665-1669）

摘要：

目的：探讨基于行为转变理论的护理模式对老年膝骨性关节炎患者疾病相关知识及自我管理行为的影响。方法：方便抽样选取本院骨科240例膝骨性关节炎患者，按照随机数字表法分为观察组和对照组，每组120例。对照组采取常规健康教育和随访，观察组采取基于行为转变理论的护理模式，两组患者均实施6个月的随访干预。结果：干预后，观察组患者的膝骨性关节炎主要临床症状（69.17%）、危害性知识（61.67%）、运动锻炼知识（68.33%）、膝关节的保护知识（70.83%）、饮食及体重控制知识（75.83%）、情绪管理知识（66.67%）、定期复检的必要性（79.17%）等知识知晓率均高于对照组（P<0.05）。观察组患者控制饮食与体重（68.33%）、适当运动锻炼（72.50%）、关节功能保护（76.67%）、认知症状管理（67.50%）、定期复检及随访（77.50%）等自我管理行为均高于对照组（P<0.05）。观察组患者疼痛（6.72±2.80）、僵硬（2.75±1.44）、日常活动（20.46±8.65）等WOMAC指数评分均低于对照组患者（P<0.05）。结论：基于行为转变理论的护理模式可以提高膝骨性关节炎患者的疾病认知和自我管理行为，改善患者的膝骨关节症状，值得临床推广。

Objective:To explore the nursing effect of trans-theoretical model of behavior on knowledge and self-management behavior in elderly patients with knee osteoarthritis. Methods:160 knee osteoarthritis participants were chosen by convenience sampling, according to the method of random numbers, the participants were randomly divided into observation group and control group, 80 in each. The control group received routine health education, while the observation group received trans-theoretical model of behavior for 6 months, and then the awareness of the disease, self-management behavior and the clinical symptoms of the knee were compared. Results:After the intervention, the rate of awareness of main clinical symptoms(69.17%), the damage of knee osteoarthritis (61.67%), exercise(68.33%), the protection of the knee joint(70.83%), diet and weight control (75.83%), emotion management(66.67%) and the importance of regularly review(79.17%) of the observation group were significantly higher than that of the control group(P<0.05); The awareness of diet and weight control(68.33%), moderate exercise(72.50%), joint function protection(76.67%), cognitive symptom management(67.50%), regular review(77.50%) of the observation group was significantly higher than that in the control group(P<0.05). The WOMAC scores of the pain scores(6.72±2.80),the stiff scores(2.75±1.44), the daily activities scores (20.46±8.65) of the observation group were significantly lower than those of the control group (P<0.05). Conclusion:Nursing based on the trans-theoretical model of behavior can enhance the awareness and self-management behavior, improve the symptoms of knee osteoarthritis.

参考文献：

[1] 邓荣悦,杨坤,邢凤梅,等.社区老年膝骨性关节炎患者自我管理行为的现状调查[J].现代预防医学,2013,40(21):3966-3968,3973.
[2] BHANDARI M,SMITH J,MILLER L E,et al.Clinical and economic burden of revision knee arthroplasty[J].Clin Med Insights Arthritis Musculoskelet Disord,2012,5:89-94.
[3] PROCHASKA J O,DICLEMENTE C C,VELICER W F,et al.Criticisms and concerns of the transtheoretical model in light of recent research[J].Br J Addict,1992,87(6):825-828.
[4] 孙瑞.基于行为转变理论的护理模式对骨肿瘤患者生存质量与不良反应的影响[J].现代医学,2016,44(1):117-120.
[5] 黄柳华,李荔,汤垂丽.行为转变理论在骨外科糖尿病前期病人护理中的应用[J].护理研究,2013,27(2):441-442.
[6] 中华医学会骨科学分会.骨关节炎诊治指南(2007年版)[J].中华关节外科杂志(电子版),2007,1(4):254-256.
[7] BRADY T.Strategies to support self-management in osteoarthritis:five categories of interventions,including education[J].Orthop Nurs,2012,31(2):124-130.
[8] 王文丽,谭晓菊,赵兴娥,等.骨性关节炎患者自我管理行为的研究现状[J].中南大学学报(医学版),2013,38(11):1188-1192.
[9] BELLAMY N,KIRWAN J,BOERS M,et al.Recommendations for a core set of outcome measures for future phase Ⅲ clinical trials in knee,hip,and hand osteoarthritis.Consensus development at OMERACT Ⅲ[J].J Rheumatol,1997,24(4):799-802.
[10] BEZALEL T,CARMELI E,KATZ-LEURER M.The effect of a group education program on pain and function through knowledge acquisition and home-based exercise among patients with knee osteoarthritis:a parallel randomized single-blind clinical trial[J].Physiotherapy,2010,96(2):137-143.
[11] BENNELL K L,HINMAN R S.A review of the clinical evidence for exercise in osteoarthritis of the hip and knee[J].J Sci Med Sport,2011,14(1):4-9.
[12] 汪凤兰,张小丽,邢凤梅,等.农村中老年膝骨性关节炎患者自我管理行为的现状及相关因素分析[J].中国卫生事业管理,2013,4:280-282.
[13] BAIRD C L,MURAWSKI M M,WU J.Efficacy of guided imagery with relaxation for osteoarthritis symptoms and medication intake[J].Pain Manag Nurs,2010,11(1):56-65.
[14] MOSACK K E,PATTERSON L,BROUWER A M,et al. Evaluation of a peer-led hypertension intervention for veterans:impact on peer leaders[J].Health Educ Res,2013,28(3):426-436.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录