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刘欢, 肖倩, 段洪超, 等. 基于健康信念模式的智能健康教育在颈椎病术后恐动症患者中的效果研究[J]. koko体育app 学报(医学版), 2024, 55(2): 309-314. DOI:
引用本文: 刘欢, 肖倩, 段洪超, 等. 基于健康信念模式的智能健康教育在颈椎病术后恐动症患者中的效果研究[J]. koko体育app 学报(医学版), 2024, 55(2): 309-314. DOI:
LIU Huan, XIAO Qian, DUAN Hongchao, et al. Effect of Intelligent Health Education Based on Health Belief Model on Patients With Kinesophobia After Surgical Treatment of Cervical Spondylosis[J]. Journal of Sichuan University (Medical Sciences), 2024, 55(2): 309-314. DOI:
Citation: ജ LIU Huan, XIAO Qian, DUAN Hongchao, et al. Effect of Intelligent Health Education Based on Health Belief Model on Patients With Kinesophobia After Surgical Treatment of Cervical Spondylosis[J]. Journal of Sichuan University (Medical Sciences), 2024, 55(2): 309-314. DOI:

基于健康信念模式的智能健康教育在颈椎病术后恐动症患者中的效果研究

Effect of Intelligent Health Education Based on Health Belief Model on Patients With Kinesophobia After Surgical Treatment of Cervical Spondylosis

  • 摘要:
    目的 探究基于健康信念模式的智能化健康教育在颈椎病术后恐动症患者中的应用效果。
    方法 针对单中心神经脊柱中心行前路颈椎间盘切除减压融合术,并在术后存在恐动症的患者,开展前瞻性队列研究,由患者自愿选择是否接受智能健康教育干预治疗,将患者分为对照组和智能化教育组,从术后第2天进行干预。智能化教育组从术后第2天开始,依托微信小程序进行智能化教育,该小程序以健康信念模式作为理论框架,以患者问题-需求-导向-实践-反馈的思路进行设计,共分为4个板块(知识、智能锻炼、克服障碍、分享互动),包括提醒功能、趣味锻炼跟练功能、监测与记录功能。对照组从术后第2天开始,采用“图文手册+微信群提醒”的健康教育方式。分别于出院前、术后3个月对两组患者进行问卷调查。两组比较的主要结局指标:恐动程度;次要结局指标包括:功能锻炼依从性(功能锻炼依从性量表)、疼痛程度(Visual Analogue Scale评分)、颈椎功能障碍程度(颈椎残障指数)、生活质量(通过quality of life short form 12量表,主要评定心理健康得分和生理健康得分)等方面的差异。
    结果 共纳入112例患者,108例患者完成了随访。最终智能化教育组53例,对照组55例。患者均未发生运动相关损伤。出院时两组间主要结局指标和次要结局指标差异无统计学意义。术后3个月,智能化教育组恐动程度(25.72±3.90)低于对照组(29.67±6.16),差异有统计学意义(P<0.05)。智能化教育组的疼痛程度〔中位数(P25,P75)〕〔0(0,0)〕低于对照组〔1(1,2)〕(P<0.05),功能锻炼依从性(63.87±7.26 vs. 57.73±8.07,P<0.05)、心理健康(40.78±3.98 vs. 47.78±1.84,P<0.05)、身体健康(43.16±4.41 vs. 46.30±3.80,P<0.05)均优于对照组,差异有统计学意义。颈椎功能障碍程度〔中位数(P25,P75)〕〔1(1,2)vs. 3(2,7), P>0.05〕,两组间差异无统计学意义。
    结论 基于健康信念模式的智能化健康教育,可有助于降低颈椎病术后恐动症患者的恐动程度且改善预后。
     
    Abstract:
    Objective To explore the application effect of intelligent health education based on the health belief model on patients with postoperative kinesophobia after surgical treatment of cervical spondylosis.
    Methods A prospective cohort study was conducted with patients who underwent anterior cervical discectomy, decompression, and fusion surgery with a single central nerve and spine center, and who had postoperative kinesophobia, ie, fear of movement. The patients made voluntary decisions concerning whether they would receive the intervention of intelligent health education. The patients were divided into a control group and an intelligent education group and the intervention started on the second day after the surgery. The intelligent education group received intelligent education starting from the second day after surgery through a WeChat widget that used the health belief model as the theoretical framework. The intelligent health education program was designed according to the concept of patient problems, needs, guidance, practice, and feedbacks. It incorporated four modules, including knowledge, intelligent exercise, overcoming obstacles, and sharing and interaction. It had such functions as reminders, fun exercise, shadowing exercise, monitoring, and documentation. Health education for the control group also started on the second day after surgery and was conducted by a method of brochures of pictures and text and WeChat group reminder messages. The participants were surveyed before discharge and 3 months after their surgery. The primary outcome measure compared between the two groups was the degree of kinesophobia. Secondary outcome measures included differences in adherence to functional exercise (Functional Exercise Adherence Scale), pain level (Visual Analogue Scale score), degree of cervical functional impairment (Cervical Disability Index), and quality of life (primarily assessed by the Quality of Life Short Form 12 SF-12 scale for psychological and physiological health scores).
    Results A total of 112 patients were enrolled and 108 patients completed follow-up. Eventually, there were 53 cases in the intelligent education group and 55 cases in the control group. None of the patients experienced any sports-related injuries. There was no statistically significant difference in the primary and secondary outcome measures between the two groups at the time of discharge. At the 3-month follow-up after the surgery, the level of kinesophobia in the intelligent education group (25.72±3.90) was lower than that in the control group (29.67±6.16), and the difference between the two groups was statistically significant (P<0.05). In the intelligent education group, the degree of pain (expressed in the median 25th percentile, 75th percentile) was lower than that of the control group (0 0, 0 vs. 1 1, 2, P<0.05), the functional exercise adherence was better than that of the control group (63.87±7.26 vs. 57.73±8.07, P<0.05), the psychological health was better than that of the control group (40.78±3.98 vs. 47.78±1.84, P<0.05), and the physical health was better than that of the control group (43.16±4.41 vs. 46.30±3.80, P<0.05), with all the differences being statistically significant. There was no statistically significant difference in the degree of cervical functional impairment between the two groups (1 1, 2 vs. 3 2, 7, P>0.05).
    Conclusion Intelligent health education based on the health belief model can help reduce the degree of kinesophobia in patients with postoperative kinesophobia after surgical treatment of cervical spondylosis and improve patient prognosis.
     
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