The Application Of Health Education Model Based On BCW In Patients With Cancer Pain

Objective:To construct the model of health education based on the behavior change wheel(BCW)and investigate the application effects on cancer patients with pain to seek effective strategies and approaches of health education for cancer patients with pain.Methods:This is an experimental study.Sixty-six cancer patients from one department of chemotherapy in a tertiary hospital,Shandong province,were randomly divided into test group and control group.The test group received health education model based on the BCW,while the control group received routine health education.Patients completed Barriers questionnaire(BQ-L),the Numeric rating scale(NRS),the 8-item Morisky Medication Adherence Scale(MMAS-8),Quality of life questionnaire for Chinese cancer patients(QLQ).SPSS 17.0 was used to analyze the data.Results:1.There was no significant difference in the age,sex,marital status,education level,type of cancer,residence,style of payment,location and characteristics of pain between two groups(p>0.05).2.There were no significant differences between two groups in analgesic use types and routes of administration(p>0.05).3.Comparison of pain intensity scores(1)Comparison of pain intensity scores between two groups:Before the intervention,the pain scores were 3.3 9±1.13 in the test group and 3.50 ±1.31 in the control group.There was no statistically significant difference in pain score between two groups(t=-0.263,p>0.05).After the intervention,the pain score was 2.30±0.67 in the test group,it was lower than the pain score 2.92 ±0.47 in the control group.The difference of pain score between two groups was statistically significant(t=-3.091,p<0.01).(2)Comparison of pain intensity scores in the test group before and after intervention:Before the intervention,the pain intensity score was 3.39± 1.13,and after the intervention,the pain intensity score was 2.30±0.67.The pain intensity score after the intervention was lower than that before the intervention in the test group and the difference was statistically significant(t=3.236,P<0.05).(3)Comparison of pain intensity scores in the control group before and after intervention:Before the intervention,the pain intensity score was 3.50±1.31,and after the intervention,the pain intensity score was 2.92 ±0.47.There was no statistically significant difference in pain intensity score before and after intervention(t=1.364,P>0.05).4.Comparison of medication adherence score(1)Comparison of medication adherence score between two groups:Before the intervention,the analgesic medication adherence scores were 5.64 ±1.37 in the test group and 5.38 ± 1.39 in the control group,both groups’ compliance levels were low.The difference of medication adherence score between two groups was not statistically significant(t=0.766,p>0.05).After the intervention,medication adherence score in the test group was 6.96±0.83,and the compliance level was medium.The medication adherence score was 5.48 ± 1.06 in the control group,the compliance level is low.The medication adherence of the test group was higher than that of control group,the difference was statistically significant(t=4.737,p<0.001).(2)Comparison of medication adherence score in the test group before and after intervention:Before the intervention,the analgesic medication adherence score was 5.64 ± 1.37,3 cases(9.09%)had high level medication adherence(score 8),16 cases(48.48%)had medium level adherence(score 6-7),and 14 cases(42.43%)had low level adherence(score<6).After the intervention,medication adherence score was 6.96 ±0.83,13 cases(39.39%)had high level medication adherence(score 8),17 cases(51.52%)had medium level adherence(score 6-7),and 3 cases(9.09%)had low level adherence(score<6).The medication adherence after the intervention was higher than that before the intervention in the test group and the difference was statistically significant(t=4.737,p<0.001).(3)Comparison of medication adherence score in the control group before and after intervention:Before the intervention,medication adherence score was 5.38 ±1.39;and after the intervention,medication adherence score was 5.48 ± 1.06.There was no statistically significant difference in medication adherence score before and after intervention(t=-0.117,p>0.05).5.Comparison of quality of life score(1)Comparison of quality of life score between two groups:Before the intervention,the quality of life scores were 45.16 ±6.23 in the test group and 42.94±5.65 in the control.There was no statistically significant difference in quality of life score between two groups(t=0.307,p>0.05).After the intervention,the quality of life scores were 45.72 ± 5.86 in the test group and 42.31 ± 7.54 in the control group.There was no statistically significant difference in quality of life score between two groups(t=0.310,p>0.05).(2)Comparison of quality of life score in the test group before and after intervention:Before the intervention,the quality of life score was 45.16±6.23;after the intervention,the quality of life scores was 45.72 ±5.86.There was no statistically significant difference in quality of life score in the test group before and after intervention(t=0.970,p>0.05).(3)Comparison of quality of life score in the control group before and after intervention:Before the intervention,the quality of life scores was 42.94±5.65;after the intervention,the quality of life scores was 42.31 ±7.54.There was no statistically significant difference in quality of life score in the control group before and after intervention(t=1.872,p>0.05).Conclusions:1.The health education model based on the BCW theory can reduce the intensity of pain in patients with cancer pain.2.The health education model based on the BCW theory can improve medication adherence in patients with cancer pain.3.The health education model based on the BCW theory had no significant effect on quality of life in patients with cancer pain.