Impact Of Health Education Based On PRECEDE-PROCEED Model On Self-management Of Patients With Ischemic Stroke

Objective:1.Summarizing the evidence from self-management of patients with ischemic stroke with the aid of evidence-based methods,for the sake of provide reference for making more scientific health education programs.2.Guided by the PROCEDE-PRECEED model,to investigate and analyze the main factors affecting the self-management of in-patients with ischemic stroke in a tertiary hospital in Nanchang city,and to formulate health education programs for intervention based on these factors and combined with evidence summary content.To make a thorough inquiry the influence of health education on the strength of the PROCEDE-PRECEED model on stroke-related knowledge,self-management behavior,rehabilitation self-efficacy,neurological function recovery and recurrence in patients with ischemic stroke.Method:Part I: BMJ Best Practice,Up To Date,Guidelines International Network(GIN),Registered Nurses’ Association of Ontario(Registered Nurses’ Association of Ontario,Guidelines,expert consensus,evidence summary and best practice on selfmanagement,secondary prevention or health education for patients with ischemic stroke in databases such as RNAO,ASA,Yimitong,Cochrane Library,Pub Med,CNKI,VIP,CBM,and Wanfang Database.The Johns Hopkins University test rating and Quality evaluation method was used to evaluate the quality and evidence of the literature involved,and finally integrate and summarize the best evidence for selfmanagement of ischemic stroke patients.Part II: By convenient sampling method,82 patients with ischemic stroke who were hospitalized in a tertiary hospital in Nanchang city were recruited from September to October 2022.Dividing the patients into test group(n = 41)and experimental group(n = 41)according to the ward.The control group were given conventional health education,and the test group were given health education based on the PROCEDE-PRECEED model on the basis of routine health education,and determined the tendency,promotion and reinforcement factors that affect the selfmanagement of patients with ischemic stroke at the behavioral diagnosis stage.The health education was developed and intervention was implemented aiming at these three factors combined with the best evidence of self-management of patients with ischemic stroke for three months.The intervention consequence was assessed by the stroke related knowledge questionnaire,the stroke patient self-management behavior evaluation scale,the stroke rehabilitation self-efficacy scale,the modified Rankin scale and the readmission rate.The collected data were analyzed and processed with SPSS 26.0 software.Result:Part I: A total of 10 articles were included,including 8 guidelines,1 expert consensus and 1 clinical decision.31 evidences were summarized from five dimensions of risk factor management,diet management,exercise management,health education and self-management.Part II: Due to loss of follow-up,death and other reasons,74 subjects were finally brought into the study.Previous to the intervention,there was no significant difference between the two groups in general data,stroke related knowledge,selfmanagement behavior,rehabilitation self-efficacy and m RS score(P>0.05).In the intervention after,,the results of repeated measures analysis of variance revealed that there were time effects,intervention effects and interaction effects(P<0.05).In terms of stroke related knowledge score,the test group was higher than the control group(P<0.05).The results of repeated measure analysis of variance about selfmanagement behavior scores in ilka aspect of patients in the two groups revealed that there was no intervention effect in the dimensions of safe medication management,emotion management,social function and interpersonal management(P>0.05).The scores of disease,diet,daily life and rehabilitation exercise management of the test group were more advanced than the control group(P<0.05).The stroke rehabilitation self-efficacy of the test group is more advanced than control group(P<0.05).The m RS Score of the test group was more advanced than the control group(P<0.05).Patients of the test group had better recurrence(P<0.05).Conclusion:Health education based on PRECEDE-PROCEED model can improve the selfmanagement knowledge,attitude and behavior of patients with ischemic stroke,improve the disease cognition,disease management,diet management,daily life management,rehabilitation exercise management behavior and rehabilitation selfefficacy of patients,improve neurological function recovery and reduce the risk of recurrence.