| ObjectiveBased on the health belief model,this study constructed a health education program applied to ischemic stroke patients.This protocol was further explored for its application in ischemic stroke patients,and provided a reference for improving patients’self-management level.MethodThrough the review of relevant literature at home and abroad,a preliminary intervention plan was constructed.After 2 rounds of consultation with 13 experts in related fields,and revised according to expert opinions.Verify the feasibility of the intervention plan,further modify the plan according to the problems existing in the implementation process,and determine the final intervention plan.Using the convenience sampling method,80 patients with first-time ischemic stroke who were hospitalized in the fifth ward of the Department of Neurology and the sixth ward of the Department of Neurology of a tertiary hospital were selected as the research subjects.The patients in the five wards of the Department of Neurology were the control group,and the patients in the six wards of the Department of Neurology were the intervention group,with 40 cases in each group.The control group received routine health education from neurology,and the intervention group implemented a health education program based on the health belief model on the basis of routine health education.The health beliefs,self-efficacy and self-management level of patients were evaluated by the Short Form Health Belief Model Scale for Stroke Patients,Chronic Disease Self-efficacy Questionnaire and Stroke Self-Management Behavior Evaluation Scale.Data were collected at three time points:before the intervention,one month after the intervention,and three months after the intervention.The recurrence rate of the two groups was calculated 3 months after the end of the intervention and the effect of health education was evaluated.The data analysis adopts statistical methods such as chi-square test,t-test,and analysis of variance for repeated measures.Result1.The results of the two rounds of expert consultation showed that the enthusiasm of experts was 86.7%and 100%,respectively.The authoritative coefficients（Cr）were 0.79 and 0.81,respectively.In the first round of consultation,the average value of the importance of expert consultation fluctuated from3.62±0.87～4.92±0.28.In the second round of consultation,the average value of the importance of expert consultation fluctuated between 3.77±0.83～4.92±0.28.The coefficients of variation of the two rounds of expert consultation were 0.06～0.24 and 0.06～0.22,respectively.The coordination coefficients of expert opinion in the two rounds were 0.312 and 0.346,respectively.2.A total of 75 of the 80 patients completed this study,including 38 in the control group and 37 in the intervention group.There was no significant difference in the pre-intervention general data and scores of each index between the two groups（P<0.05）.（1）The scores of health beliefs in the two groups were compared:the scores of the intervention group at 1 month and 3 months after the intervention were higher than those in the control group（P<0.001）.The results of repeated measurement ANOVA showed that the temporal effect,interaction effect and between-group effect of the scores of the two groups were statistically significant(F time=340.073,F interaction=155.369,F group=16.711,P<0.001).The intra-group comparison of each time point in the intervention group showed that the post-intervention period was higher than that before the intervention（P<0.001）,indicating that the health beliefs of patients were increased at one month and three months after the intervention,but there was no significant difference in the scores of the intervention group one month after intervention and three months after the intervention（P=0.795）.The control group scored higher health beliefs at one month after the intervention than before and three months after the intervention（P<0.001）,After the intervention in the control group,the health beliefs of patients first increased and then decreased,but there was no significant difference between 3 months after the intervention and before the intervention（P=0.229）.（2）The self-efficacy scores of the two groups were compared:the self-efficacy scores of the intervention group at 1 month and 3 months after the intervention were higher than those in the control group（P<0.001）.The results of repeated measures of ANOVA showed that the temporal effect,between-group effect and interaction effect of self-efficacy score were statistically significant(F time=189.647,F interaction=35.677,P<0.001,F group=12.420,P=0.001).There were statistically significant differences between the two comparisons between the two groups in the intervention group for different time points（P<0.05）.It also showed a trend of first rising and then decreasing,but it was still higher than before intervention 3 months after intervention（P<0.001）.The control group was higher than that at one month and three months after intervention（P<0.001）,but there was no significant difference between one month after intervention and three months after intervention（P=0.08）.（3）The self-management scores of the two groups were compared:the self-management scores of the intervention group at 1 month and 3 months after the intervention were higher than those in the control group,and the difference was statistically significant（P<0.001）.The results of repeated measurement ANOVA showed that the temporal effect,interaction effect and between-group effect of the two groups were statistically significant(F time=807.689,F interaction=144.856,F group=17.388,P<0.001).There were significant differences between the two groups in the group with different time point scores（P<0.05）,after the intervention,the total self-management scores of both groups showed an upward trend.（4）Relapse rates were compared between the two groups:Three months after the end of the intervention,2 patients in the intervention group relapsed and 5 patients in the control group relapsed.The recurrence rates of patients in the intervention group and the control group were 5.4%and 13.2%,respectively.The recurrence rate of the control group was higher than that of the intervention group,but there was no significant difference in the recurrence rate between the two groups（P=0.249）.ConclusionThe self-management health education program for ischemic stroke patients based on the health belief model is scientific and feasible.This program can stably enhance patients’health beliefs,enhance the self-efficacy of their health behaviors,improve patients’self-management level,and the intervention effect is more durable,which can be used for self-management health education of stroke. |
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