Application Of Health Education Based On TMSC Model In Patients With Ischemic Stroke

Objective1 To understand the current situation of emotional and social dysfunction in patients with ischemic stroke;2 To understand the status of health behavior in patients with ischemic stroke;3 The relationship among health belief,social support,emotion and social dysfunction,coping style and healthy behavior was analyzed.4 Explore the factors influencing the health behavior of patients with ischemic stroke;5 To explore the effects of health education based on TMSC model on coping style,emotional and social dysfunction and health behavior in patients with ischemic stroke.Methods(1)The research object of this study was to select the one in 3 first-class ternary hospitals in tianjin in 213 cases of ischemic cerebral apoplexy patients from June to July 2019,through the design of general data questionnaire,short stroke health belief and medical coping style questionnaire,emotional and social dysfunction scale,understanding social support scale,and stroke as a research tool to understand health behavior scale of ischemic cerebral apoplexy patients with emotional and social dysfunction,and the present situation of the health behavior,explore the health belief,coping styles,social support,health behavior,emotion and social dysfunction five variables of the relationship between each other,and to explore the influence factors of health behavior.(2)From August to November 2019,82 patients with ischemic stroke who were hospitalized in the Department of Neurology were selected in a tertiary Grade A general hospital in Tianjin.The control group received conventional nursing,and the intervention group received health education based on TMSC model except conventional nursing.The intervention time was from the fourth day after admission.The in-hospital intervention was conducted for 5 times of health education based on TMSC model every two days,about30?40min each time.The out-of-hospital intervention was mainly conducted for telephone follow-up once a week for 4 weeks,a total of 4 times,about 20?30min each time.Before intervention,on the day of discharge,and 4 weeks after discharge,the efficacy of ischemic stroke patients was evaluated.Outcome measures included emotional and social dysfunction,medical coping style and stroke health behavior.(3)SPSS 22.0 was used for statistical analysis.In this study,descriptive statistical analysis,two independent samples t test or one-way analysis of variance,Pearson correlation analysis,multiple linear regression analysis,repeated measures analysis of variance,paired sample t test and chi-square test were used for statistical analysis.Results1 The results of the investigation(1)The health behavior score of patients with ischemic stroke was(65.04±11.489).Age,gender,educational level,frequency of disease onset,family history of stroke,smoking,drinking,physical exercise and other chronic diseases had statistically significant differences in the total health behavior score(P<0.05).(2)Patients with ischemic stroke had a health belief score of(3.10±0.459)and an emotional and social dysfunction score of(75.27±14.276).(3)The healthy behavior scores of patients with ischemic stroke are positively correlated with the health beliefs,social support,and facing dimension scores,that is,the higher the health beliefs,facing dimension scores,and social support scores of the patients,the higher the health behavior scores;The health behavior scores of patients with ischemic stroke were negatively correlated with emotional and social dysfunction,avoidance and yield scores,in other words,the lower the score of emotional and social dysfunction,the lower the avoidance and yield scores,and the higher the score of healthy behavior.(4)The results of multiple linear regression analysis showed that a total of 13 variables entered the regression equation with an adjustment coefficient of R~2 is 0.631.The 13 variables accounted for 63.1%of the total variation in patient health behaviors.From the standardized regression coefficients,it can be seen that the independent variables that have an effect on the dependent variable are in order from other chronic disease types,avoidance,alcohol consumption,and stroke patients in the family,education level,facing dimension,gender,whether Participation in physical exercise,age,emotional and social dysfunction,whether smoking,social support,yielding.2 The result of the interventionAt the end of the intervention,a total of 80 patients with ischemic stroke completed in-hospital and out-of-hospital follow-up interventions and all data collection.There were 40participants in the intervention group and 40 participants in the control group.The intervention results showed:(1)After health education based on the Transactional Model of Stress and Coping,the main effect of health behavior in the two groups of ischemic stroke patients was statistically significant(P<0.05).The results of comparison between groups showed that the health behavior scores of patients with ischemic stroke on the day of discharge and 4 weeks after discharge were higher than those of the control group,and the difference was statistically significant(P<0.05).The results of intra-group comparison showed that the health behavior score of ischemic stroke patients in the intervention group showed an increasing trend with the passage of time,and the difference was statistically significant between the day of discharge and the group before the intervention,the day of discharge and the four weeks before the discharge,and the four weeks after the discharge and the group before the intervention(P<0.017).In the control group,the ischemic stroke patients'health behavior scores showed a trend of continuous decline and then gradually increase with the passage of time.Comparisons between groups at each time point showed no significant difference(P>0.017).(2)After the health education intervention based on the Transactional Model of Stress and Coping,the emotional and social dysfunction scores of the two groups of patients with ischemic stroke had statistical significance in the main effect of the intervention(P<0.05).The results of comparison between the groups showed that the scores of emotional and social dysfunction of the patients with ischemic stroke on the day of discharge and 4 weeks after discharge were lower than control group,and the differences were statistically significant(P<0.05).Comparison results within the group showed that the scores of emotional and social dysfunction of patients with ischemic stroke in the intervention group showed a downward trend over time.The day of discharge and before the intervention,the day of discharge and the day of discharge,the day of discharge and the group By comparison,the difference was statistically significant(P<0.017);the emotional and social dysfunction scores of patients with ischemic stroke in the control group showed a trend of first decline and then increase over time,the comparison results at each time point showed that the difference was not statistically significant(P>0.017).(3)After the health education intervention based on the Transactional Model of Stress and Coping,the facing dimensional scores of the two groups of patients with ischemic stroke had statistical significance in the main effect of the intervention(P<0.05).The comparison results between the groups showed that the patients with ischemic stroke in the intervention group on the day of discharge and 4 weeks after discharge were higher than control group,and the difference was statistically significant(P<0.05).The comparison results within the group showed that the coping scores of patients with ischemic stroke in the intervention group showed an upward trend over time.The results of intra-group comparison showed that the facing dimension score of patients with ischemic stroke in the intervention group increased with the passage of time,the results of intra-group comparison between the day of discharge and the day before intervention,four weeks after discharge and the day after discharge,four weeks after discharge and the day before intervention showed statistically significant differences(P<0.017);the facing dimension score of patients with ischemic stroke in the control group showed a trend of increasing and then decreasing gradually with the passage of time,the comparison results at different time points in the group showed hat the difference was not statistically significant(P>0.017).(4)After the health education intervention based on the Transactional Model of Stress and Coping,the yield response scores of the two groups of patients with ischemic stroke were statistically significant in the main effect of the intervention(P<0.05).The results of comparison between groups showed that the yield response scores of patients with ischemic stroke on the day of discharge and 4 weeks after discharge were lower than those in the control group,and the difference was statistically significant(P<0.05).The comparison results within the group showed that the yield response scores of the two groups of patients with ischemic stroke showed a decreasing trend over time,comparison results within the group between discharge date and before intervention,4 weeks after discharge and discharge date four weeks after discharge and the day before intervention showed statistically significant differences(P<0.017);the yield coping score of patients with ischemic stroke in the control group,and the comparison results within the group at each time point showed no significant difference(P>0.017).(5)After the health education intervention based on the Transactional Model of Stress and Coping,the avoidance response scores of the two groups of patients with ischemic stroke were statistically significant in the main effect of the intervention(P<0.05).The comparison between the groups showed that the avoidance coping scores of the patients with ischemic stroke on the day of discharge and four weeks after discharge were lower than those of the control group,the difference was statistically significant(P<0.05).The results of the ratio within the group indicate that the scores of avoidance coping of ischemic stroke patients in the two groups showed a decreasing trend over time.The scores of avoidance coping of patients in the intervention group were compared with those before the intervention,those four weeks before the discharge,those four weeks after the discharge,and those before the intervention,with statistically significant differences(P<0.017).The avoidance response scores of ischemic stroke patients in the control group were not statistically significant(P>0.017).Conclusion(1)Patients with ischemic stroke have a health belief score of(3.10±0.459),which is at a moderately high level;a health behavior score of(65.04±11.489),which is at a medium level;emotional and social dysfunction scores(75.27±14.276)minutes,at a medium level.(2)There was a positive correlation between health behavior,health belief,social support and coping in patients with ischemic stroke.The health behavior of patients with ischemic stroke was negatively correlated with emotional and social dysfunction,avoidance coping and surrender coping;Emotional and social dysfunction were positively correlated with avoidance coping and surrender coping,but negatively correlated with coping.(3)Suffering from other types of chronic diseases,avoidance,alcohol consumption,family members with or without stroke,education level,facing dimension,gender,participation in physical exercise,age,emotional and social dysfunction,smoking,social support,yielding It is the main predictor of healthy behavior in patients with ischemic stroke.(4)Health education based on the Transactional Model of Stress and Coping improved the level of the facing coping of patients with ischemic stroke.(5)Health education based on the Transactional Model of Stress and Coping reduced the level of the yield coping style and avoidance coping style of ischemic stroke patients.(6)Health education based on the Transactional Model of Stress and Coping reduced the level of the emotional and social dysfunction in patients with ischemic stroke.(7)Health education based on the Transactional Model of Stress and Coping improved the level of the health behavior score of patients with ischemic stroke.(8)After the health education based on Transactional Model of Stress and Coping,the level of the patients'facing dimension scores and health behavior on the day of discharge and4 weeks after discharge were higher in the intervention group than before the intervention.Surrender,emotional and social dysfunction,and avoidance were lower than before the intervention.