| Aims1.To develop a cognitive questionnaire of patients with hypertriglyceridemia-induced acute pancreatitis.2.To explore the influencing factors of cognitive level in patients with hypertriglyceridemia-induced acute pancreatitis.3.To understand the self-management experience of patients with hypertriglyceridemia-induced acute pancreatitis at home during the convalescent period,which is the later stage to provide reference for lifestyle intervention.4.Conduct and construct and implement intervention programs,and preliminarily verify intervention effects,as follows formulate relevant health management measures to provide reference.Methods1.The first draft was determined through two rounds of expert letter consultation,and the final draft was determined by reliability and validity test,difficulty and differentiation.2.Follow-up of convalescent patients with hypertriglyceridemia-induced acute pancreatitis in a tertiary hospital;In-patient questionnaires were conducted at two Grade III hospitals.General information,cognitive questionnaire and laboratory test data were collected in the follow-up group,and general information and cognitive questionnaire were collected in the hospitalization group,and the influencing factors of score were analyzed.3.A descriptive study was conducted on patients in the follow-up group.The methods of semi-structured interview and open interview,one-to-one interview and focus group orientation were adopted to analyze data by subject analysis method.and explore patients’ self-management experience.4.Construct intervention plan and conduct 1-year health behavior improvement on the intervention group;The control group received routine education.The levels of blood lipid and fasting blood glucose,body fat percentage and weight without fat,physical activity level,nutrient energy ratio in diet and disease cognition were compared between the two groups at baseline,6 months and 12 months after intervention,respectively.Results1.The cognitive questionnaire for patients with hypertriglyceridemia-inducedacute pancreatitis included 14 questions and 4 dimensions:basic knowledge,knowledge of blood lipids,diet knowledge and exercise knowledge;The full score is 55.The reliability test is determined by internal consistency reliability and retest reliability.The Guttman coefficient of the total questionnaire was 0.872,the Guttman coefficient of the four dimensions was 0.605-0.872,the retest reliability of 2 weeks interval was 0.736-0.813,and the overall correlation coefficient was 0.75.Expert evaluation method and confirmatory factor analysis were used to test the content validity and structure validity.The overall content validity of the questionnaire was 0.74,and the content validity of each item was between 0.090-1.Confirmatory factor analysis was conducted according to the preset dimensions of the earlier expert letter consultation,and the fitting indexes were as follows:X2/df:1.767,RMSEA:0.058,IFI:0.948,CFI:0.946,TLI:0.926,NFI:0.879,RFI:0.834.The questionnaire has good reliability and validity.At the same time,the difficulty and differentiation test were carried out.The total difficulty of the questionnaire was 0.65,and the difficulty range of each dimension was 0.217-0.834.The total differentiation of the questionnaire was 0.36,and the differentiation of each dimension was 0.20-0.542.The identification of the questionnaire was good.Since it basically meets the difficulty and differentiation of the test paper,60%full mark is used as the cut-off value,that is,33 points.2.The mean value of HTG-APKQ was 35.90,which was at the pass line level.Multivariate linear regression analysis showed that the score was correlated with marital status,low density lipoprotein level,blood glucose level 2 hours after meals,intake frequency of red meat,fat meat and viscera,and body weight(P<0.05).The score was negatively correlated with low density lipoprotein,blood glucose 2 hours after meals and the intake frequency of red meat,fat meat and offal.3.A total of 25 patients and 2 family members were interviewed in the qualitative study.After analyzing the data,the following five themes were generated:regret,uncertainty,conflict,coping style and benefit.After experiencing the painful struggle,the patient finally reached a relatively stable coping state.4.Before intervention,baseline data were comparable in each group(P<0.05).After intervention,repeated measurement variance analysis and T-test results of the two groups were analyzed as follows.4.1 There was no intergroup effect,number of measurements effect and interaction effect on blood lipid and fasting blood glucose(P>0.05).The blood glucose measured after intervention group was lower than baseline,and the blood glucose measured after control group was higher than baseline(P<0.001).4.2 The total score of disease cognition and knowledge of blood lipid had an interactive effect(P<0.05),and the medium test was higher than the pre-test.There was no intergroup effect on total score(P>0.05),but there was an intergroup effect on knowledge of blood lipid(P<0.05),and the intervention group was larger than the control group(P<0.05).4.3 The group effect and interaction effect of body fat percentage were not significant(P<0.05),but the number of measurements was significant(P<0.05),and the posttest was higher than the middle test.The posttest and middle testvalues of the intervention group were lower than those of the control group(P<0.05).There was no group effect,number of measurements effect and interaction effect(P>0.05).4.4 There was no group effect,number of measurements effect or interaction effect on the physical activity intensity(P<0.05),and the physical activity intensity in the intervention group was higher than that in the control group(P<0.05).4.5 In nutrient energy supply ratio,protein energy supply ratio had no intergroup effect,number of measurements effect and interaction effect(P>0.05).The energy supply ratio of fat had an interaction effect(P<0.05),but no intergroup effect or number of measurements effect(P>0.05).The energy supply ratio of carbon and water had the measurement frequency effect and the interaction effect(P<0.05),and the pre-test was higher than the middle test.The carbon and water energy supply ratio in the intervention group was lower than that in the control group at the time of post-test,and the fat energy supply ratio in the intervention group was higher than that in the control group at the time of mid-test and post-test(P<0.05).4.6 Chi-square test results showed that the proportion of high physical activity level in the intervention group was greater than that in the control group,while the proportion of medium physical activity level in the intervention group was lower than that in the control group(P<0.05).T-test results showed that the recurrence rate in the intervention group was lower than that in the control group(P<0.05).Conclusion1.The cognitive questionnaire for HTG-AP patients has good reliability and validity,and all indicators basically meet the measurement standards,which can be applied to the patient population.2.The overall cognitive level of TG-AP patients was fair and at the level of passing line.There is a certain correlation between patient behavior and disease cognition,so we should pay attention to health education after discharge.3.Patients with HTG-AP still need to undergo relatively strict lifestyle management during the recovery period after discharge,but this process is usually difficult,with a series of problems and obstacles to overcome.External support should be strengthened to assist patients.4.The research to improve patients’health behavior can effectively improve patients’ cognitive level,optimize their diet structure,improve some objective indicators and reduce the recurrence rate. |
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