Zhongguo cuzhong zazhi (Nov 2023)
基于健康行动过程取向理论的罗盘式护理模式对中青年首发卒中患者的影响 The Effects of Compass Nursing Model Based on Health Action Process Approach Theory in Young and Middle-Aged Patients with the First Stroke
Abstract
目的 探讨基于健康行动过程取向（health action process approach，HAPA）理论的罗盘式护理模式在中青年首发卒中患者中的应用效果。 方法 前瞻性、连续入组2021年6—12月首都医科大学附属北京天坛医院收治的18～45岁的首次卒中患者，将患者随机分为对照组和干预组。对照组实施常规护理及延续性护理，干预组在对照组基础上实施基于HAPA理论的罗盘式护理模式3个月，比较两组患者干预后的卒中自我管理行为量表各维度得分及总分、卒中专用生活质量量表总分、焦虑自评量表总分、抑郁自评量表总分的改善情况。 结果 共计104例中青年首发卒中患者入组，脱落6例，最终干预组、对照组各纳入49例。干预组卒中自我管理行为量表总分、卒中专用生活质量量表总分均高于对照组（P<0.001，P=0.025）；干预组焦虑自评量表总分、抑郁自评量表总分均低于对照组（P=0.001，P＜0.001）。 结论 基于HAPA理论的罗盘式护理模式可有效提高患者自我管理能力，缓解患者的焦虑、抑郁情绪，提高其生活质量。 Abstract: Objective To investigate the effects of compass nursing model based on health action process approach (HAPA) theory in young and middle-aged patients with the first stroke. Methods Patients aged 18-45 years with the first stroke admitted to Beijing Tiantan Hospital, Capital Medical University, were prospectively and continuously enrolled from June 2021 to December 2021. The patients were randomly assigned to one of the two groups: control or intervention group. The control group received routine nursing and extended nursing, while the intervention group was implemented a compass nursing model based on HAPA theory for three months. The improvements in each dimensional score and total score of the self-management behavior scale for stroke, the stroke specific quality of life scale, the self-rating anxiety scale, and the self-rating depression scale were compared between the two groups after intervention. Results 104 young and middle-aged patients with the first stroke were enrolled in the study, and 6 cases dropped out. 49 patients were assigned to the intervention group and 49 were assigned to the control group finally. The intervention group had higher total scores on the self-management behavior scale for stroke and the stroke specific quality of life scale than the control group (P<0.001, P=0.025). The intervention group had lower total scores on the self-rating anxiety scale and the self-rating depression scale than the control group (P=0.001, P<0.001). Conclusions The compass nursing model based on HAPA theory can effectively improve the self-management ability of patients, relieve their anxiety and depression, and improve their quality of life.
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