基于跨理论模型的健康教育策略对乳腺癌患者内分泌治疗依从性的影响研究<sup>★</sup>

doi:10.3969/j.issn.2095-1264.2024.01.18

首页 > 过刊浏览>2024年第1期 >108-115. DOI:10.3969/j.issn.2095-1264.2024.01.18

基于跨理论模型的健康教育策略对乳腺癌患者内分泌治疗依从性的影响研究★
DOI:
                        10.3969/j.issn.2095-1264.2024.01.18
                    
作者:
                        
                        
                    
作者单位:1.中南大学湘雅二医院，临床护理学教研室，湖南 长沙，410011;2.中南大学湘雅二医院，普外六病区，湖南 长沙，410011;3.湖南省肿瘤医院/中南大学 湘雅医学院附属肿瘤医院 护理部，湖南 长沙，410013;4.常德市第一人民医院，湖南 常德，415000
作者简介:贺晓华，女，硕士，主管护师，研究方向：肿瘤护理。
通讯作者:季静芬，女，硕士，主管护师，研究方向：肿瘤护理。
中图分类号:R737.9;R473.73
基金项目:★2023年湖南省自然科学基金（2023JJ60409）；2021年湖南省卫生厅科研基金课题（202214023433）；中南大学湘雅二医院院级课题（2019-HLKY-3）。

Effects of a trans-theoretical model-based health education strategy on the adherence of breast cancer patients undergoing adjuvant endocrine therapy^★

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Affiliation:

1.Department of Clinical Nursing,;2.The Sixth Ward of General Surgery Department, the Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China;3.Chinese Nursing Management, Hunan Cancer Hospital/the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410013, Hunan, China;4.The First People’s Hospital of Changde, Changde, 425000, Hunan, China

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摘要:

目的探讨以跨理论模型为基础的健康教育策略对乳腺癌患者内分泌治疗依从性的影响。方法选取长沙市某三甲医院乳腺外科乳腺癌术后拟实施内分泌辅助治疗的154例患者为研究对象，应用方便抽样法分为干预组和对照组，每组77例。对照组患者实施常规的健康教育，干预组患者实施以跨理论模型为基础的干预方案，比较干预前后两组患者不同行为阶段人数占比，分别评价两组干预前、干预后1个月和干预后6个月的服药依从性和合理用药自我效能。结果干预后，干预组患者各行为阶段人数占比显著高于对照组，差异有统计学意义（P<0.05）。重复测量方差分析结果显示，两组患者服药依从性和合理用药自我效能组间主效应、时间主效应和交互作用均具有统计学意义（P<0.05）。结论应用以跨理论模型为基础的健康教育策略可帮助乳腺癌患者建立良好的服药行为，从而提高其辅助内分泌治疗依从性，是一种具有一定效果的健康教育方法。

Abstract:

Objective To investigate the effects of a trans-theoretical model-based health education strategy on the adherence of breast cancer patients undergoing adjuvant endocrine therapy.Methods A total of 154 breast cancer patients who underwent adjuvant endocrine therapy after breast cancer surgery in a grade-A tertiary hospital in Changsha were recruited as the study subjects. The subjects were allocated into the observation group (77 cases) and the control group (77 cases) by convenience sampling method. The control group received conventional health education, and the observation group received intervention education based on a trans-theoretical model. The proportions of patients in different behavior stages before and after intervention were evaluated by SOC (Stages of Change Questionnaires), and were compared between the two groups. Patients' medication adherence and self-efficacy were evaluated by eight-item Morisky Medication Adherence Scale (MMAS-8) and Self-efficacy for Appropriate Medication Use Scale (SEAMS) before intervention and at 1 or 6 months after intervention, respectively.Results After the intervention, the proportion of patients at each behavior change stage in the observation group was significantly better than that in the control group (P<0.05). The results of one-way repeated measures analysis of variance showed that the main effect, time main effect and interaction of medication compliance and self-efficacy were statistically significant (P<0.05).Conclusion Health education strategies based on a trans-theoretical model can effectively help patients to cultivate a good medication behavior, and improve patients' medication adherence and self-efficacy. It is an effective method of health education.