摘要目的 探讨联合应用授权教育(empowerment education,EE)和健康信念模式(health belief model,HBM)教育对高血压患者自我管理能力和自我效能的影响.方法 选择2017年2月—2018年5月,在山东中医药大学附属医院心内科180例符合纳入标准的高血压住院患者,随机分为传统教育组、HBM组和EE+HBM组,每组各60例,分别在入组时、干预3个月及6个月后收集3组的高血压患者自我管理能力及自我效能的评分问卷.结果 传统教育组、HBM组和EE+HBM组患者的年龄分别为(57.0±10.7)岁、(53.6±11.7)岁、(56.1±13.2)岁,男性比分别为49%、46%、50%,3组患者基线资料差异无统计学意义(P均＞0.05),具有可比性.干预前,自我管理维度在传统教育组、HBM组和EE+HBM组分值分别为(104.1±7.4)分、(106.8±7.6)分、(104.5±7.3)分,差异无统计学意义(P>0.05);干预前自我效能维度3组的分值分别为(32.3±4.0)分、(33.0±4.0)分、(33.0±3.9)分,差异无统计学意义(P>0.05);在时间效应上,3组患者干预后6个月内得分均有所提高,差异有统计学意义(P＜0.05);在分组比较中,传统教育组、HBM组和EE+HBM组干预后得分逐次升高,差异有统计学意义(P＜0.05);在时间与组间效应上,存在交互作用(P＜0.05),故排除时间效应的影响,比较3组相同时间点的得分可知,干预6个月自我管理维度的得分分别为(133.4±9.0)分、(140.0±7.5)分、(164.1±6.1)分,自我效能维度的得分分别为(42.0±3.6)分、(46.7±3.8)分、(51.6±2.2)分,均呈现上升趋势,差异均有统计学意义(P均＜0.05).结论 联合应用EE和HBM教育能够有效提高患者对自身疾病的管理信心和能力,且效能较为持久.

abstractsObjective To explore the influence of combined use of empowerment education (EE) and health belief mode (HBM) education on self‐management behavior ability and self‐efficacy in patients with hypertension. Methods From February 2017 to May 2018, 180 patients with hypertension who met the inclusion criteria in the department of cardiology of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine were selected and randomly divided into 3 groups, namely: traditional health education group, HBM group and EE+HBM group, each group had 60 patients. All patients were asked to fill out"essential status scale","hypertension self‐management behavior ability scale" and "hypertension self‐efficacy questionnaire scale"respectively at the time of enrollment, 3 months and 6 months after received education. After the intervention, we compared and analyzed the 3 groups patients' ability of self‐management and self‐efficacy. Results The age of traditional education group, HBM group and EE+HBM group were (57.0±10.7), (53.6±11.7) and (56.1±13.2) .The male ratio was 49%, 46% and 50% respectively. There was no significant difference in baseline data among the three groups (P>0.05).Before intervention, the scores of self‐management in traditional education group, HBM group and EE+HBM group were (104.1±7.4) , (106.8±7.6)and (104.5±7.3) respectively, with no significant difference (P>0.05). Before intervention, the scores of self‐efficacy dimension in three groups were (32.3±4.0), (33.0±4.0) and (33.0±3.9). There was no significant difference (P>0.05). In terms of time effect, the scores of the three groups were improved within 6 months after intervention, and the difference was statistically significant (P <0.05). In the group comparison, the scores of traditional education group, HBM group and EE+HBM group increased gradually after intervention, with statistical significance (P<0.05); there was interaction between time and group effect (P<0.05), so excluding the influence of time effect. Comparing the scores of three groups at the same time point, we can see that the scores of self‐management dimension in six months of intervention were (133.4± 9.0), (140.0±7.5) and (164.1±6.1) respectively. The scores of self‐efficacy dimension and self‐efficacy dimension were (42.0±3.6), (46.7±3.8) and (51.6±2.2), respectively, showing a gradual upward trend, with significant differences (P<0.05). Conclusions The combination of EE and HBM education can effectively improve patients'confidence and ability in the management of their own diseases, and the effectiveness is more lasting.