黎勤华　严程芬　严卓云　罗小燕

[摘要]目的 探討健康信念模型（HBM）在断指再植术患者自我管理中的运用价值。方法 选取2018年7月～2019年6月在我院断指再植术的120例患者，通过随机数字表法分为对照组和观察组，每组各60例。对照组实施常规治疗和常规护理，观察组在对照组基础上实施基于HBM护理干预策略，比较两组干预前后健康信念评分、自我护理能力（ESCA）评分、焦虑自评量表（SAS）、抑郁自评量表（SDS）评分、生活质量评分及患指功能恢复情况。结果 干预前，两组健康信念、ESCA、生活质量、SAS、SDS评分比较，差异无统计学意义（P>0.05）;干预后，观察组健康信念、ESCA、生活质量评分及患指功能恢复优良率高于对照组，SAS和SDS评分低于对照组，差异均有统计学意义（P<0.05）。结论 对断指再植术患者实施基于HBM护理干预可促进提高患者健康信念、自我护理能力，改善患者负面心理情绪，促进患指功能恢复，提高患者的生活质量。

[关键词]健康信念模型;断指再植术;自我管理;生活质量

[中图分类号] R473.6          [文献标识码] A          [文章编号] 1674-4721（2020）6（c）-0236-04

Application of health belief model in self-management of patients undergoing replantation of severed fingers

LI Qin-hua1   YAN Cheng-fen2   YAN Zhuo-yun1   LUO Xiao-yan3

1. Department of Hand Surgery， Foshan Gaoming District People′s Hospital， Guangdong Province， Foshan   528500， China; 2. The Third Department of Surgery， Foshan Gaoming District People′s Hospital， Guangdong Province， Foshan   528500， China; 3. The First Department of Surgery， Foshan Gaoming District People′s Hospital， Guangdong Province， Foshan   528500， China

[Abstract] Objective To explore the application value of health belief mode （HBM） in patients′ self-management after replantation of severed fingers. Methods A total of 120 cases of replantation of severed fingers in our hospital from July 2018 to June 2019 were selected， they were divided into control group and observation group by the random number table method， 60 cases in each group. The control group was given routine treatment and nursing， and the observation group was given HBM based nursing intervention strategy on the basis of the control group. The health belief score， self-care ability score， the exercise of self-care agency （ESCA）， self-rating anxiety scale （SAS）， self-rating depression scale （SDS）， quality of life score and the recovery of finger function of the two groups were compared before and after the intervention. Results Before intervention， there were no significant differences in the scores of health belief， quality of life， ESCA， SAS and SDS between the two groups （P>0.05）. After intervention， the patients′ health belief score， ESCA， quality of life and the excellent and good rate of finger function recovery in the observation group were higher than those in the control group， and the SAS and SDS scores were lower than those in the control group， the differences were statistically significant （P<0.05）. Conclusion The nursing intervention strategy based on HBM can improve the patients′ health belief and self-care ability， improve the patients′ negative psychological mood， promote the recovery of patients′ finger function， and improve the patients′ quality of life.

[Key words] Health belief model; Replantation; Self-management; Quality of life

手指离断属意外创伤，以中青年人群为主要患病群体，其承担社会和家庭双重责任，断指再植术后患者断指康复情况及生活质量值得医护人员关注[1]。虽然随外科显微手术技术发展，断指再植术成功率已高达90%以上[2]，但患者术后仍要漫长康复过程来恢复患者功能和外观。突然意外创伤、长时间术后康复过程、手指功能和外观康复程度未知、患指对日后生活和工作影响等，不仅给患者带来生理痛苦，对患者心理更是严重刺激源，大部分患者易出现焦虑、恐惧等负面心理[3]，影响患者疾病治疗和康复效果，降低患者生活质量。有研究指出[4]，负面心理会导致患者血管收缩痉挛，诱发血管静脉危象，而导致再植失败。积极……