邬菊英　　胡文　　徐晶

[摘要] 目的 探討“知信行”干预对慢性乙型肝炎患者不确定感、自我效能、自我健康管理的影响。 方法 选择2020年1—8月在我院诊断治疗的慢性乙型肝炎患者60例为研究对象，随机数字表法分为干预组30例与对照组30例。对照组实施常规健康教育干预，干预组采用“知信行”干预。比较两组入院时、出院时疾病不确定感、自我效能、自我健康管理、对慢性乙型肝炎相关知识掌握情况以及干预满意度。 结果 ①出院时，两组疾病不确定感评分较入组时低，并且干预组较对照组低，差异有统计学意义（P<0.05）。②出院时，两组自我效能评分较入组时高，并且干预组较对照组高（P<0.05）。③两组出院时自我管理水平较入组时高，并且干预组较对照组高（P<0.05）。④出院时，两组在疾病基本知识、预防知识、治疗知识得分以及总分均较入组时高，并且干预组较对照组高（P<0.05）。⑤干预组总体满意度要高于对照组，差异有统计学意义（P<0.05）。 结论 “知信行”干预可改善乙型病毒性肝炎患者对慢性乙型肝炎相关知识的掌握情况，减轻疾病不确定感，提高自我效能、自我管理水平。

[关键词] “知信行”干预;慢性乙型肝炎;不确定感;自我效能;自我健康管理

[中图分类号] R512.62          [文献标识码] B          [文章编号] 1673-9701（2021）11-0070-04

Effects of "knowledge， belief and action" intervention on uncertainty， self-efficacy and self-health management in patients with chronic hepatitis B

WU Juying   HU Wen   XU Jing

Department of Hepatopathy， Hangzhou Xixi Hospital， Hangzhou   310023， China

[Abstract] Objective To explore the effects of "knowledge， belief and action" intervention on the uncertainty， self-efficacy and self-health management of patients with chronic hepatitis B. Methods A total of 60 patients with chronic hepatitis B who were diagnosed and treated in our hospital from January to August 2020 were selected as the research subjects， and they were divided into 30 cases in the intervention group and 30 cases in the control group by the random number table. The control group was given routine health education interventions， and the intervention group was given "knowledge， belief and action" intervention. Illness uncertainty， self-efficacy， self-health management level， knowledge of chronic hepatitis B， and intervention satisfaction were compared between the two groups upon admission and at discharge. Results ①At discharge， the illness uncertainty scores in the two groups were lower than those upon admission， and the intervention group was lower than the control group， with significant differences（P<0.05）. ②At discharge， the self-efficacy scores in the two groups were higher than those upon admission， and the intervention group was higher than the control group（P<0.05）. ③At discharge， the self-management level in the two groups was higher than those upon admission， and the intervention group was higher than the control group（P<0.05）. ④At discharge， the scores of basic disease knowledge， prevention knowledge， treatment knowledge and total scores in the two groups were higher than those upon admission， and the intervention group was higher than the control group（P<0.05）. ⑤The overall satisfaction in the intervention group was higher than that in the control group， and the difference was statistically significant（P<0.05）. Conclusion "Knowledge， belief and action" intervention can now improve the knowledge of chronic hepatitis B in the patients with viral hepatitis B， reduce illness uncertainty， and improve self-efficacy and self-management level.

[Key words] "Knowledge， belief and action" intervention; Chronic hepatitis B; Uncertainty; Self-efficacy; Self-health management

全球大约有3.5亿人感染HBV后转为慢性，其中亚洲人占75%，有近1/3左右的患者最终发展为肝硬化或者肝癌。HBV感染导致的死亡占人类死亡原因的第9位。乙型病毒性肝炎是以肝脏病变为主的传染病。疾病不确定感属于认知范畴，可影响患者的情绪、治疗依从性[1]。自我效能是人对自我能力的一种主观判断[2]。自我健康管理是个体对自身健康信息、威胁健康的危险因素的分析、预测以及预防疾病的过程[3]。“知信行”模式是一种行为干预理论，研究显示[4]，“知信行”理论可改善高血压健康行为，而自我效能发挥中介及调节作用。本文将“知信行”干预用于乙型病毒性肝炎患者，观察其对患者不确定感、自我效能、自我健康管理的影响。

1 资料与方法

1.1一般资料

选择2020年1—8月60例在我院诊断治疗的慢性乙型肝炎患者纳入研究。……