赵颖

【摘要】 目的：探討基于行动导向为核心的健康教育对甲状腺癌术后疾病认知及自理能力的影响。方法：选取2022年1—12月在鹰潭市人民医院行甲状腺癌手术的患者84例，随机分为两组，观察组（42例）和对照组（42例）。对照组采用常规护理干预；观察组在对照组基础上采用基于行动向导为核心的健康教育。干预前后比较两组自制疾病认知问卷、焦虑自评量表（SAS）、抑郁自评量表（SDS）、自我护理能力量表（ESCA）、生活质量核心量表（QLQ-C30）；采用功能锻炼依从性量表比较干预后两组锻炼依从性；干预后比较两组并发症发生率及护理满意度。结果：干预后，观察组自制疾病认知问卷（疾病早期识别、疾病的危害、预防复发事项、饮食注意事项）良好例数均多于对照组（P<0.05）；观察组SAS、SDS评分均低于对照组（P<0.05）；观察组自我概念、自我护理技能、自护责任感、健康知识水平评分均高于对照组（P<0.05）。观察组躯体功能、角色功能、社会功能评分均高于对照组（P<0.05）。观察组锻炼总依从率高于对照组（P<0.05）。观察组并发症总发生率低于对照组（P<0.05）；观察组护理总满意率高于对照组（P<0.05）。结论：基于行动导向为核心的健康教育能有效提高甲状腺癌术后患者疾病认知能力和自理能力，缓解焦虑及抑郁心理，提高锻炼依从性和生活质量，同时减少并发症发生率，提升护理满意度。

【关键词】 行动导向 健康教育 甲状腺癌术后 疾病认知 自理能力

Effects of Based Action-oriented as the Core Health Education on Disease Cognition and Self-care Ability of Thyroid Cancer Patients after Surgery/ZHAO Ying. //Medical Innovation of China， 2024， 21（08）： 0-079

[Abstract] Objective： To explore the effects of based action-oriented as the core health education on disease cognition and self-care ability of thyroid cancer patients after surgery. Method： A total of 84 patients undergoing thyroid cancer surgery in Yingtan City People's Hospital from January to December 2022 were selected， and randomly divided into observation group （42 cases） and control group （42 cases）. The control group was given routine nursing， while observation group was additionally given based action-oriented as the core health education. Before and after intervention， scores of self-made disease cognition questionnaire， self-rating anxiety scale （SAS）， self-rating depression scale （SDS）， exercise of self-care agency scale （ESCA） and the core quality of life （QLQ-C30） were compared between the two groups; the exercise compliance in the two groups was compared after intervention by functional exercise compliance scale; after intervention， incidence of complications and nursing satisfaction were compared between the two groups. Result： After intervention， the number of good cases in self-made disease cognition questionnaire （early disease identification， disease harm， recurrence prevention matters， dietary precautions） in observation group were more than those in control group （P<0.05）， scores of SAS and SDS were lower than those in control group （P<0.05）， scores of self-concept， self-care skills， self-responsibility and health knowledge level in the observation group were higher than those in control group （P<0.05）; scores of physical function， role function and social function in the observation group were higher than those in control group （P<0.05）. Total compliance rate of exercise in the observation group was higher than that in control group （P<0.05）. Total incidence of complications in the observation group was lower than that in control group （P<0.05）. Nursing total satisfaction rate in the observation group was higher than that in control group （P<0.05）. Conclusion： Based on action-oriented health education as the core can effectively improve disease cognition and self-care ability in patients after thyroid cancer surgery， relieve anxiety and depression， improve exercise compliance and quality of life， reduce the incidence of complications and improve nursing satisfaction.

[Key words] Action-oriented Health education Thyroid cancer surgery Disease cognition Self-care ability

First-author's address： Department of General Surgery， Yingtan City People's Hospital， Yingtan 335000， China

doi：10.3969/j.issn.1674-4985.2024.08.017

甲状腺癌是甲状腺中最常见的恶性肿瘤之一，主要发生于甲状腺滤泡上，绝大多数的甲状腺癌只发生在一侧，为单个肿瘤，发病率与地区、种族、性别有一定关系，其中女性发病率较男性高，且该病能发生于各种年龄段，主要以青壮年多见[1-2]。甲状腺癌早期颈部会出现结节或肿块，不明显容易被忽略，常常在体检中发现，该病进展时会引起声音嘶哑，呼吸困难或吞咽困难等。目前临床上多采用手术切除病灶来治疗甲状腺癌，但若术后对患者干预不到位，会导致术后出现各种并发症，影响预后效果[3-4]。行动导向为核心健康教育是以“行动导向驱动”为主要形式，在教学中通过角色扮演的方式，以患者为学生，护理人员为教师，引导患者学习疾病相关知识和自理技能，提升患者参与度，达到患者能健康自护的作用[5-6]。……