基于患者指南的健康教育对缺血性卒中患者二级预防用药依从性的影响

doi:10.3969/j.issn.1673-5765.2025.02.007

摘要/Abstract

摘要： 目的验证基于课题组制定的缺血性卒中二级预防患者指南（简称患者指南）的健康教育干预是否能提高缺血性卒中患者二级预防用药依从性。
方法采用前瞻性随机对照试验研究设计，选取2021年6月—2022年8月香港大学深圳医院收治的首次缺血性卒中患者为研究对象，采用随机数字表法将其分为干预组与对照组。对照组采用常规的健康教育方案，干预组在对照组基础上实施基于患者指南的健康教育方案，包括口袋书和教学视频两种形式。分别于干预后1个月、3个月、6个月和1年收集两组患者二级预防用药依从性及mRS评分；于干预前、干预后收集两组患者疾病知识得分及干预后护理满意度得分。
结果共纳入200例（干预组与对照组各100例）缺血性卒中患者。广义估计方程结果显示，干预组第1个月、3个月、6个月二级预防用药依从性均优于对照组，差异有统计学意义（P＜0.05）；Mann-Whitney U检验结果显示，干预组疾病知识得分获得显著提升且护理满意度提高（P＜0.05）；干预组和对照组各评估时间点mRS评分均呈下降趋势（P＜0.05），但组间差异无统计学意义（P＞0.05）。
结论基于患者指南的健康教育方案能显著提升缺血性卒中患者6个月二级预防用药依从性，提高疾病知识得分与护理满意度，但对轻型缺血性卒中患者6个月后mRS评分无显著影响。

文章导读： 基于患者指南的健康教育方案可显著提高缺血性卒中患者6个月二级预防用药依从性，并有效提升患者疾病知识得分与护理满意度。本研究为优化缺血性卒中二级预防策略提供了循证依据。

关键词: 患者指南; 缺血性卒中; 二级预防; 健康教育; 用药依从性

Abstract: Objective To verify whether health education interventions based on the patient version of guidelines for secondary prevention of ischemic stroke (abbreviated as patient version of guidelines) formulated by the research group can enhance the medication compliance of ischemic stroke patients in secondary prevention.
Methods A prospective randomized controlled trial design was used to select patients with first ischemic stroke who were admitted to the University of Hong Kong-Shenzhen Hospital from June 2021 to August 2022 as the study objects, and they were divided into the intervention group and the control group by random number table method. The control group adopted the conventional health education program, and the intervention group implemented the health education program based on the patient version of guidelines on the basis of the control group, including two forms of pocket books and educational videos. Secondary prevention medication compliance and mRS scores of the two groups were collected at 1 month, 3 months, 6 months, and 1 year after intervention. The scores of disease knowledge and post-intervention nursing satisfaction of the two groups were collected before and after intervention.
Results A total of 200 patients (100 patients each in the intervention group and the control group) with ischemic stroke were included. The results of generalized estimating equation showed that the medication compliance of secondary prevention in the intervention group was better than that in the control group at 1 month, 3 months, and 6 months, and the difference was statistically significant (P<0.05). The results of Mann-Whitney U test showed that the disease knowledge score and nursing satisfaction in the intervention group were significantly improved (P<0.05). The mRS scores of the intervention group and the control group showed a decreasing trend at each evaluation time point (P<0.05), but there was no statistical significance between groups (P>0.05).
Conclusions The health education program based on the patient version of guidelines can significantly improve the 6-month medication compliance with secondary prevention, and increase the score of disease knowledge and nursing satisfaction. However, there is no statistical effect on the 6-month mRS score of patients with mild ischemic stroke.

Key words: Patient version of guidelines; Ischemic stroke; Secondary prevention; Health education; Medication compliance

中图分类号:

王瑞香, 朱思静, 梁嘉贵, 晏利姣, 蓝远霞. 基于患者指南的健康教育对缺血性卒中患者二级预防用药依从性的影响[J]. 中国卒中杂志, 2025, 20(2): 171-180.

WANG Ruixiang, ZHU Sijing, LIANG Jiagui, YAN Lijiao, LAN Yuanxia. Effects of Health Education Based on the Patient Version of Guidelines on Medication Compliance in Secondary Prevention among Patients with Ischemic Stroke[J]. Chinese Journal of Stroke, 2025, 20(2): 171-180.

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