| Objective:1.To develop a good reliability and validity of the KAP Questionnaire guided by the behavioral diagnostic framework of the PRECEDE-PROCEED model for prevention of calculi recurrence in patients with percutaneous nephrolithotomy(PCNL),and to investigate the status for prenvention of calculi recurrence in PCNL patients with upper urinary calculi.2.To develop a health intervention program for PCNL patients based on the PRECEDE-PROCEED model health intervention theory.3.To explore the health intervention effects of health intervention program for PCNL patients with upper urinary calculi based on the RECEDE-PROCEED model.Methods:1.Guided by the behavioral diagnosis theory of the PRECEDE-PROCEED model and the theory of KAP,an item pool was construted of KAP Questionnaire for prenvention of calculi recurrence in PCNL patients with upper urinary calculi,and a preliminary draft of the questionnaire was formed.Two rounds of expert correspondence were conducted with Delphi method,and the items in the preliminary draft questionnaire were screened and evaluated.2.A total of 300 patients with PCNL who attended a tertiary general hospital in Fujian Province from April 2019 to October 2019 were selected as the study subjects,the knowledge,attitude and practice of PCNL patients were investigated with the KAP Questionnaire for prenvention of calculi recurrence.3.Based on the PRECEDE-PROCEED model,combining with the results of the survey,the first draft of health intervention program for PCNL patients had formed,and was adopt Delphi expert consultation method to conduct two rounds of consultation and determination of the program,through constant revision and refinement,the PCNL patient health intervention program based on the PRECEDE-PROCEED model was finally developed.4.70 cases of PCNL were selected from November 2019 to January 2020 in the department of urology of a second level general hospital in Fujian Province,divided into test group and control group,35 cases each.During the perioperative period,the experimental group adopted a health intervention program based on the PRECEDE-PROCEED Model,while the control group received general health education.Objective: to compare the difference of knowing-believing-doing level,calculi recurrence rate,postoperative complication rate,perioperative anxiety,hospitalization satisfaction and postoperative quality of life between the two groups at different time points of admission,operation,discharge and 6 months after operation.Results:1.Based on the framework of the PRECEDE-PROCEED model theory,the KAP Questionnaire for PCNL patients’ includes 25 items,including three dimensions:knowledge,attitude and behavior practice.The questionnaire had 0.968 content validity index,0.729 Cronbach’s coefficient and 0.816 retest reliability.2.The items of KAP of 300 PCNL patients were 2.00 ± 0.61,2.13 ± 0.70 and 2.21± 0.72,respectively.The scores were 51.24%,52.12% and 54.71%,respectively.The results showed that:(1)age,BMI and access to knowledge were the main influencing factors of upper urinary calculi prevention knowledge in PCNL patients(P﹤0.05);(2)BMI was the main influencing factor for upper urinary calculi prevention attitude of PCNL patients(P﹤0.05),and knowledge acquisition was the main influencing factor for upper urinary calculi prevention behavior of PCNL patients(P﹤0.05).3.After two rounds of expert inquiry,we completed the construction of PCNL patient health intervention program based on PRECEDE-PROCEED model.The approval rate of the program was 100%,the content validity index was 0.867,and the Kendal Harmony Coefficient was 0.314 and 0.325,respectively.4.At the time of admission,the general information,KAP level and anxiety level of the test group and the control group were comparable(P > 0.05).The patients in the test group and the control group had a significant decrease in anxiety after operation.The degree of decrease in anxiety in the test group was significantly higher than that in the control group(P ﹤ 0.05),however,there was no significant difference in the incidence of postoperative complications(P﹥0.05),the patients in the test group were more satisfied with hospitalization than those in the control group(P﹤0.05),and the patients in the test group had a lower calculi recurrence rate of 6 months after operation than those in the control group,the score and total score of KAP were higher than that of the control group,and the quality of life was also better than that of the control group(P﹤0.05).Conclusions:1.Based on PRECEDE-PROCEED model,KAP Questionnaire for the prevention of calculi has a good reliability and validity,and can be used as a measuring tool for the prevention of calculi recurrence in PCNL patients.2.The score of upper urinary calculi patients in the prevention of low KAP level,need to arouse the attention of nursing staff,can be improved through standard health education to prevent the level of KAP.3.Based on the format model,the peri-operative health intervention program for PCNL patients has a high degree of enthusiasm and authority of participating experts,a good degree of coordination of opinions,and a good feasibility of the project content formed,can better meet the nursing needs of PCNL patients.The scheme can effectively improve the PCNL patients’ KAP level,improve patients’ life quality and satisfaction in hospital,and reduce the recurrence rate of stones. |
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