Study On The Effect Of Health Education Combined With PRECEDE-PROCEED Model And Mind Mapping On Patients With Cervical Precancerous Lesions

Objective:Based on PRECEDE-PROCEED Model and thought map,this study applied this approach to cervical intraepithelial neoplasias patients to enhance the effectiveness of health education,to evaluate the influence of the nursing health education method on the patients’disease-related knowledge,disease-related attitude,the rate of follow-up visit and the quality of life,to provide a theoretical basis for the health education and management of CIN patients in the future.Methods:In this study,a quasi-experimental design was used to study CIN patients treated in a grade III,Class A hospital department of gynecology in Baoding,Baoding,from February to July 2022,two gynecological wards of the hospital were used as research sites（because health education was used as a means of nursing intervention to prevent contamination of the effect of intervention between groups）,subjects were randomly assigned to either gynecological Ward 1（intervention group）or gynecological Ward 2（control group）,patients with CIN who entered intervention group were given nursing intervention based on PRECEDE-PROCEED Model and mind map,which assessed the factors affecting patients’quality of life and health behaviors.The intervention group was also given nursing intervention based on PRECEDE-PROCEED Model,to determine their demands for health education,to formulate nursing health education plan and thinking map health education manual,to conduct 2 months of in-hospital health education and online health education for patients;The patients in control group were given routine gynecological health education.Before intervention（T₀）,on the day of discharge or the day before（T₁）,2 months after discharge（T₂）,disease knowledge,disease-related attitudes and the quality of life of CIN patients were assessed with the HPV and HPV vaccine knowledge and behavior questionnaire and European five-dimensional health scale（EQ-5D-5L）,the disease reexamination rates of CIN patients one month after discharge（T₃）and two months after discharge（T₂）were collected and used to form the original database with the software of EPIDATA 3.1.The data were analyzed by SPSS 23.0 software.Results:1.A total of 116 patients with CIN were enrolled in the study according to the admission criteria.At the end of the study,112 patients（4 patients lost to follow-up during the study）were enrolled,of whom 54 patients were enrolled in the intervention group,there were 58 cases in control group.The effective rate of study sample was 96.55%,the age,marital status,educational level,nationality,occupation,mode of payment,residence,living habit,cervical lesion stage,family history,HPV awareness rate,cervical cancer vaccine awareness rate of the two groups were compared,after statistical analysis,the two groups of patients were comparable at baseline.2.The scores of HPV and HPV vaccine knowledge,attitude and Practice Questionnaire in the intervention group were higher than those in the control group,there were time-point effect,inter-group effect and interaction effect in the scores of disease knowledge and attitude between the Intervention intervention group and the control group（P<0.05）.At the time of admission（T₀）,the disease knowledge score and disease attitude score were compared between the two groups at baseline The scores of disease cognition and attitude of CIN patients in intervention group were higher than those in control group on the day of discharge（T₁）and two months after discharge（T₂）.3.The rate of re-visit in intervention group was higher than that in control group:there was no significant difference between the two groups in the rate of re-visit one month after discharge（T₃）（P>0.05）,however,there were more patients in intervention group than in control group,and there was a significant difference between the two groups at two months after discharge（T₂）（P<0.05）.4.The quality of life in the intervention group was better than that in the control group,the EQ-5D-5L Health Index and EQ-VAS score showed significant time-point effect,inter-group effect and interaction effect（P<0.05）.Health utility（U）and EQ-VAS scores at admission（T₀）EQ-5D-5L were statistically comparable at baseline;the EQ-5D-5L health utility（U）and EQ-VAS score were higher in CIN patients than those in controls on the day before discharge（T₁）and 2 months after discharge（T₂）.Conclusions:PRECEDE-PROCEED Model combined with mind map can improve the cognition level of CIN patients,the attitude related to disease and the quality of life.