| Objective:To observe the application effect of IMB model guided nursing health education in adults with atopic dermatitis with spleen deficiency,and evaluate its effects on medical symptoms,SCORAD score,self-efficacy,quality of life and negative emotions,which provides new ideas and methods for future research on dermatological health education.Methods:From August 2021 to December 2022,60 adult patients with atopic dermatitis with spleen deficiency who were hospitalized in the Department of Dermatology of a third-class traditional Chinese medicine hospital in Hunan Province were selected,and the subjects were divided into two groups of 30 cases in each group according to the random number table method.All patients received basic treatment and care for atopic dermatitis during the study period.The control group was given routine health education in addition to basic treatment and care.The trial group was given an IMB model health education method based on basic treatment and care,including information intervention,motivation intervention,and behavioral skills intervention three links,considering the patient’s hospital stay,disease characteristics and the application effect of the Internet in the disease,and chose to use the We Chat Internet technology platform to carry out online + offline IMB health education intervention,the main contents are as follows:1.Information intervention(1)One-on-one health education: First,distribute the health education manual to the patient,and make the corresponding courseware to carry out one-on-one health education for the patient,each time explaining 2 aspects,once every 4 days,15～20 minutes each time,a total of three times.After the end,encourage the patient to ask questions about what they don’t understand.(2)Establish a We Chat group: Establish a We Chat group of "Atopic Dermatitis Home",and regularly push the latest guidelines/consensus,articles and videos on atopic dermatitis released by authoritative media to patients and their families in a timely manner.For patients and their families who are confused about their inquiries,the team members arrange to respond centrally from 14:30 to 17:30 every day.2.Motivational intervention(1)Set goals: through communicating with patients,understand their unhealthy behaviors,help research subjects formulate a short-term small goal,such as insisting on exercise every day,drinking less alcohol,etc.,establish a clock-in record table for patients,encourage patients to insist on clocking in every day,and give appropriate rewards to patients with good performance.(2)Peer interaction support: Through the We Chat communication group of "atopic dermatitis" patients,patients with better nursing effect are invited to share their experiences.(3)Family participation support: Encourage the patient’s family to participate in the whole trial process,so that the patient can feel the care and love of the family,so as to better improve the level of self-care.3.Behavioral skills intervention(1)Dietary intervention: teach patients and their families how to choose foods suitable for spleen deficiency atopic dermatitis,and learn mix your diet wisely.(2)Exercise intervention: teach patients to master the essentials of Baduan Jin Fitness Therapy,and exercise once a day in the morning during hospitalization.The average length of hospital stay for adult patients with atopic dermatitis with spleen deficiency was 2 weeks,and the above interventions were completed during hospitalization,and patients who could not receive the full course of intervention used We Chat for online intervention.After discharge,the two groups of patients were followed up by nurses on We Chat or by phone,and the frequency was once every two weeks for one month.The changes of TCM symptoms,SCORAD score,self-efficacy,quality of life,anxiety and depression indexes before intervention and one month after discharge were compared between the two groups.Outcomes:1.TCM syndrome scores: the TCM symptom scores before and after the intervention of the experimental group were 6.24±1.46 points,2.76±1.43 points,the TCM symptom scores before and after the intervention of the control group were 6.23±1.48 points,4.53±1.66 points,the TCM symptom scores of the two groups were improved compared with before the intervention(P<0.05),and the difference between the TCM symptom scores of the experimental group before and after the intervention was 2.69±1.34 points,which was greater than that of the control group by 1.97±1.29 points,and the difference was statistically significant(P<0.05)。2.SCORAD score: the SCORAD score before and after the intervention of the experimental group was 47.5(45,50.65)points and 36.5(34.5,38.1)points,the SCORAD score of the control group before and after the intervention was 47.5(45.43,50.58)points and 43.1(41.9,45.55)points,the SCORAD score of the patients in both groups was improved compared with that before the intervention(P<0.05),and the difference in SCORAD score before and after the intervention of the experimental group was 11(8.75,13.75)points,which was 4.5(1.85,5.95)points larger than that of the control group,and the difference was statistically significant(P<0.05).3.Self-efficacy score: the self-efficacy score of the experimental group before and after intervention was 5(5,6)points and 8(7,9)points,the self-efficacy score of the control group before and after the intervention was 5(5,6)points and 6(6,7)points,the self-efficacy scores of the patients in both groups were improved compared with those before the intervention(P<0.05),and the difference between the self-efficacy scores of the experimental group before and after the intervention was 2(2,3)points,which was greater than that of the control group 1(0,1)points,and the difference was statistically significant(P<0.05).4.Quality of life score: the quality of life score of the experimental group before and after intervention was 18(17,19)points and 9(8,10)points,the quality of life score of the control group before and after intervention was 18(17,19)points and 15(14,16)points,the quality of life score of patients in both groups was improved compared with before the intervention(P<0.05),and the difference in quality of life score before and after intervention in the experimental group was 9(9,9)points,which was greater than that of the control group 3(3,3)points,and the difference was statistically significant(P<0.05).5.Anxiety score: the anxiety score of the experimental group before and after intervention was 58(55,63)points and 45(42.5,50)points,the anxiety scores of the control group before and after intervention were 59(56.5,63)points and 55(50,55)points,and the anxiety scores of the patients in both groups were improved compared with those before the intervention(P<0.05),and the difference in anxiety scores before and after the intervention in the experimental group was 13(10,15)points,which was greater than that of the control group by 7(5,10)points,and the difference was statistically significant(P<0.05).6.Depression scores: The depression scores before and after intervention in the dry test group were 55(55,60)points and 45(45,50)points,and the depression scores before and after the intervention in the control group were 56(55,60)points and 55(50,55)points,and the depression scores of the two groups were statistically significantly improved compared with those before the intervention(P<0.05).The difference in depression scores before and after intervention in the experimental group was 10(10,12)points,which was greater than that in the control group 5(3,5)points,and the difference was statistically significant(P<0.05).Conclusions: IMB model health education is of great significance in improving the TCM symptoms and SCORAD score,improving self-efficacy,quality of life,and reducing negative emotions in adults with atopic dermatitis with spleen deficiency. |
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