Effect Of "321" Health Education Model On Uncertainty In Illness And Anxiety And Depression State In Patients Following Endoscopic Submucosal Dissection

Objective:To evaluate the effect of "321" health education model (a disease-health educational exchange manual, two-time multimedia videoinformation supporting, three-time face to face emotional communication) on uncertainty in illness, anxiety and depression in early gastric cancer patients following endoscopic submucosal dissection, thus providing scientific basis for clinical nurses to develop targeted health education scheme.Methods:A sample of 96 early gastric cancer patients were recruited from the Department of Gastroenterology, Shandong Provincial Hospital during January 2008 to May 2010. They are evenly assigned into the control group (48 cases) and the experimental group (48 cases) according to the patients' admission time. The conventional health education was provided to the control group, while the experimental group were brought into the "321" health education program. Measurements of uncertainty in illness, anxiety and depression were respectively taken by Mishel Uncertainty in Illness Scale, State Anxiety Inventory, Center for Epidemiological Studies depression Scale at each time point (the admission day, the evening before operation, the day of their discharge). Besides, the general information was taken by the general condition questionnaire.Results 1. The mean score on uncertainty in illness of all the patients is 101.33±6.978 on the admission day, belonging to the middle level. No statistical significance was obtained between the control group and the experimental group (p>0.05). After intervention, there was a trend of significantly declined scores on uncertainty in illness in the experimental group than in the control group (p<0.05). Uncertainty score in the experimental group was significantly lower than that of the control group on the evening before operation and the day of their discharge (p<0.05).2. There was no statistical significance in ambiguity dimension, complexity dimension and lack of information dimension between the control group and the experimental group on the admission day (p>0.05). After intervention, there was a trend of significantly declined scores on each dimension in the experimental group than in the control group (p<0.05). Each dimension score in the experimental group was significantly lower than that of the control group on the evening before operation and the day of their discharge (p<0.05). No statistical significance of scores on unpredictability dimension, the trend with time and at each time point was obtained between the two groups (P>0.05).3. The mean anxiety score of all the patients (60.47±7.324) was significantly higher than that of national norm (39.91) on admission day (p<0.00). Meanwhile, the mean depression score of all the patients(18.22±4.344) was significantly higher than that of national norm (11.52) on admission day (p<0.00). There was no statistical significance in anxiety score and depression score between the experimental group and the control group (p>0.05). After intervention, there was a trend of significantly declined scores on anxiety dimension and depression dimension in the experimental group than in the control group (p<0.05). Anxiety score and depression score in the experimental group were both significantly lower than that of the control group on the evening before operation and the day of their discharge (p<0.05).Conclusions"321" health education model can provide abundant content and diverse forms, thus it can to a large extent meet patients' needs of information and emotional sustenance. Meanwhile it is an effective approach in reducing uncertainty in illness, anxiety and depression.