| Objective:This study is using "KABP" as a theoretical guide and a healthy literacy intervention to educate the hemodialysis patients.To understand the health literacy,uncertainty,appraisal of uncertainty,self-management of hemodialysis patients,to evaluate the uncertainty and self-management of hemodialysis patients before and after the intervention of health literacy,so as to provide the basis for improving the level of health literacy,reducing the sense of uncertainty and improving self-management.Methods:This study was a quasi-experimental study,using a convenient sampling method.Hemodialysis patients were from June 2016 to October 2016 in a hemodialysis room from a top three 'hospital in Yanji City.According to the patient scheduling,hemodialysis patients on Monday and Tuesday were divided into observation group and control group by tossing a coin.Patients who met the inclusion criteria were selected according to the medical records and patient' s intention,and the baseline survey was completed.To develop health literacy intervention strategy as the theory of KABP,the health literacy intervention was implemented in the intervention group,the control group was given regular health education.The data was collected after 1 and 3 months,repeated-measure analysis of variance was performed on changes of mean score in health literacy,uncertainty in illness,the appraisal of uncertainty and the self-management before and after the intervention in both groups.All data was analyzed by using statistical software SPSS17.0.Results:(1)The overall health status of hemodialysis patients before intervention was poor,the ratio of patients with healthy literacy was 24.4%;patients were with a high level of uncertainty,the proportion of patients with disease uncertainty was 54.4%;the patients' uncertainty evaluation overall was more inclined to as the opportunity,with a positive and optimistic attitude;Self-management ability of patients was low,the ratio of the patients with no self-management was 92.2%.(2)There was no significant difference between the two groups in terms of basic data,health literacy,uncertainty in illness,appraisal of uncertainty and self-management ability(P>0.05).(3)Repeated-measure analysis of variance of health literacy mean score showed the time effect(F=134.884,P<0.001),group effect(F=4.767,P=0.032)and the interaction effect of two groups(F=95.999,P<0.001)were all statistically significant.(4)Repeated-measure analysis of variance of uncertainty in illness mean score showed the time effect(F=49.655,P<0.001)and the interaction effect of time and group(F=38.556,P<0.001)were all statistically significant.But group effect(F=1.945,P=0.167)was not significant.(5)Repeated-measure analysis of variance of appraisal of uncertainty as opportunity mean scores showed the time effect(F=67.586,P<0.001),group effect(F=30.788,P<0.001)and the interaction effect of both(F=57.161,P<0.001)were all significant.Repeated-measure analysis of variance of appraisal of uncertainty as danger mean scores showed the time effect(F=44.365,P<0.001)and interaction effect of time and group(F=37.281,P<0.001)were all significant,but group effect(F=1.458,P=0.230)was not significant.(6)Repeated-measure analysis of variance of self-management mean score showed the time effect(F=195.309,P<0.001),group effect(F=28.674,P<0.001)and the interaction effect of both(F=122.243,P<0.001)were all statistically significant.Conclusions:(1)75.6%of patients did not have health literacy,54.4%of patients had a higher level of uncertainty in illness,hemodialysis patients' evaluation of the uncertainty in illness tend to opportunities,92.2%of patients did not have self-management capacity.(2)With the reference to the theory of "KABP" in modern health education theory to guide health literacy intervention,it could improve patients' health literacy,uncertainty in illness,appraisal of uncertainty and self-management ability.Scientific rigorous guiding theory embodies the scientific and operable nature of the intervention model. |
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