Influences Of Teach-back Method On Self-management Of Patients With Hepatitis Cirrhosis

ObjectiveTo study the current situation of self-management performance and medical coping of the patients with hepatitis cirrhosis;and to analyze theis influences on the patients' self-management behavior and the relationship between self-management behavior and medical coping.To provide the basic references for improving clinical health education,teach-back method was used to intervene the patients with hepatitis cirrhosis,and evaluate the intervention effects.Methods(1) "The general information questionnaire","The patients' self-management behavior quantification chart" and "Medical coping questionnaire" were used to investigate 280 patients with hepatitis cirrhosis,who were hospitalized in January 1 to March 31,2017,in six tertiary general hospitals in Hengyang by using random cluster sampling sampling.The current situation of the self-management behavior and medical coping of the patients were analyzed,and their influential factors were evaluated.Then,the correlation between self-management performance behavior and medical coping was analyzed.(2)The patients,who were hospitalized into the first or second zone in January 1 to July 31,2017 in the tertiary hospitals in Hengyang,were as the samples.The patients in the first zone were as the control group and in the second zone were as the intervention group."The general information","Patients' self-management behavior","medical coping",and the examination reports of liver functions in the two groups were compared.Both the two groups were taken the traditional health education pattern and follow-up visit,but the patients in the intervention group were given with teach-back method as an additional health education.During the hospitalization,the two groups were given the same class and health education data.After discharge,they were given the same number of times telephone or network return visit.When the patients discharging,"Patients' self-management behavior","medical coping",satisfaction rate for nursing work,rehospitalized in 3 months,and the inspection results of liver function were evaluated.the self-management behavior,medical coping questionnaire scores,And when the intervention finished,the two group's self-management performance,medical coping questionnaires scores,satisfaction rate for nursing work and the inspection result of liver function were evaluated again.(3)The database was built.Statistical Product and Service Solutions(SPSS18.0)was used to analyze the data including advantage of frequency,percentage,mean,standard deviation,t-test,variance analysis,chi-square test,rank sum test,spearman rank correlation analysis,multiple stepwise regression to analyze the data.a value of 0.05 and bilateral test,it be regarded as meaningful when P value was less than 0.05.Results(1)The scores of self-management performance of the patients with hepatitis cirrhosis were [(66.35±7.63)].According to the scores of dimensions from high to low,they were respectively drug use administration [(70.25±11.77)],daily life management [(68.29±9.72)],diet management [(66.72±8.98)],illness condition monitoring [(59.20±11.71)].Their main influential factors included payment way of hospitalization cost,regular life style,degree of education and profession.These 4 elements accounted for 20.4% of total variation of equation.(2)In the medical coping of the patients with hepatitis cirrhosis,the scores of dimension of "accept and face","avoid",and "give in" were [(16.46±2.99)],[(15.84±1.29)],and [(11.21±3.36)],respectively.(3)Among the patients with hepatitis cirrhosis,there was a positive correlation between "accept and face" way and self-management behavior(r=0.62,P<0.001),and between "avoid" way and self-management behavior(r=0.23,P<0.001);but there was a negative correlation between "give in" way and self-management behavior(r=-0.17,P<0.001).But there were no correlation between "diet management" dimension of self-management behavior and "avoid" and "give in" of coping method.(4)Before intervention,the differences of the patients' general information,self-management behavior,medical coping scores and liver functions results in the intervention group were not statistically significant compared to that in the control(P>0.05).(5)When discharging and after three months of discharging,the scores of self-management behavior and medical coping in the intervention group were markedly higher than that in the control(P<0.05).(6)When discharging,satisfaction rate for nursing work in the intervention group was obviously higher than that in the control(P<0.05).In three months after discharging,the rehospitalization rate of the patients in the intervention group was significantly lower than that in the control(P<0.05).(7)When discharging,the differences of TBA,CHE,CHO between two groups had no statistically significant(P>0.05).However,ALB in the intervention group was obviously higher than that in the control(P<0.001).After three months of discharging,TBA,ALB,CHE,and CHO in the intervention group were significantly better than that in the control(P<0.05).Conclusions(1)The self-management behavior of the patients with hepatitis cirrhosis was at a medium levels.Payment way of hospitalization cost,regular life style,degree of education and profession were their main influential factors.(2)Most of the patients with hepatitis cirrhosis took the way of "avoid" and "give in",less patients took the "accept and face" way.(3)The "accept and face" way and "'avoid" way had a positive correlation with the patients' self-management behavior;"give in" way showed a negative correlation.(4)The teach-back health education way could improve the patients' self-management behavior and coping and the liver function.They also increase the patients' satisfaction rate for nursing work,and decrease the rehospitalization rate.