| ObjectiveTo investigate the current status and influencing factors of radiation dermatitis knowledge-belief-action,self-perceived burden and perceived self-efficacy in patients with nasopharyngeal carcinoma radiotherapy;To explore the influence of health education model based on"Skinner"theory on the knowledge-belief-action,self-perceived burden,perceived self-efficacy,and occurrence of acute radiation dermatitis in patients with nasopharyngeal carcinoma radiotherapy Provide reference basis for nursing interventions.Methods(1)The general information questionnaire,self-made radioactive dermatitis knowledge-trust-line questionnaire,self-perceived burden scale,perceived self-efficacy scale were used as survey tools.From September 1,2018 to October 30,2019,Hunan Province 4 A total of 380patients with nasopharyngeal carcinoma radiotherapy in the third-class first-class hospitals were investigated.Frequency and percentage are used to describe general demographic data,and mean and standard deviation are used to describe radiation-dermatitis knowledge-belief-behavior,self-sensation burden and perceived self-efficacy scores of patients with nasopharyngeal carcinoma radiotherapy;nasopharyngeal carcinoma radiotherapy is analyzed according to multiple linear stepwise regression Factors influencing patients'radiation dermatitis behavior,self-perceived burden or perceived self-efficacy.Pearson correlation analysis was used to analyze the correlation between self-perceived burden or perceived self-efficacy,with a statistical difference of P<0.05;a structural equation model was established to analyze the knowledge-belief-action,self-perceived burden and self of radiation dermatitis in patients with nasopharyngeal carcinoma radiotherapy relationship of management effectiveness.(2)Patients with radiotherapy of nasopharyngeal carcinoma who met the inclusion criteria were selected as the research subjects from March 1,2019 to June 30,2019.Random number table method was used to randomly divide patients with nasopharyngeal carcinoma who met the inclusion criteria into a control group(38 cases)and an intervention group(38 cases),and combined with the Skinner theory to formulate a health education intervention plan.The control group used conventional radiation dermatitis health education for radiotherapy;the intervention group used health education based on Skinner's teaching theory for a7-week intervention.Radiation dermatitis awareness-belief,self-perceived burden,and perceived self-efficacy were evaluated in two groups of patients with nasopharyngeal carcinoma radiotherapy before and after 7weeks of intervention.The grade of acute radiation dermatitis was measured daily during the intervention.Comparisons between the two groups were performed using one-way analysis of variance,or approximate F-test,two-sample independent t-test,approximate t-test,and chi-square test.There was a statistical difference at P<0.05.Results(1)The actual knowledge score of patients with nasopharyngeal carcinoma radiotherapy was(23.65±3.18)points,and the percentage score was(57.62±15.31)points.The knowledge level was excellent,good and poor accounting for 26.8%,35.3%and 37.9%,respectively.The awareness rate of each item is reported in the reverse mode instead of the positive one,as shown in Table 3.2.Judging from the awareness rate of all items,patients with nasopharyngeal carcinoma radiotherapy lack comprehensive and in-depth knowledge of radiation dermatitis.There is less knowledge of the risk factors and prevention of radiation dermatitis.The actual attitude score was(16.27±2.73)points,and the percentile score was(68.34±7.37)points.The good,good,and poor attitudes accounted for 47.1%,28.6%,and 24.3%,respectively.The actual behavior score was(31.63±5.79)points,and the percentage system score was(64.77±10.52)points.The good,good,and poor behaviors accounted for 39.4%,42.1%,and 18.5%,respectively.Knowledge,attitude,family monthly income,grading of radiation dermatitis,and frequency of radiation therapy are the main influencing factors of radiation dermatitis behavior in patients with nasopharyngeal carcinoma radiotherapy.factors for their daily life.(2)The total score of self-perceived burden of patients with nasopharyngeal carcinoma radiotherapy is(30.05±7.49)points,which is at a moderate level;the average score of each dimension from high to low is emotional burden(3.20±0.88)and physical burden(1.64±0.69),economic burden(1.64±0.73).The main influencing factors are TMN stage,family monthly income,radiotherapy frequency,and radiation dermatitis classification.The total score of patients'self-management effectiveness was(86.06±18.34)points,which was at a moderate level;the average scores of each dimension from high to low were positive attitude(3.13±0.85),self-decision(3.05±0.77)and self-decompression(2.86±0.96).The monthly household income,TMN staging,and the number of radiotherapy sessions were the main influencing factors.(3)The results of the structural equation model show that the total effect of knowledge on the burden of self-perception is-0.501,of which the direct effect is-0.056,and the indirect effect of behavior on the burden of self-perception is-0.445;the total effect of belief on the burden of self-perception is-0.191,where the direct effect is-0.103,and the indirect effect on self-perceived burden through behavior is-0.087;the total effect of knowledge on self-management efficiency is 0.254,where the direct effect is 0.071,and the indirect effect on self-management efficiency through behavior 0.183;the total effect of belief on self-management efficiency is 0.637,of which the direct effect is 0.148,and the indirect effect of self-management efficiency through behavior is0.488.(4)Before the intervention,the general average questionnaires of the intervention group and the control group,disease data,knowledge of radiation dermatitis,self-perceived burden,and perceived self-efficacy were compared.(5)After the intervention,the total scores of radiation dermatitis knowledge,beliefs and behaviors of the two groups of patients were higher than before the intervention(P<0.05).The total scores of radiation dermatitis knowledge,beliefs and behaviors of the patients in the intervention group were significantly higher than those in the control group.There was statistical significance(P<0.05).(6)There was no significant difference between the total average score of self-perceived burden level and the scores of each dimension in the control group before and after the intervention(P>0.05);the total average emotional burden and the total physical burden of the intervention group patients after the intervention The score was significantly lower than before the intervention(P<0.05),but the total average financial burden score was not significantly different before and after the intervention(P>0.05);after the intervention,the patients in the intervention group had a total average self-perceived burden level and an average emotional burden.The scores of total and body burden were significantly lower than those of the control group,and the differences were statistically significant(P<0.05).(7)The average scores of perceived self-efficacy and the scores of all dimensions in the control group and the intervention group of patients with nasopharyngeal carcinoma before radiotherapy were significantly lower than those after intervention(P<0.05).The control group's positive mean total score,total self-decompression total score,and self-decision total score after radiotherapy were significantly lower in the control group than in the intervention group,and the differences were statistically significant(P<0.05).(8)The study found that 38 patients had grade?radiation dermatitis,16 in the control group and 22 in the intervention group;23patients had grade?radiation dermatitis,13 in the control group,and 10in the intervention group;Eight patients developed grade III radiation dermatitis,5 in the control group and 3 in the intervention group;1patient in the control group developed grade?radiation dermatitis,and the incidence of radioactive dermatitis in the control group above grade?was 54.29%,and the intervention group?The incidence of radiation dermatitis above grade 1 was 37.14%.?~2 test results showed that the difference in the incidence of acute radiation dermatitis between the two groups was statistically significant,?~2=6.216,P=0.04.Conclusion(1)The content of radioactive dermatitis in patients with radiotherapy of nasopharyngeal carcinoma is lack of knowledge-information,and medical staff must strengthen the education of radioactive dermatitis in knowledge of radiation-dermatitis in the early stage of radiotherapy.(2)The self-experience burden and self-management efficiency of patients with nasopharyngeal cancer radiotherapy are at a moderate level.Medical staff need to strengthen the assessment of patients'psychological changes,effectively use the social medical security system,reduce the patient's medical burden,and improve the patient's sense of perceived self-efficiency.(3)The knowledge and belief of radiation dermatitis in patients with nasopharyngeal carcinoma radiotherapy can directly affect the burden of self-perception and self-management efficiency,and can also have an indirect effect through behavior.(4)The health education program based on the"Skinner"teaching theory can help patients with radiation therapy of nasopharyngeal cancer to acquire knowledge about radiation dermatitis,establish health beliefs,and establish self-care behaviors.Alleviate the burden of self-perception,improve the effectiveness of self-management of the disease,and alleviate the occurrence of acute radiation dermatitis above grade?. |
PDF Full Text Request