Application Of Health Management Based On The Precede-proceed Model In High-risk Population Of Stroke

ObjectiveTo investigate the status of the prevention knowledge and preventive behavior of the high-risk population of stroke and analyze the factors affecting the knowledge and behavior level of the high-risk population of stroke.To explore the influence of precede-proceed model based health management program on the prevention knowledge and behavior,healthy lifestyle and risk factor level of the high-risk population of stroke,so as to provide reference for further improving the standardized management of the high-risk population of stroke.Methods(1)By the method of convenience sampling,283 people with high-risk of stroke in Changsha city A and B communities were investigated by the general information questionnaire,the health knowledge questionnaire for stroke and the health behavior questionnaire for preventing stroke,so as to understand the knowledge level of preventing stroke and the health behavior status of preventing stroke in high-risk population.(2)76 people with high risk of stroke who met the inclusion criteria were selected from communities A and B,then randomly divided into the intervention group and the control group.The control group received routine follow-up education for high-risk population,and the intervention group implemented health management based on precede-proceed model for 6 months on the basis of routine follow-up education.The level of knowledge and behavior was evaluated again at the end of 3 months and the end of 6 months.The scores of Health-Promoting Lifestyle Profile and the levels of various risk factors were compared before and after the intervention.(3)The data were analyzed by SPSS22.0 statistical software,mean ± standard deviation,composition ratio / percentage were used for descriptive analysis.Statistical analysis were performed by t-test,One-way ANOVA test,multiple stepwise regression analysis,chi-square test and repeated measurement analysis of variance for data comparison between the two groups.P < 0.05 was considered statistically significant.Results(1)The 283 people with high risk of stroke in this study were all scored(63.79±14.85)in total health knowledge,with the highest score of exercise program(76.67±42.36),and the poor scores of diet nutrition and low salt were(57.60±39.78)and(45.58±49.89),respectively.The prevention behaviors of 283 people at high risk of stroke were(2.83±0.32),the highest score was alcohol restriction(3.46±0.77),and the lowest score was physical activity(2.04±0.59).There was a significant positive correlation between knowledge level and preventive behavior score(r=0.437,P<0.001).(2)One-way ANOVA test showed that there were statistical differences in knowledge scores among high-risk population with different age,education level,occupation,family per capita monthly income,history of stroke and family history of stroke(P<0.05).These results of multiple stepwise regression analysis showed that age,education level,family monthly income per capita,stroke history,and family history of stroke are the main factors affecting the scores of prevention knowledge of high-risk population.(3)Before the intervention,there was no statistically significant difference between the two groups in the general information,knowledge and behavior scores,HPLP II scores,blood pressure,blood lipid and body mass index of the high-risk population(P>0.05).(4)At the end of 3 months and the end of 6 months,knowledge and behavior scores of high-risk population in the intervention group were higher than those in the control group(P<0.05).The results of repeated measures ANOVA showed that the knowledge and behavior scores of the two groups of high-risk population were statistically different at different time points and in different groups(P<0.05),and there was an interaction between time factors and grouping factors(P<0.05).(5)At the end of 6 months,the total score of HPLP II in the intervention group was significantly higher than that in the control group(P<0.05),and the scores of five dimensions of health responsibility,physical activity,nutrition,interpersonal relationship and stress management were all higher than that in the control group(P<0.05).However,there was no significant difference in the dimensions of spiritual growth between the two groups(P>0.05).(6)After intervention,systolic blood pressure,diastolic blood pressure,total cholesterol and low density lipoprotein cholesterol in the intervention group were all lower than those in the control group(P<0.05),but there was no statistically significant difference in body mass index between the two groups(P>0.05).Conclusions(1)The prevention knowledge and behavior of the high-risk population of stroke are at a medium or low level.The main factors affecting the knowledge and prevention awareness of high-risk population include age,education level,family monthly income per capita,stroke history,and family history of stroke.(2)The health management based on precede-proceed model can improve the knowledge level of the disease,strengthen the prevention behavior,improve the healthy lifestyle and reduce the risk factor level of the high-risk population of stroke.