The Application Of Health Failure Model And Effect Analysis In Health Education Of First Ischemic Stroke Patients

ObjectivesTo explore the effects of health education based on the analysis of health failure modes and effects on the health knowledge,health behavior and self-efficacy of the first ischemic stroke patients.MethodsRandomized controlled trial.According to the inclusion and exclusion criteria of this study,120 first ischemic stroke patients were divided into test group and control group,60 cases each group when admitted in the neurosurgery department of a hospital at Lanzhou from January 2019 to December 2019.Control group: the routine health education model was given.The education contents include hospital and ward environment,doctors,nurses,department management,safety knowledge,discharge procedure and related matters after discharge.Daily education,specialist guidance,diet guidance and rehabilitation guidance were be carried in daily work,and without the limits of frequency,times,process and forms.The education nurses are all professional nurse with good communication and expression ability,they work from Monday to Friday to ensure the continuity of education work.Experimental group: Based on medical failure model and effect analysis,in this group.And details were as follows:(1)Set up a team and training: Set up a health education group for stroke patients,Composed by the head nurse(group leader),heart and brain health manager and two responsible group leaders.(2)Graphing the flow chart of health education for patients with stroke in hospital in total five main,21 sub-procedures.(3)Establishing the failure severity assessment standard and failure possibility assessment standard,combined with the reality of the stroke patient health education.(4)Confirming the failure model and conduct hazard analysis: According to the HFMEA risk priority index,the failure risk assessment and hazard analysis were conducted for the analysis of severity of failure and probability of failure.(5)Adopting the "brainstorming method" to analyze the causes of failure risk priority number(RPN?8 points)and formulate improvement measures.Health knowledge,health behavior and self-efficacy of stroke patients were measured by health knowledge scale,health behavior scale and rehabilitation selfefficacy scale for stroke patients.Using Epidate13.0 database software for data entry,general data using statistical description mean,standard deviation,frequency by the statistical description,measurement data using mean add and subtract standard deviation,group comparison between the two independent sample t-test,materials do not conform to the normal distribution of data using median(interquartile spacing)[M](QIR),the comparison of different time points within the same group USES the data a rank is not equidistant repetitive measure analysis of variance,comparison between groups using nonparametric two independent sample test.SPSS24.0 was used to analyze the data.The test level was 0.05,and P < 0.05 was considered statistically significant.Results1.There were no statistically significant differences between the two groups in GCS score,LDL level,diabetes mellitus,hypertension,health knowledge level at admission,health behavior score,and self-efficacy level(P?0.05),indicating comparability.2.Comparison of the failure risk priority index(RPN value)before and after the implementation of medical failure mode and effect analysis: the difference between the failure risk priority index(RPN value)before the implementation of HFEAM and the failure risk priority index(RPN value)after the implementation of HFEAM was statistically significant(P < 0.05).3.Health knowledge level of stroke patients: there was no significant difference in health knowledge level between the two groups at the time of admission(P?0.05).The score of health knowledge in the experimental group was significantly higher than the control group at discharge,1 month after discharge and 3 months after discharge,with statistically significant difference(P < 0.05).4.Health behavior scores of stroke patients: the health behavior scores of the test group were significantly higher than the control group,with significant difference(P < 0.05).5.Self-efficacy of stroke patients: the self-efficacy scores of the test group were significantly higher than the control group with statistically significant differences(P < 0.05).6.Blood glucose control: Blood glucose level were compared between the two groups.There was no statistically significant difference in the random blood glucose level at admission between the two groups(P?0.05).The random blood glucose in the experimental group at discharge was significantly lower than that of the control group,and the difference was statistically significant(P < 0.05).Conclusions1.Health education model based on health failure mode and effect analysis applied to health education of stroke patients can improve the health knowledge level and selfefficacy of stroke patients,and promote the establishment of health behaviors of patients.2.The application of health education model based on health failure mode and effect analysis to the health education of stroke patients can promote the patients to master the knowledge of blood glucose control,which is helpful for the patients recovery.