Effects Of Health Education Under The Guidance Of Health Belief Model On Secondary Prevention Of Ischemic Stroke Patients

Objective:The one-year recurrence rate after the first stroke in China can reach 17.7%.A large number of studies have demonstrated that enhancing secondary prevention in patients with ischemic stroke can reduce the recurrence rate.However,the compliance of stroke patients with risk factor control and secondary prevention was unsatisfactory in China,so it is necessary to improve patients' compliance with secondary prevention through health education.The health belief model can be used to guide the methods of health education programs to improve individual health beliefs and help patients consciously adopt preventive measures.To analyzed the influence of health education under the guidance of health belief model on the control level of blood pressure,fasting blood glucose,blood lipid and medication compliance of ischemic stroke patients after discharged compared with general health education.To explore the way of health education that can effectively increased patients' compliance with medical treatment,improved prognosis and reduce disease recurrence,provide theoretical basis and methodological guidance for improving patients' compliance with secondary prevention.Methods:This was a quasi-experiment study.Convenience sampling was used to select 170 patients with ischemic stroke who were first admitted to the department of neurology of a third-class hospital in Changchun from January to April in 2019 to be included in the control group,another 170 patients with ischemic stroke from May to August in 2019 were enrolled in the intervention group.The control group received routine health education during hospitalization.Patients in the intervention group received health education under the guidance of health belief model,including group health education courses during hospitalization and enhanced management through We Chat group implementation after discharge.Evaluated the blood pressure,fasting blood glucose,lipid control level,medication compliance and disease prognosis of the two groups 3 months after discharge.Results:A total of 315 patients finished the 3 month follow up in this study(155 in the control group,160 in the intervention group).During hospitalization,7 patients were excluded due to the length of stay < 7 days,and 1 patient in the intervention group voluntarily requested to withdraw from the study.There were 17 patients were not followed up for 3 months after discharge,including 6 patients in the control group with recurrence,1 patient died,2 patients in the intervention group with recurrence,and the remaining patients were lost to follow-up.3 months after discharge,the mean systolic blood pressure(145.83 ± 18.45 mmHg)and diastolic blood pressure(84.93 ± 11.38 mmHg)of the patients with hypertension in the intervention group were lower than those in the control group(P < 0.05).However,there was no statistical difference between the two groups in the proportion of patients reaching the target blood pressure.The fasting blood glucose level(7.17 ± 1.81 mmol /L)in the intervention group was lower than that in the control group(8.17 ± 2.30 mmol /L,P < 0.05).The control level of LDL-C in the intervention group(2.08 ± 0.63 mmol/L)was better than that in the controls(2.24 ± 0.80 mmol/L,P < 0.05).At 3 months,the overall medication compliance of the intervention group(96/155,61.94%)was significantly higher than that of the control group(133/160,83.13%,P < 0.001).In addition to the antihypertensive drugs,the persistence for patients taking antiplatelet,hypoglycemic and statins were significantly higher in the intervention group(P < 0.05).Although the compliance of warfarin in the intervention group(84.61%)was higher than that in the control group(40.00%),there was no statistical difference due to the small number of patients.There was no statistically significant difference between the two groups in the proportion of patients with good functional prognosis at the third month after onset(82.58% vs.81.88%,P > 0.05),and the recurrence rate was 3.70% and 1.23%,respectively,with no statistically significant difference either(P > 0.05).Conclusion:Compared with general health education,health education under the guidance of health belief model can improved the control effect of systolic blood pressure,fasting blood glucose and low density lipoprotein cholesterol in patients with ischemic stroke.Health education under the guidance of health belief model can improved the overall medication compliance of patients with ischemic stroke and the medication compliance of hypoglycemic agents,statins and antiplatelet agents.