CAJ | 학술논문

目的：评价基于跨理论模型（TTM）的动机访谈对促进首发脑卒中患者健康行为改变的效果。方法2012年11月-2013年6月采用便利抽样法选取郑州市某医院神经内科住院的60例首发脑卒中患者，根据入院顺序将患者分为干预组（n =30）和对照组（n =30）。干预组给予基于 TTM 的动机访谈，包括饮食、运动管理、戒烟限酒行为等，对照组给予常规脑卒中教育。两组干预前后分别测评健康行为知识、态度得分，健康行为阶段及行为信心得分。结果干预后对照组健康行为知识、态度得分〔（4.87±2.44）、（22.73±4.87）分〕与干预前〔（3.60±2.16）、（19.47±5.18）分〕比较，差异均有统计学意义（t =-3.379、-14.903，P <0.05）；干预组健康行为知识、态度得分〔（11.47±1.46）、（32.63±3.34）分〕与干预前〔（4.70±2.71）、（20.70±2.64）分〕比较，差异均有统计学意义（t =-4.533、-14.582，P <0.05）；且干预后干预组患者健康行为知识与态度得分均高于对照组，差异有统计学意义（P <0.05）。干预组患者干预前前意向阶段21例、意向阶段4例、准备阶段4例、行为阶段1例，干预后前意向阶段2例、意向阶段8例、准备阶段7例、行为阶段13例，差异有统计学意义（χ2=28.133，P <0.05）。干预后对照组行为信心水平低水平11例、中等水平15例、高水平4例，干预组低水平5例、中等水平10例、高水平15例，差异有统计学意义（χ2=9.618，P <0.05）。结论基于 TTM 的动机访谈技术是一种有效的认知、行为改变方法，能提高首发脑卒中患者健康行为知识和态度，提高其行为信心。
목적：평개기우과이론모형（TTM）적동궤방담대촉진수발뇌졸중환자건강행위개변적효과。방법2012년11월-2013년6월채용편리추양법선취정주시모의원신경내과주원적60례수발뇌졸중환자，근거입원순서장환자분위간예조（n =30）화대조조（n =30）。간예조급여기우 TTM 적동궤방담，포괄음식、운동관리、계연한주행위등，대조조급여상규뇌졸중교육。량조간예전후분별측평건강행위지식、태도득분，건강행위계단급행위신심득분。결과간예후대조조건강행위지식、태도득분〔（4.87±2.44）、（22.73±4.87）분〕여간예전〔（3.60±2.16）、（19.47±5.18）분〕비교，차이균유통계학의의（t =-3.379、-14.903，P <0.05）；간예조건강행위지식、태도득분〔（11.47±1.46）、（32.63±3.34）분〕여간예전〔（4.70±2.71）、（20.70±2.64）분〕비교，차이균유통계학의의（t =-4.533、-14.582，P <0.05）；차간예후간예조환자건강행위지식여태도득분균고우대조조，차이유통계학의의（P <0.05）。간예조환자간예전전의향계단21례、의향계단4례、준비계단4례、행위계단1례，간예후전의향계단2례、의향계단8례、준비계단7례、행위계단13례，차이유통계학의의（χ2=28.133，P <0.05）。간예후대조조행위신심수평저수평11례、중등수평15례、고수평4례，간예조저수평5례、중등수평10례、고수평15례，차이유통계학의의（χ2=9.618，P <0.05）。결론기우 TTM 적동궤방담기술시일충유효적인지、행위개변방법，능제고수발뇌졸중환자건강행위지식화태도，제고기행위신심。
Objective To evaluate the influence of motivational interviewing based on Transtheoretical Model(TTM) on health behaviors of initial stroke patients. Methods From November 2012 to June 2013,sixty patients from one hospital of Zhengzhou,were conveniently selected and randomly divided into two groups according to their admission order. Patients in con-trol group(n = 30)received routine stroke education while the patients in intervention group(n = 30)received motivational in-terviewing based on TTM including diet,exercise management,smoking cessation and limited alcohol behaviors. The patients of both groups were evaluated about their health behavior knowledge,attitude,healthy behavior stage and behavior confidence be-fore and after intervention. Results The differences of health behavior knowledge scores and attitude scores in control group and intervention group before and after intervention were both significant,they were〔(3. 60 ± 2. 16), (19. 47 ± 5. 18)〕and〔(4. 87 ± 2. 44),(22. 73 ± 4. 87)〕respectively in control group(t = - 3. 379, - 14. 903,P < 0. 05)and〔(4. 70 ± 2. 71), (20. 70 ± 2. 64)〕and〔(11. 47 ± 1. 46),(32. 63 ± 3. 34)〕respectively in intervention group(t = - 4. 533, - 14. 582,P <0. 05). The improvement degree in intervention group was superior to that in control group(P < 0. 05). Before intervention, there were 21 patients in pre - intention stage,4 in intention stage,4 in preparing stage and 1 in behavior stage in intervention group while after intervention they were 2,8,7,13 respectively and the difference was significant(χ2 = 28. 133,P < 0. 05). After intervention,in terms of behavior confidence,in control group 11 patients were in low level,15 were in middle level,4 patients were in high level while in intervention group 5 were in low level,10 were in middle level,15 were in high level;the difference was significant(χ2 = 9. 618,P < 0. 05). Conclusion Motivational interviewing based on TTM,an effective tech-nique in change of cognition and behavior,can improve health behavior knowledge,attitude and behavior confidence of initial stroke patients.