基于时机理论的O2O健康教育模式提高术后青光眼日间手术患者自我管理行为的研究 [中文引用][英文引用]

目的  探讨基于时机理论的 O2O（Online-to-Offline）健康教育模式提高青光眼日间手术患者自我管理行为的应用效果，为临床全程健康教育提供依据。方法  采用随机对照试验，选取 2023 年 7 月至 12 月于本院行青光眼日间手术患者 70 例，随机分为对照组和试验组各 35 例，对照组采用常规护理，试验组在此基础上实施基于时机理论的 O2O 健康教育模式，分别在干预前、干预 1 个月和干预 3 个月后，比较两组患者的青光眼意识与知识问卷（glaucoma awareness and knowledgequestionnaire，GAKQ）、慢性病管理自我效能感量表（self-efficacy to manage chronic disease scale，SEMCD）和青光眼自我管理行为问卷（glaucoma self-management questionnaire，GSMQ）得分。结果  试验组 32 例和对照组 27 例患者完成研究。广义估计方程结果显示，两组患者 GSMQ 总分在交互效应有统计学显著性（F=8.408，P<0.05）；SEMCD 总分在时间主效应有统计学显著性（F=54.660，P<0.001）；GAKQ 总分在时间主效应、组间主效应以及交互效应有统计学显著性（F=128.483，P<0.001；F=7.991，P<0.05；F=32.652，P<0.001）。进一步分析发现，试验组干预 1 个月后 GSMQ 总分与 SEMCD 总分明显高于对照组（Z=-2.004，P<0.05；Z=-2.029，P<0.05），试验组干预 1 个月和 3 个月后 GAKQ 总分明显高于对照组（Z=-3.987，P<0.001；Z=-4.505，P<0.001）。结论  基于时机理论的 O2O 健康教育模式可在术后康复的关键期有效提高患者自我管理行为、自我管理效能及青光眼知识水平，帮助患者在日间手术模式下更好地应对围手术期自我管理。

Objective To evaluate the efficacy of an online-to-offline（O2O）health education guided by the‘Timing Theory’ in improving self-management behaviours among the patients with glaucoma after day surgery. Methods In this randomised controlled study conducted between July and December 2022, 70 patients with glaucoma after day surgery in our hospital were assigned to a control group and an experimental group, with 35 patients per group. Patients in control group received routine nursing care, while those in experimental group received O2O health education based on timing theory in addition to the routine nursing care. Outcomes were evaluated using the glaucoma awareness and knowledge questionnaire（GAKQ）, self-efficacy to manage chronic disease scale（SEMCD） and glaucoma self-management questionnaire（GSMQ）at baseline, at 1 month and 3 months after surgery. Results A total of 32 patients in the experimental group and 27 in the control group completed the study. The generalised estimating equation（GEE）analysis showed a significant difference, respectively, in total score of GSMQ in interaction effect（F=8.408, P=0.015）and SEMC in time main effect（F=54.660, P<0.001）. There were significant differences in total scores of GAKQ in time main effect, inter-group main effect and interaction effect（F=128.483, P<0.001；F=7.991, P<0.05；F=32.652, P<0.001, respectively）. At one-month after intervention, the experimental group showed significantly higher GAKQ and SEMCD scores than the control group（Z=-2.004, P<0.05；Z=-2.029, P<0.05, respectively）. At 1- and 3-months after intervention, the experimental group demonstrated significantly higher GAKQ scores（Z= -3.987, P<0.001；Z=-4.505, P<0.001, respectively）. Conclusion The timing theory based O2O health education significantly improves knowledge of glaucoma, self-efficacy and self-management behaviours among day surgery patients and helps patients better cope with perioperative self-management over day surgery.