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自我效能咨询技巧在糖尿病患者健康教育中的应用

[The application of self-efficacy counseling skills to health education in patients with diabetes].

作者信息

Wang Shu-Fang, Li Yu-Chan, Chang Jia-Rong, Courtney Mary, Chang Yueh-Ling

机构信息

Department of Nursing, National Taipei College of Nursing & School of Nursing, Queensland University of Technology, Australia.

出版信息

Hu Li Za Zhi. 2007 Feb;54(1):70-7.

Abstract

As the incidence of chronic disease increases, empowerment of patients with chronic disease to adopt self-care responsibilities becomes paramount. Self-efficacy is a belief in one's ability to perform a task that will lead to the desired outcome. Utilizing self-efficacy counseling skills is an effective way to enhance patients' compliance with self-care activities. The development of such skills can compensate for the lack of traditional health education provided for diabetes patients and plays a significant part in the prevention of acute and chronic complications. Self-efficacy counseling strategies involve: asking questions; focusing on patient's agenda; planning personal treatment schedules; defining problems; setting goals (taking a step-by-step approach); regular follow-up and contact with patients; scaling questions; brainstorming solutions; considering past efforts, successes and failures; reassessing confidence; and finally checking behavior changes. Self-efficacy counseling skills can be learned through structured training courses in counseling skills. The aims of this report were twofold: (1) to undertake a literature review on self-efficacy and counseling skills used as the theoretical framework in a health education training program for diabetes; (2) to analyze cases when a counseling guide based upon a self-efficacy framework was used by health counselors to help patients improve their self-confidence and self-care ability. This report reveals it is important to promote the application of counseling skills in nursing interventions in the clinical practice field.

摘要

随着慢性病发病率的上升,使慢性病患者承担起自我护理责任变得至关重要。自我效能感是指个人相信自己有能力执行一项任务并能带来预期结果。运用自我效能感咨询技巧是提高患者对自我护理活动依从性的有效方法。培养此类技巧可以弥补糖尿病患者传统健康教育的不足,并在预防急慢性并发症方面发挥重要作用。自我效能感咨询策略包括:提问;关注患者的议程;制定个人治疗计划;明确问题;设定目标(采取循序渐进的方法);定期随访并与患者保持联系;进行量表提问;集思广益寻求解决方案;考虑过去的努力、成功与失败;重新评估信心;最后检查行为变化。自我效能感咨询技巧可以通过结构化的咨询技巧培训课程来学习。本报告的目的有两个:(1)对自我效能感以及作为糖尿病健康教育培训项目理论框架的咨询技巧进行文献综述;(2)分析健康咨询师使用基于自我效能感框架的咨询指南帮助患者提高自信心和自我护理能力的案例。本报告表明,在临床实践领域的护理干预中促进咨询技巧的应用很重要。

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