Sullivan Karen A, Katajamaki Anita
School of Psychology and Counselling and Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia.
Top Stroke Rehabil. 2009 Sep-Oct;16(5):377-87. doi: 10.1310/tsr1605-377.
The effect of patient education on reducing stroke has had mixed effects, raising questions about how to achieve optimal benefit. Because past evaluations have typically lacked an appropriate theoretical base, the design of past research may have missed important effects.
This study used a social cognitive framework to identify variables that might change in response to education. A mixed design was used to evaluate two approaches to an intervention, both of which included education. Fifty seniors completed a measure of stroke knowledge and beliefs twice: before and after an intervention that was either standard (educational brochure plus activities that were not about stroke) or enhanced (educational brochure plus activities designed to enhance beliefs about stroke). Outcome measures were health beliefs, intention to exercise to reduce stroke, and stroke knowledge.
Selected beliefs changed significantly over time but not differentially across conditions. Beliefs that changed were (a) perceived susceptibility to stroke and (b) perceived benefit of exercise to reduce risk. Benefit beliefs, in particular, were strongly and positively associated with intention to exercise.
Findings suggest that basic approaches to patient education may influence health beliefs. More effective stroke prevention programs may result from continued consideration of the role of health beliefs in such programs.
患者教育对降低中风风险的效果不一，这引发了关于如何实现最佳效益的问题。由于过去的评估通常缺乏适当的理论基础，以往研究的设计可能忽略了重要影响。
本研究采用社会认知框架来确定可能因教育而改变的变量。采用混合设计来评估两种干预方法，两种方法均包括教育。五十名老年人在一项干预前后两次完成中风知识和信念的测量：干预要么是标准的（教育手册加上与中风无关的活动），要么是强化的（教育手册加上旨在增强对中风信念的活动）。结果测量指标包括健康信念、为降低中风风险而锻炼的意愿以及中风知识。
选定的信念随时间有显著变化，但在不同条件下无差异。发生变化的信念有：（a）感知到的中风易感性，以及（b）感知到的锻炼对降低风险的益处。特别是益处信念与锻炼意愿密切且呈正相关。
研究结果表明，患者教育的基本方法可能会影响健康信念。持续考虑健康信念在这类项目中的作用，可能会产生更有效的中风预防项目。
