结构化健康教育对青少年情绪相关障碍患者照顾者压力的影响

Effect of structured health education on the caregiver burden of adolescent patients with mood disorders

中文关键词:  结构化健康教育  青少年情绪相关障碍  照顾者

英文关键词:Structured health education  Adolescent mood disorders  Caregiver

中文摘要:

      背景 青少年情绪相关障碍的疾病负担日益加重，照顾者面临的心理和照顾压力较大。现有健康教育的形式和培训机制存在不足，难以满足照顾者的需求。目的 探讨结构化健康教育对青少年情绪相关障碍患者照顾者压力的影响，为减轻其照顾压力提供参考。方法 连续纳入2020年6月1日—2022年7月31日在绵阳市某三甲医院儿童心理卫生科住院的青少年情绪相关障碍患者的照顾者（n=195）为研究对象。采用随机数字表法分为研究组（n=99）和对照组（n=96）。两组均接受常规健康教育，研究组在此基础上接受3个模块的结构化健康教育，内容涵盖疾病知识、药物管理、家庭压力应对和日常生活指导。入院时，采用自编问卷收集照顾者及被照顾者的基本信息。患者入院时、出院当天及出院后1、3、6个月，使用中文版照顾者压力量表（CSI）评定照顾者的压力水平；于患者出院当天，采用自编健康教育反馈问卷收集照顾者对健康教育的反馈；患者出院后6个月，记录被照顾者再入院情况。结果 最终完成研究者，研究组85名（85.86%）、对照组84名（87.50%）。广义估计方程结果显示，研究组和对照组CSI评分的时间效应、时间与组别的交互效应均有统计学意义（Wald χ²=790.347、10.047，P<0.05或0.01）。两组疾病信息获取渠道、信任偏好和核心信息需求比较，差异均无统计学意义（P均>0.05）；研究组对被照顾者疾病相关知识了解程度以及对健康教育的有效性评价均优于对照组，差异均有统计学意义（P均<0.01）。结论 与常规健康教育相比，结构化健康教育可能有助于缓解青少年情绪相关障碍患者照顾者的压力。

英文摘要:

      Background The adolescent mood disorders become more prevalent， imposing progressively greater perceived and actual caregiving burdens on caregivers， while the current health education resources， delivery formats and training programs remain insufficient in addressing their needs.Objective To evaluate the effect of structured health education on the caregiver burden associated with adolescent mood disorders， thereby informing evidence-based strategies for alleviating the burden.Methods A total of 195 caregivers of adolescent inpatients with mood disorders admitted to a tertiary general hospital in Mianyang from June 1， 2020 to July 31， 2022 were consecutively enrolled and randomly assigned to either the research group （n=99） or the control group （n=96） using random number table method. Both groups received routine health education. In addition， the research group participated in a structured health education program comprising three modules covering disease knowledge， medication management， coping with family stress， and guidance for daily living. Upon admission， baseline information regarding both caregivers and adolescent inpatients was collected though a self-administered questionnaire. Caregiver Strain Index （CSI） was administered to assess caregiver burden at admission， discharge， and 1， 3 and 6 months post-discharge. A self-designed health education feedback questionnaire was administered on the day of discharge to evaluate caregivers' feedback on the health education. At 6 months post-discharge， data on any hospital readmission were collected.Results Ultimately， 85 caregivers （85.86%） in the research group and 84 caregivers （87.50%） in the control group completed the study. Generalized estimating equation analysis revealed significant time effects and group-by-time interaction effects on CSI scores between the two groups （Wald χ2=790.347， 10.047， P<0.05 or 0.01）. There was no statistically significant difference between the two groups in terms of access to disease information， trust preference and core information needs （P>0.05）. Additionally， caregivers in the research group reported significantly better understanding of the disease-related knowledge and higher ratings on the effectiveness of health education when compared to the control group， with statistically significant differences （P<0.01）.Conclusion In contrast to routine health education， structured health education may help alleviate caregiving burden among caregivers of adolescents with mood disorders.［Funded by Sichuan Medical Association Project （number， Q190004）］