|关键词||上尿路结石 知识 态度 行为|
|其他题名||Study on knowledge, attitude and behaviour in patients with upper urinary tract calculus|
采用方便抽样法，选取北京市某三级甲等医院泌尿外科2013年12月1日～2014年5月31日期间因患上尿路结石住院治疗、符合入选条件的患者共246例为调查对象。在患者入院24小时内，收集患者的一般人口学资料和疾病相关资料，并采用自行设计的疾病相关知识问卷、态度问卷、食物频率表及国际体力活动情况调查表（(international physical activity questionnaire,IPAQ)）对调查对象进行疾病相关知识、态度与行为（饮食及活动）情况的调查，并将所得结果进行分析。
2． 上尿路结石患者疾病相关知识调查问卷总分20分,本次调查患者平均得分为（9.34±4.29）分，处于较低水平；其在所涉及的各方面知识中，基础知识及饮食知识得分较低差，饮水及治疗和预防知识的得分稍高；年龄较大的患者的相关知识得分低于年龄较小者（6.72±5.20 vs 10.31±4.23，P＝0.000）。
3． 疾病预防态度的相关态度的得分最低12分，最高20分，平均（18.75±1.44）分。以 “完全同意”和“同意”进行统计，97.6%的调查对象认为泌尿系结石的复发与饮食和活动有关系；93.5%的调查对象认为改变饮食习惯对结石的预防有必要；93.1%的调查对象认为适量增加活动对结石的预防有利； 94.3%的调查对象认为健康宣教可能使结石延缓复发，愿意接受医护人员的指导和宣教。
4． 在饮食行为方面，在饮食行为方面，本组上尿路结石患者米面谷类的摄入量411.8±187.0g/d，其中131例（53.3%）在正常范围内，115例（46.7%）高于正常；油类摄入量36.7±15.4 g/d,只有53例（21.5%）在正常标准内，仅占调查总数的21.5%；蔬菜和水果摄入量355.1±225.9 g/d和73.9±70.1g/d,低于正常低限的有114例（46.3%）和215例（87.4%）；奶制品的摄入量107.0±106.1g/d，符合要求的只有5例，低于正常的达241例(98.0%)；食盐的摄入量10.5±5.2 g/d，有172例（69.9%）超标；肉类和蛋类的摄入量136.0±90.4g/d和52.9±37.2g/d，172例（69.9%）和146例（59.3%）超标。
5． 在体力活动方面，其中48例患者有重体力活动，246 例患者每周静坐时间为9.80 h～64.53 h(31.3±13.8h)，按照IPAQ分类方法， 本组患者有50例(20.3 %)体力活动活跃属于高体力活动者， 131例（53.2 %）为适中体力活动者，65例（26.4 %）为不活跃的低体力活动者。
6． 相关分析发现：与上尿路结石患者蔬菜摄入相关的是性别、发病情况、有无泌尿道管路。肉类摄入量相关的因素是性别、工作状态、体重指数。饮水量相关的是性别、年龄、疾病知识、疾病态度，与食盐的摄入有关的是性别、工作状态、发病情况和疾病态度，与体力活动情况有关的因素是工作状态、体重指数、文化程度、疾病知识、疾病态度及年龄, 多因素相关的分析发现:患者性别、发病情况、工作状态、体重指数、疾病知识及态度得分对上尿路结石患者的行为产生一定影响男性的食盐摄入量较女性高，复发的患者蔬菜的摄入量反而不如初发的患者，在职的患者蔬菜的摄入低而肉类的摄入高，体重指数越高的患者肉类摄入越多而活动越少，疾病知识得分高和疾病态度积极的患者在食盐的摄入、体力活动情况及水的摄入量情况好于得分较低的患者。
To investigate the situations of the disease-related knowledge, attitude and behavior (KAB)of patients with upper urinary tract calculi in a Third-Grade Class A hospital.To analyze the correlations between the patients’ disease-related knowledge, attitude and behavior, and to discuss how to improve their cognitive ability and the attitude to urolithiasis, as well as the healthy lifestyle. To provide the evidence for comprehensive scientific health education in clinical practice.
Using convenient sampling method, 246 qualified patients with upper urinary tract calculi were collected from a Department of Urology in a Third-Grade Class A hospital of Beijing during the period from 1st Dec,2013 to 31st May, 2014. The General demographic information and medical history was collected within 24 hours of admission. We took Disease related knowledge questionnaire, attitude questionnaire、food frequency questionnaires and international physical activity questionnaire(IPAQ) for interview and analysis.
1. 246 cases involved in our research group, the oldest was 76 years old, and the youngest one was at the age of 18 among them. The mean age is 45.84±11.14. In the whole group, recurrence occurred in 154 patients, and the rate is 62.6%. Overweight and obese was found in 148 patients for 60.2% of the population in this group.
2. The total points were 20 of the related knowledge questionnaire. The patients scored 9.34±4.29 which showed a low level. In this section, basal knowledge and dieting knowledge was poorer while the knowledge of drinking water, treatment and prevention was richer. Elder people had less related knowledge than youngers. （6.72±5.20vs10.31±4.23，P＝0.000）
3. The score interval of questionnaire about disease prevention attitude were between 12-20 with an average level of 18.75±1.44. Statistical Analysis was processed in the way of “agree” or “absolutely agree”. 97.6% people found the recurrence of upper urinary tract calculi was correlated with dieting and activities. 93.5% of them recognized modification of dieting habit was of great help in calculus precaution. Among them, 93.1% considered it necessary to take more activities to prevent calculus. In addition,94.3% patients thought health preach could delay the calculus recurrence and they were willing to receive the guidance and education from the medical staffs.
4. In the dieting section, the daily intake of cereal food of the patients in our group was 411.8±187.0g/d. 131 cases were in the normal range(53.3%) and 113 cases(46.7%) were above the normal. The oil uptake was 36.7±15.4 g/d and only 53 cases(21.5%) was in the normal range. People in our group had 355.1±225.9 g/d and 73.9±70.1g/d of vegetables and fruits. 114 cases (46.3%) and 215 cases were below the limit of vegetables and fruits uptake. Only 107.0±106.1g/d milchigs were taken in the population in our group and there were just 5 subject meeting the requirements. Salt uptake was a little heavier, the daily average was 10.5±5.2 g. 69.9% of them exceeded the limits. Meat and eggs were taken in at the level of 136.0±90.4g/d and 52.9±37.2g/d. 172 cases (69.9%) and 146 cases (59.3%) were over proof.
5. In the physical activities, 48 of 246 had taken hard physical labor. The seating time of the whole group is 9.80h～64.53 h(31.3±13.8h). According to the IPAQ, 50 patients (20.3%) had high physical activity, 131 patients (53.2%) had moderate physical activity, and 65 patients (26.4%) had inactive physical activity.
6. Through correlation analysis we demonstrated, vegetables uptake in the patients with calculus was correlated with gender, incidence and the existing of urinary tract.Meat uptake was related to gender, work status and body mass index. Water drinking was related to gender, age, disease knowledgeand attitude. Salt uptake was associated with gender, work status, incidence and disease attitude. The correlated factors with physical activities were work status, body mass index, education level, disease knowledge, disease attitude and age. The correlation analysis demonstrated gender, incidence, work status, body mass index, disease knowledge and attitude could affect the behaviors of the patients with calculus. Male ate saltier than female. Recurrence patients had less vegetables than others. Working people took more meat while less vegetables. The ones with higher BMI ate too much meat but less exercise. When the people got higher scores in disease knowledge and had healthier attitude to disease, they showed us a better performance than the others.
Patients with upper urinary tract calculi had positive attitude in disease treatment and precaution, however, they were short of disease-related knowledge. Disease behavior (dieting and activities) was unsatisfactory. Gender, incidence, were work status, body mass index, disease knowledge, education level anddisease attitude exerted an influence in the behavior of the patients.Male ate saltier than female. Recurrence patients had less vegetables than others. Working people took more meat while less vegetables. The ones with higher BMI ate too much meat but less exercise. When the people got higher scores in disease knowledge and had healthier attitude to disease, they showed us a better performance than the others. Thus, in order to prevent disease and improve the way of life, we should modify the way of dieting and activities. It is the key to increase the knowledge. What’s more, due to the variation with each individual, it is necessary for medical workers to pay more attention on the targeted and individualized disease propaganda and education to the society.
|刘春霞. 上尿路结石患者疾病相关知识、态度与行为情况的研究[D]. 北京大学护理学院. 北京大学,2014.|