标题：基于视觉传达理论的视频宣教结合回授法在痛风患者饮食及尿酸控制中的应用

      作者：刘荣华，万媛，李万玲，毛莉华    刘荣华，万媛，李万玲，毛莉华复旦大学附属华山医院北院护理部，上海 201906

      卷次： 2023年34卷8期

      【摘要】 目的 探究基于视觉传达理论的视频宣教结合回授法对痛风患者饮食知信行及尿酸水平的影响。方法 采用便利抽样法，选取2020年4~11月复旦大学附属华山医院收治的47例痛风患者作为对照组进行常规健康宣教，选取2021年1~8月我院收治的48例痛风患者作为观察组，采用基于视觉传达理论的视频宣教结合回授法干预，均于出院前3 d开展，干预前后比较两组患者饮食控制知信行水平、饮食习惯变化及尿酸水平。结果 最终有90例(对照组44例，观察组46例)患者完成研究；出院当天与出院后3个月，观察组患者的知识评分[(52.87±2.83)分、(53.46±2.51)分]、信念评分[(54.61±5.58)分、(56.87±4.73)分]、行为评分[(41.42±5.08)分、(42.67±5.21)分]明显高于同期对照组[(48.26±3.07)分、(49.28±2.84)分、(51.07±5.16)分、(52.36±5.27)分、(38.43±4.62)分、(39.92±5.86)分]，差异均有统计学意义(P<0.05)，且时间、组间及交互效应比较差异均有统计学意义(P<0.05)；两组患者的饮食习惯均较干预前改善，且观察组患者的肉类、啤酒、食用油、海鲜进食量明显少于对照组，差异均有统计学意义(P<0.05)，但两组间的蔬菜、水果摄入量比较差异均无统计学意义(P>0.05)；出院后3个月，观察组患者的尿酸水平为(406.27±26.45) μmol/L，明显低于同期对照组的(439.83±30.52) μmol/L，差异均有统计学意义(P<0.05)。结论 基于视觉传达理论的视频宣教结合回授法可提高痛风患者饮食控制知信行水平，改善饮食习惯，降低尿酸水平，具有一定的临床应用价值。
      【关键词】 痛风；视觉传达理论；视频宣教；回授法；饮食控制；尿酸
      【中图分类号】 R473.5 【文献标识码】 A 【文章编号】 1003—6350（2023）08—1163—06

Application of video education based on visual communication theory combined with teach-back method in dietand uric acid control of gout patients.
LIU Rong-hua, WAN Yuan, LI Wan-ling, MAO Li-hua. Department of Nursing,North Hospital, Huashan Hospital Affiliated to Fudan University, Shanghai 201906, CHINA
【Abstract】 Objective To explore the effect of video education based on visual communication theory combinedwith teach-back method on dietary knowledge and behavior and uric acid levels in patients with gout.Methods By con-venience sampling method, 47 patients with gout undergoing routine health education admitted to Huashan Hospital Affili-ated to Fudan University from April to November 2020 were selected as the control group, and 48 patients with gout ad-mitted to the hospital from January to August 2021 were selected as the observation group. The video education based onvisual communication theory combined with teach-back method intervention was carried out 3 days before discharge. Be-fore and after intervention, the levels of knowledge, behavior and practice of diet control, dietary habits, and uric acidlevels were compared between the two groups. Results A total of 90 subjects (44 patients in the control group and46 patients in the observation group) completed the study. On the day of discharge and 3 months after discharge, the scoreof knowledge [(52.87±2.83) points, (53.46±2.51) points], belief [(54.61±5.58) points, (56.87±4.73) points], and behaviorscores [(41.42 ± 5.08) points, (42.67 ± 5.21) points] in the observation group were higher than [(48.26 ± 3.07) points,(49.28±2.84) points], [(51.07±5.16) points, (52.36±5.27) points], [(38.43±4.62) points, (39.92±5.86) points] in the controlgroup (P<0.05). There were significant differences among different time points, between the two groups, and amongdifferent interaction effects (P<0.05). The eating habits of the two groups were improved compared with those beforethe intervention, and the intake of meat, beer, edible oil, and seafood was significantly less than that in the controlgroup, with statistically significant differences (P<0.05); however, there was no significant difference in vegetable andfruit intake between the two groups (P>0.05). Three months after discharge, the uric acid level in the observationgroup was (406.27±26.45) μmol/L, which was significantly lower than (439.83±30.52) μmol/L in the control group (P<0.05). Conclusion Video education based on visual communication theory combined with teach-back method can im-prove the level of knowledge, behavior of diet control in gout patients, improve eating habits and reduce uric acid level,which has certain clinical application value.
      【Key words】 Gout; Visual communication theory; Video education; Teach-back; Diet control; Uric acid