摘要
目的 分析市场营销4C理论即顾客（customer）、成本（cost）、方便（convenience）、沟通（communication）在结核病患者健康教育中的应用效果.方法 选择2016年1月至2016年12月在上海市肺科医院住院治疗的结核病患者7176例,采用类实验性研究方法,将就诊结核一科和结核二科的患者分别作为实验组（3864例）和对照组（3312例）,每个科各2个病区.对照组患者根据住院后事件发生的时间顺序按照常规的健康教育方法进行宣传教育（简称“宣教”）,包括入院时的环境、医护人员介绍,住院期间治疗、检查、用药、饮食等宣教及出院前随访、康复宣教.实验组患者根据整合营销4C理论,以患者的需求为导向,包括健康教育需求评估、健康教育的实施、健康教育的效果评价.对两组实施健康教育的效果用本院住院患者健康教育效果评价表单（表单内容包括宣教内容、宣教方式、宣教材料、宣教时间、宣教人员能力5个项目）及护士实施健康教育内容所需要的日累计时间和患者结核病防治核心信息及知识要点知晓测评表平均得分（测评表共20个单选题,每题5分,满分100分）进行评价.结果 对照组3312例住院患者健康教育效果评价表单宣教内容、宣教方式、宣教材料、宣教时间、宣教人员能力各条目平均得分分别为（3.08±1.07）分、（2.21±1.06）分、（2.54±1.07）分、（2.76±1.15）分、（2.17±0.70）分,实验组3864例患者的得分分别为（4.15±0.49）分、（3.82±0.69）分、（4.13±0.74）分、（3.97±0.70）分、（4.02±0.68）分,差异均有统计学意义（t值分别为9.15、8.20、8.31、9.31、9.11,P值均＜0.05）.对照组护士实施人院宣教、饮食宣教、用药宣教、检查宣教、疾病宣教、治疗宣教、出院宣教各项所需要的日累计时间分别为（20.34±4.51）min、（19.88±3.47） min、（52.64±8.77） min、（19.56±3.59） min、（62.17±6.22） min、（22.44±4.36） min、（28.76±5.83） min,实验组分别为（9.17±2.50） min、（15.64±2.91） min、（20.33±5.68） min、（13.61±3.55） min、（36.72±6.04） min、（13.45±2.06） min、（15.72±3.46） min,差异均有统计学意义（t值分别为7.12、6.99、11.21、5.62、10.54、8.47、8.44,P值均＜0.05）.患者结核病防治核心信息及知识要点知晓测评平均得分对照组和实验组分别为（71.01±8.90）分和（92.64±5.17）分,差异有统计学意义（t=7.13,P=0.000）.结论 利用市场营销4C理论制定结核病患者健康教育方案,能满足患者对健康教育内容及方式的需求,缩短护士实施健康教育的时间,提高患者对健康教育内容的掌握程度.
Objective To analyze the application effectiveness of the Marketing Theory of 4C （customer,cost,convenience and communication） in health education to patients with pulmonary tuberculosis （PTB）.Methods A total of 7176 PTB patients who hospitalized in Shanghai Pulmonary Hospital from January 2016 to December 2016 were enrolled in this study.The quasi-experimental research design was used to divide the enrolled patients into two groups：experimental group （3864 cases） and control group （3312 cases）.The patients in the control group received the conventional health education following the order of events occurring after hospitalization：introduction of the hospital environment and medical staff,treatment,examination,medication and diet during hospitalization period,as well as the follow-up and rehabilitation education before leaving hospital.The patients in the experimental group were given the health education with a comprehensive program developed by using the marketing theory of 4C.This health education program was oriented by the patients＇ needs,and was developed following health education needs assessment,health education implementation and health education effects evaluation.A hospital health education evaluation form （including 5 items.：education contents,teaching methods,teaching materials,education time and ability in providing education）,the average daily cumulative time spent on health education （the average value of the cumulative time that all nurses spent on health education） and the average score that the patients obtained based on their awareness to the core information and knowledge points （a total of 20 single choice questions,and each question was worth 5 points,the total was 100 points） were used to evaluate the health education effectiveness in the two groups.Results As for the evaluation form of the hospital health education effectiveness,the average scores on education contents,teaching methods,teaching materials,education time and ability in providing education were 3.08± 1.07,2.21± 1.06,2.54± 1.07,2.76± 1.15,2.17±0.70 in 3312 cases of control group;those scores were 4.15±0.49,3.82±0.69,4.13±0.74,3.97±0.70,4.02±0.68 in 3864 cases of experimental group.The differences were statistically significant （t=9.15,8.20,8.31,9.31,9.11;P〈0.05）.The average daily cumulative time that the nurses carried out the hospital admission education,diet education,administering medicine education,examination education,disease education and treatment education,hospital discharge education in the control group was （20.34 ± 4.51） minutes,（19.88 ± 3.47） minutes,（52.64 ± 8.77） minutes,（19.56±3.59） minutes,（62.17±6.22） minutes,（22.44±4.36） minutes,（28.76±5.83） minutes,respectively;those values in the experimental group were （9.17±2.50） minutes,（15.64±2.91） minutes, （20.33±5.68） minutes,（13.61±3.55） minutes,（36.72±6.04） minutes,（13.45±2.06） minutes,（15.72±3.46） minutes respectively;the average daily cumulative time in the experimental group was statistically significant shorter than those in the control group （t=7.12,6.99,11.21,5.62,10.54,8.47,8.44;P〈0.05）.The average scores of the patients＇awareness on the core information and knowledge were 71.01±8.90 in the control group and 92.64±5.17 in the experimental group （t=7.13,P=0.000）.Conclusion The health education program on TB developed by using the marketing theory of 4C can meet the needs of the patients with PTB on health education contents and methods,shorten the nurses＇ time on carrying out health education to the patients,and improve the patients to understand the contents of health education.
作者
朱毓萍
王琳
周景雯
Yu-ping WANG Lin ZHOU Jing-wen(The Second TB Department of Shanghai Pulmonary Hospital Affiliated to Tongji University School of Medicine, Shanghai 200433, Chin)
出处
《中国防痨杂志》
CAS
2017年第10期1035-1041,共7页
Chinese Journal of Antituberculosis
关键词
结核
健康教育
对比研究
4C理论
Tuberculosis
Health education
Comparative study
4Cs theory
