LEARNS模式健康教育配合自信心训练在面部瘢痕修复患者中的应用

李燕 韩莹 王晓红 韩文娟

[關键词]LEARNS模式;健康教育;自信心训练;面部瘢痕修复;应用效果

[中图分类号]R473.75    [文献标志码]B    [文章编号]1008-6455（2021）11-0161-05

Application of Learns Model Health Education Combined with Self-Confidence Training in Patients with Facial Scar Repair

LI Yan，HAN Ying，WANG Xiao-hong，HAN Wen-juan

（Department of the Second Ward of Plastic Surgery，the First Affiliated Hospital of Air Force Medical University，Xi'an 710032，Shaanxi，China）

Abstract： Objective  To explore the application effect of LEARNS model health education combined with self-confidence training on patients with facial scar repair. Methods  A total of 106 patients with facial scars who were admitted to the authors hospital from January 2017 to January 2021 were selected as the research objects. The selected patients were randomly divided into observation group and control group with 53 cases in each group by convenience sampling method. Both groups were treated with repair surgery. After routine care， patients in the control group were given regular health education for intervention， and patients in the observation group were given LEARNS model health education and self-confidence training for intervention. The recovery indicators， negative emotions， inferiority levels， and inferiority levels of the two groups after intervention were compared. Coping style， quality of life score and complication rate. Results  After the intervention， the recovery index of the observation group was better than that of the control group， and the difference was statistically significant （P<0.05）. After the intervention， the negative emotion scores of the two groups were significantly reduced （P<0.05）， and the observation group decreased more significantly than the control group （P<0.05）. After the intervention， the inferiority complex scores of the two groups were significantly reduced （P<0.05）， and the observation group decreased more significantly than the control group （P<0.05）; after the intervention， the coping style scores of the two groups were significantly optimized. Among them， the face score increased significantly， the yield and avoidance scores decreased significantly （P<0.05）， and the observation group was better than the control group （P<0.05）. After the intervention， the quality of life scores and total scores of the two groups increased significantly （P<0.05）， and the observation group increased significantly compared with the control group （P<0.05）， during the intervention period， the incidence of complications in the observation group was lower than that of the control group （P<0.05）. Conclusion  Applying LEARNS model health education combined with self-confidence training can significantly improve the negative emotions and low self-esteem of patients with facial scar repair， make patients face treatment more actively， effectively reduce the occurrence of complications， and further improve the quality of life of patients and promote patient recovery. Worthy of clinical application.

Key words： LEARNS model; health education; self-confidence training; facial scar repair; application effect

LEARNS是由六个单词的首字母缩写构成，分别是聆听（Listen）、建立（Establish）、应用（Adopt）、提高（Reinforce）、反馈教学（Name）、强化（Strengthen），LEARNS模式健康教育是一种全程性健康教育模式，其核心内容是在平等互信的护患关系基础上为患者提供所需的健康信息，目前主要应用于慢病管理中[1]。当患者发生面部瘢痕时，临床一般需要用手术治疗的方法进行修复，包括瘢痕磨削、分区植皮、直接及分次除、局部皮瓣等[2]。但因面部皮肤立体感强，若想达到更好的修复效果并满足患者对美学方面的要求，则需要进行多次治疗[3]。因此治疗过程就会拉长，而在这整个治疗过程中患者对瘢痕的位置及可见度极为重视。若面部瘢痕面积较大或较为显眼，则会引起患者产生焦虑、抑郁、自卑等负面情绪并影响其身心健康[4]，进而影响其治疗的配合度和依从性，并增加并发症发生率，影响最终修复效果[5]。因此，需重视面部瘢痕修复患者的健康教育和心理护理，以解除患者的思想顾虑，增强战胜疾病的信心。既往临床护理中都使用常规健康教育干预，但效果都不尽如人意。故而，本研究采用了LEARNS模式健康教育配合自信心训练的护理模式，旨在探讨其在面部瘢痕修复患者中的应用效果。

1  资料和方法

1.1 一般资料：选取2017年1月-2021年1月于笔者医院收治的106例面部瘢痕患者为研究对象。纳入标准：①瘢痕主要位于面部;②瘢痕形成超过2周;③均实施修复手术治疗;④自愿参加本研究并签署知情同意书者。……