健康信念模型三维干预对慢性鼻-鼻窦炎的影响

摘要/Abstract

摘要： 目的基于健康信念模型(health belief model, HBM)构建多维度干预方案,评估其对慢性鼻-鼻窦炎(chronic rhinosinusitis, CRS)患者健康信念、治疗依从性及临床结局的改善效应。方法将110例CRS患者随机分为干预组(55例)和对照组(55例)。对照组接受常规诊疗,干预组加用为期6个月的HBM多维度干预:个性化健康教育+分层心理干预+医疗服务优化,随访时间为24个月。比较两组健康信念水平(HBM标准化得分)、治疗依从性(morisky medication adherence scale-8, MMAS-8)、症状严重程度(visual analogue scale, VAS)、焦虑状态(self-rating anxiety scale, SAS)、生活质量(sino-nasal outcome test-22, SNOT-22)、客观病变指标(Lund-Mackay CT评分)及生物学指标(血清IL-5、IL-13、TNF-α、鼻黏膜嗜酸性粒细胞计数、上皮损伤评分)。结果干预24个月后,干预组的HBM得分、MMAS-8得分、VAS得分、SAS得分、SNOT-22得分及Lund-Mackay CT评分均明显优于对照组(P均<0.001)。干预后12个月,生物学指标亦改善(P<0.001)。结论 HBM多维度干预可显著提升CRS患者的健康信念与治疗依从性,改善症状、焦虑、生活质量及鼻黏膜炎症。

关键词: 慢性鼻-鼻窦炎, 健康信念模型, 多维度干预, 治疗依从性, 认知行为干预

Abstract: Objective To develop a multidimensional intervention based on the health belief model(HBM)and explore its effects on health beliefs, medication adherence and clinical outcomes in patients with chronic rhinosinusitis(CRS). Methods A total of 110 patients with CRS were randomly allocated into intervention and control groups(55 participants per group). The control group received routine clinical management, while the intervention group was supplemented with a 6-month HBM-based intervention consisting of personalized health education, stratified psychological intervention and optimized medical services, followed by a 24-month follow-up. Outcome measurements included standardized HBM score, the 8-item morisky medication adherence scale(MMAS-8), visual analogue scale(VAS), self-rating anxiety scale(SAS), 22-item sino-nasal outcome test(SNOT-22), lund-mackay CT score, as well as serum IL-5, IL-13, TNF-α levels, nasal mucosal eosinophil count and epithelial injury score. Results At the 24-month follow-up, all assessment scores were significantly improved in the intervention group relative to the control group(all P<0.001). Significant improvements in biological indicators were observed at the 12-month follow-up(all P<0.001). Conclusion HBM-based multidimensional intervention effectively improves health beliefs, medication adherence, symptoms, anxiety, quality of life and nasal mucosal inflammation among patients with CRS.

Key words: Chronic rhinosinusitis, Health belief model, Multidimensional intervention, Treatment adherence, Cognitive behavioral intervention

中图分类号:

R765.4

梁绍钦,林歆胜,李佳佳. 健康信念模型三维干预对慢性鼻-鼻窦炎的影响[J]. 山东大学耳鼻喉眼学报, 2026, 40(6): 30-39.

LIANG Shaoqin, LIN Xinsheng, LI Jiajia. Effects of a three-dimensional intervention based on the health belief model on chronic rhinosinusitis[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2026, 40(6): 30-39.

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