TAP GHI Y DLfOC LAM SANG 108 Tap 7- Sfi 4/2012
Danh gia hieu qua can thiep b^ng truydn thong giao due SU'C khoe trong quan ly di§u tri benh dong kinh tai cong ddng
Assessing the Effectiveness of Communicational Interventions in Healthcare Education in the Management of Epilepsy Treatment in the Community
Tran Van Tuan Truang Dgi hgc Y Duac Thai Nguyen
Tdm t i t
Muc tiiu: Danh gia hifu qua can thifip bing truyin thong giao dye site khofi trong quin ly dieu tri bfnh dong kmh tai cong dong. Doi tugng vd phuang phdp: gom 96 bfnh nhan va ngudi nha bfnh nhan dong kinh, sit dyng phuong phap can thifp CO doi chyng. ^ I t pud: kiln thye hilu b i e t v l bfinh dpng kmh mUc dp khi dnhdm can thifp tang la 43,8 % (chi so hifu q u i 527%; p < 0.05). MUc dp yeu ve kien thUc glim dupc 85.4% (chi so hifu qua 97%;
p < 0.05); thai dp dat mye khi v l bfinh dpng kinh d nhdm can thiep tang la 28,1% (chl sfi hieu q u i 64%; p < 0,05), MQc do yeu ve thai dp giim dupc 26,1% (chi so hieu q u i 8%; p < 0,05); thyc hanh ve bfinh dong kinh mUc do kha sau can thiep tang la 34,4 % (ehi so hifiu q u i 110%; p < 0.05). MiJc do yeu ve thuc hanh giam dupc 51,1% (chi so hifu qua 73%; p <0.05). Kit lugn: can duy tri bifn phip can thif p bing giio due nang eao nhan thyc ve bfinh dpng kinh cho cpng dfing.
Tirkhda: dong kinh, giao due sUc khde
Summary
Objective: To assess the effectiveness of communicational interventions In healthcare education in the management of epilepsy treatment in the community. Subjects and Methods: Studying 96 epileptic patients and their relatives, using the control interventional method. Results: The knowledge of epilepsy fair level rise in the interventional group was 43.8% (the efficiency index of 527%, p <0.05). The low level of knowledge reduced by 85.4% (the efficiency index of 97%, p <0.05), reaching a fair level attitude Increase about epilepsy in the Intervention group by 28.1% (the efficiency Index of 64%, p<0.05). The low level of attitude reduced by 26,1% (the efficiency index of 8%. p <0.05). The low degree of epilepsy practice after intervention Increased by 34.4% (the efficiency index of 110%. p <0.05). The low level of practice reduced by 51.1% (the efficiency index of 73%. p <0.05).
Conclusion: There is the need to maintain interventions in education to raise awareness of epilepsy in the community.
Keywords: epilepsy, health education.
Phan bifn khoa hpc: GS.TS. NGUYEN VAN THONG
l . D a t v a n d e
Dfing kinh I I v i n d l efi y nghTa kinh t l - x i hfii r i t quan trpng. VI I I mfit b f n h mgn tinh b i l u h i f n d dgng hoat dpng eon. nhung fi giai dogn ngoii cdn b f n h n h i n van cd t h i sinh hogt v l tham gia d c hogt dfing x i hfii blnh thudng. Tii nhyng n i m 1960 d i l u trj dfing kinh dUpc chuyen hudng t y cic b f n h vifn, d c trung t i m sang hudng q u i n 1^ v i d i l u trj tgl cfing dfing I I chii y l u . Xu hudng mdi n i y d l tgo nhilu d i l u kifn t h u i n Ipl cho b f n h n h i n dpng kinh trong vifc hfia n h i p vdi cfing dfing. Tuy nhifin, vific d i l u trj tgi cfing dfing cung cfi nhUng khfi k h i n n h i t djnh nhu q u i trinh q u i n l y v l g i i m sit sy c h i p h i n h y Ifnh ciia ngufii bfnh, q u i trinh theo dfii d i l u trj v i n cfin gap nhilu khd khin, do b f n h n h i n cdn g$p n h i l u t i e dgng khfing mong mufin. Dfing thdi, vifc t u i n thil c h l dfi d i l u trj de d l phfing cdn dfing kinh t i i p h i t ehua dupc thuc h i f n tfit, d i n d i n sy x u i t hifn tinh trgng khing thufic d b f n h n h i n dfing kinh. Vifc x i y dyng mfit mfi hinh q u i n ly d i l u trj bfinh n h i n dfing kinh dupc phfi cap va thong nhat trong cfing dfing sao cho h i f u q u i luon dUdc su quan tam cua cic n h i chuyin mfin cung nhu ele n h l hoach djnh k l hogch c h i m sdc q u i n i'j/ Y t l . Do viy, de nang cao k i l n thyc ve b f n h v l sy dung thufic hpp ly eho ngudi bj dfing kinh v i ngUdi d i n trong cfing dfing la h i t syc d n t h i l t Xuit p h i t t y thyc t l trfin, chung tdi t i l n hanh thyc h i f n de t i i n i y n h i m muc t i l u : "Odnh gid hieu qud can thiep bdng truyen thdng gido due sdc khoi trong qudn ly dieu tri benh dong kinh tgi cgng dong".
2. Dot tupng vi phuong phip nghien cdu 2.1. Ddi tuang nghiin cihi
• Gfim cic bfnh nhin dpng kinh hifn dang sfing tai d c x l , phudng trong cpng dfing dan eutlnh Thii Nguyen.
- Ngudi n h l b f n h nhan dpng kinh dang sinh hoat tai d c hp gia dinh cung vdi ngUdi b l n h .
• Tiiu chudn lUa chon ddi tugng nghiin cdu - Chpn bfinh n h i n : dya theo tilu chuan chan d o i n benh ciia Liln hfii Qufic te Chfing Dfing kinh. Cin eQvio i i m sing k i t hdp vfii cTf n n i o do [BJ.
- Ngudi n h l song eiing gia dinh vdi bfinh nhan trong cfing dfing, de dua v i o nhdm can thiep cDng vfii b f n h nhan tai ele dja diem lya chpn.
* Tiiu chudn logi trd: Khdng hdp t i c trong q u i trinh trien khai mfi hinh can thiep.
2.2. Thdi gian vd dia diem ngbiin cut/
* Thdi gian nghiin cdu: Tii t h i n g 1 n i m 2009 d i n t h i n g 12nim2010.
* Dja diem nghifin cyu: 4 x l , phudng trong tinh T h l i Nguyen.
2.3. Phuang phdp nghiin cdu
2.3.1. Thiit ki nghiin cdu: Phuong p h i p can thiff trUdc v i sau cfi dfii chyng.
2.3.2. CdmSu: Ccf m l u can t h i f p : c6 m l u ti'nh thee cfing thifc [2]
P,: TJ If nh|in thyc v l dfing kinh theo k i t q u i dieu tra trudc I I 0,3 [1].
Pj: Tf i f mong mufin dgt dUpc sau can thifp, dy kiln dgt dupc l i 0,6.
a: Myc y nghia thfing kf, xic suit cCia vifc pham p h l i sai l i m logi II, l i y I I 0,05
P: Xic suit sai l i m loai II, l i y l i 0,1.
f (o.p): Tra t y b i n g tUOng yng vOI g i i trj a.p dupc lOA Thay v i o cfing thJc tinh dupe n = 52,5. Treing qui trinh nghiin eyu d l chpn c l b f n h n h i n v i ngudi nhl dupc 96 ngufii d nhfim can thifp v l 90 nguOt fi nhfim doi chiJing. Do vfy, d i m b i o dUpc dfi tin ciy cua mau nghifn ciJfu
2.3.3. Phuang phdp chgn mdu
' Chgn dja diim di triin khai md hinh can thiip: chpn hai ddn vj I I dja d i l m can t h i f p dfi I I phudng Thjnh Dan v l xa Quylt T h i n g ; hai ddn vj l i m nhfim dfii chyng do 1^
xa H o i Thupng v l x l Cao Ngan, trong hai dja bin trien khai nhdm can t h i f p v i nhdm dfii chijfng cfi tuong dong v l vj tri dja ly v l d i l u kjin kinh t l - x l hfii, vile di lai d hai dja b i n t h u | n lpi cho vifc k h i o s i t cung nhu tien hanh can t h i f p v i theo ddi. Tgi hai dja ^ I m can thifp chpn dupe 96 ngudi, hai dja diem doi chifng chpn dUpc 90 ngudi (gfim b f n h n h i n v l ngudi n h i b f n h nhin). Cd mau n h u v l y d i m b i o dudcdd tin d y trong nghifn culU.
2.4. Cdc bu6c tiin hdnh: nghifin eiiu dupc tiln hanh qua cie budc sau:
- Thinh l i p Ban chl dgo md hinh can thifip tai phudng Thjnh D i n v l xa Quylt Thing I I dja ban can thifp, bao gfim: trudng trgm y t l x l , c i n bp phu trach q u i y thufic ciia trgm y t l x l , d c n h i n vien y t l difin bin d cic tfi can t h i f p .
- Md Idp t i p h u l n cho cic thanh v i l n trong Ban chl dgo md hinh can t h i f p .
- Nfii dung t i p h u l n d l e l p d i n benh dfing kinh vJ d e y l u tfi nguy cd g i y b l n h : cleh nhan b i l t ban dau b i l u h i f n b f n h , cic y l u to nguy cd gay bfnh, xiJf tri ban d I u khi bj b f n h tgi cfing dong v i cich d y phfing benh tai p h i t .
- Phuong p h i p hogt dfing eiia mfi hinh:
+ Tfi chitc d c budi hogt dfing truyin thfing giao due site k h o i ve b f n h dfing kinh v i d c h phfing bfnh, each vil tri ban d i u khi b f n h x i y ra (3 t h i n g /Iln). CIc cufic hpp 36
T i p 7-So 4/2012
dupc to chQc tgi phUdng, to d i n pho, b f n h n h i n va ngUdi n h i dUdc thao l u i n v l p h i t t i i lifu pho cap kien thyc cd b i n ve b f n h dpng kinh.
-)- Tram trufing y te. n h i n vien y t l thfin b i n v l chit nhiem de t l i chju trach n h i l m to chQc d c buoi truyin thong, giao dye syc khofi cho ngUdi nha va bfnh n h i n dpng kinh tai dja b i n can thifp. Dfing thdi g i i i d i p d c thac mle v l b l n h tat va d c van d l khic cfi lifin quan den benh dpng kinh.
- Giim sat qua trinh can thifip: do cac t h i n h vifin tham gia de t i l phoi hop vfii tram trudng y te cd sd thyc hifin.
- Sau thfii gian thy nghiem md hinh can thifip, t i l n hanh dieu tra lai nhfim can thifip tgi phudng Thjnh Dan, xa Quyet Thing v l nhom ehyng tgi hai x i : Cao Ngan, Hoa Thupng. So sanh trudc va sau nghien eyu, dfing thdi so sanh giQa nhdm can thifip va nhfim dfii ehumg,
2.5. Chi tieu nghiin cihi - Tuoi, gicfi. trinh do v i n h o i .
- Thyc trang k i l n thUc, thai do, thyc h i n h ciia bfinh nhan dfing kinh v l ngUfil n h i .
3. Kit q u i nghien cdu
- Danh gia hieu q u i ciia mo hinh can t h i f p q u i n ly d i l u trj b l n h dpng kinh.
2.6. Cdc chi sd ddnh gid
2.6.1. Chlsdvi KAP (Knowledge-Attitude-Practice) Dfii vdi nhdm can thifp va nhdm chyng, dya vao each tfnh diem cho d c p h i n kiln thdc, thai dfi, thye hinh, trong moi phan tinh long diem l i 10.
- X i p logi khi: sfi d i l m s: 7
- Xip loai trung binh: sfi d i l m t y 5 den 6 diem - Xip iogi ylu: sfi d l l m < 5
2.6.2. Chlsd hiiu qud:de danh g i i trUdc v i sau can thifip
Chl so hifu q u i p,
Trong dd P, l i t^/ I I trUfic can thifp. Pj l i ty' if sau can thifp.
2.7. Xdiysdlieu: Xd iy so iifiu bing phan mem thong kfi y hoc SPSS 16.0 va Epi Info 6.0.
B i n g 3 . 1 . D i e d i e m c h u n g c u a n h o m c a n t h i e p v i n h f i m d o i c h d n g
"^——^.__^^ N h o m Gidl ~ ~ - — — - _ _ ^ ^ N a m
Nijf
Trinh 36 van hoa
Biet doc. Viet T i l u hoc THCS THPT T r u n g , D H Tuoi t r u n g b i n h
N h o m can t h i e p n 48 48 15 20 38 17 6
50,0
%
50,0 15,6 20,8 39,6 17,7 6,3 45,6 ± 1 7 , 0
N h o m doi c h i i n g n
41 49 12 18 31 25 4
45,6
%
54,4 13,3 20,0 34,4 27,8 4,5 44,6 ± 16,3
P
>0,05
> 0 , 0 5
> 0 , 0 5
> 0 , 0 5
> 0 , 0 5
>0,05
> 0 , 0 5
>0,05 Nhdnxet. So sanh giya hai nhdm trUdc khi tien h i n h nghifin eyu khong thay co su khac bift ve tuoi v i gidi, trinh dp van hoa vfii p>0.05.
Bing 3.2. ThUc trang kien thdc, t h i i dp, thUc hanh cua hai nhom trUdc nghien cdu Dja d i e m
Kien thifc
Thai 36
T h u c h a n h Kha T r u n g b l n h Ylu Kha T r u n g b i n h Yeu Kha T r u n g b i n h Yeu
T o n g
N h o m can thiep n 8 4 84 42 23 31 3 26 67 96
8,3
%
4,2 87,5 43,8 23,9 32,3 3,1 27,1 69,8 100
N h o m d o i chumg n
4 8 78 44 26 20 3 30 57 90
4,4
%
8,9 86,7 48,9 28,8 22.2 3,3 33,3 63.4 100
P
> 0 , 0 5
> 0 , 0 5
> 0 , 0 5
JOURNAL OF 108 - CLINICAL MEDICINE AND PHARMACY Vol7-N°4/201
Nhdn xit Thilc trang k i l n thdc, t h i i dd, thye h i n h cCia c i hai nhdm can t h i | p vi nhdm ddi chdng, trudc khi tli h i n h cic b i | n p h i p can t h i | p v i theo ddi ddl chdng, khdng t h i y cd sy khie bl^t d eic mile d J k i l n thdc, t h i i d? v i tin h i n h v l b l n h ddng kinh vdi p > 0,05.
B i n g 3 . 3 . Sir thay ddl v l k i l n thilc, t h i l d f , thyc h i n h cda nhdm can thif p trKdc v l sau nghlln ci>u
^ ^ ^ ^ ^ T h d i gian
Chl sd KAP ^ ^ ^ ^
Kiln thufc
Thii dd
Thyc h i n h Khi Trung binh Ylu Khi Trung binh Yeu Khi Trung binh Ylu Tdng
Trudc can t h i f p n 8 4 84 42 23 31 3 26 67 96
%
8,3 4,2 87,5 43,8 23,9 32,3 3,1 27,1 69,8 100
Sau can t h i f p n 50 44 2 69 21 6 36 42 18 96
%
52,1 45,8 2,1 71,9 21.9 6,2 37,5 43,8 18,7 100
Chlsd h i f u q u i
(%)
527 990 97 64 8 80 1100
61 73
P
<0,01
<0,01
<0,01
Nhdn xit: Sau mfit n i m tien h i n h can thifp, ty If hieu b i l t k i l n thyc myc dfi k h i dfii vdl b f n h dfing kinh ting len dupe 43,8% (p < 0,01). k i l n thyc mye do y l u g i i m dupe 85,4% (p < 0,01), sy thay doi v l t h i i dfi v i thyc hinh dfiivdi bfinh ddng kinh cung cfi sU chuyen b i l n rd rft vdi p < 0,01.
B i n g 3 . 4 . Sirthay ddl ve kien thdc, t h i i dd.thtrc hinh cAa nhdm ddi chiiTng trudc v i sau nghlln cdu d
^ ^ ^ ^ T h d i gian
Chi sd KAP ^ ^ ^ ^
Kien thdc
Thai dd
Thuc hanh Khi Trung binh Yeu Kha Trung binh
Yeu Khi Trung binh Ylu Tdng
Trade nghien cdu n 4 8 78 44 26 20 3 30 57 90
%
4.4 8,9 86,7 48,9 28,8 22,2 3,3 33,3 63,4 100
Sau n g h l l n cufu n 7 9 74 49 28 13 4 36 50 90
%
7,8 10,0 82,2 54.5 31.1 14.4 4.4 40.0 55,6 100
Chlsd h i f u q u i
(%)
77 12 5 11 7 35 33 20 12
P
>0,05
>0,05
>0,0S
Nhdn xet Sau mdt n i m theo ddi, ty If h i l u b i l t k i l n thdc mdc d f k h i ddi vdi benh ddng kinh tang I l n duoc 3,4 * (p > 0,05), kiln thufc mdc dd y l u g i i m duoc 4,5 % (p > 0,05), sy thay ddi v l t h i i d f va thyc hanh ddi vdi b l n h ddng kinh cOng ed sy chuyen b i l n nhung sy khie biet khdng cd i nghia thdng k l vdi p > 0,05.
T i p 7-Sd 4/2012
Bing 3.5. So sinh sifthay ddi kiln thufc, t h i l d f , thUc hinh v l bfnh d f n g k cda nhdm can thifp v i nhdm ddl chufng sau nghiin cdu Dia diem
chlsd KAP ^ " ^ ^
Kien thdc
Thai dp
Thuc h i n h
Khi Trung binh Yeu Kha Trung binh Yeu Khi Trung blnh Y l u Tong
Nhdm ear n 50 44 2 69 21 6 36 42 18 96
thiep
%
52.1 45,8 2,1 71,9 21,9 6,2 37,5 43,8 18,7 100
Nhdm ddi chufng n
7 9 74 49 28 13 4 36 50 90
%
7,8 10,0 82,2 54,5 31,1 14,4 4,4 40,0 55,6 100
P
<0,05
<0,05
<0,05
Nhdn xit: So sanh ket q u i trUdc v l sau nghiin curu giUa hai nhfim thay chl sfi KAP d nhdm can thifp cd sy khic nhau rd r f t so vdi nhdm chdng d d c mdc dp d i t h i l n t i n g myc k h i va g i i m myc yeu. Sy khic bift n i y ed y nghTa thfing kfi vdi p<0,05.
4. Bin luin
4.1. Dgc diem chung cda nhdm can thiep vd nhdm ddi chuing
Ket qua dieu tra cho thay khong cd sy khie nhau v l dd tuoi d e l hai nhdm can thifp v i dfii chuTig, sU phin bfi tuong dfii dong d i u d d c nhfim tuoi va gidi. Trinh dp hpc van cua hai nhdm khic nhau khdng ed y nghTa thong ke, nhin chung chii y l u t y mUc trung hpc cd sd trd xuong. Tgi d c dja diem nghien cilfu. tuy la 6 gan khu vUc trung tam thanh pho, nhung van de hieu b i l t chung v l b l n h dfing kinh v i n edn rat thap, nguyen nhan cd the l i do hp ehUa thuc sy quan t i m den d n b f n h n i y hole do chUa dUpc cung d p day du nhQng thong tin ve bfnh va nhQng I n h hudng ciia nd doi vdi cupc song, mot so ngUfil khi dupe hdi ve bfinh thi hoan t o i n khong b i l l gi. Nhu d u d n d c djch vy y te de giai dap ve nhQng van de lifin quan den cham sfic sQc khoe d benh n h i n ddng kinh rat nhilu, so ngudi dupc phdng van thay rang d n to chQc cac buoi ndi chuyfin djnh ky hole cd ndi de hdi gill d i p thic mle ve bfnh dfing kinh chiem ty If rat eao.
Qua mpt sfi thong tin phdng van chung, ehung tdi thay vile thinh lap d c dja diem tgi ca sfi, de cd t l i lieu tham khio, t u v i n , giii d i p thac mac giup cho blnh nhan ddng kinh v l ngudi nha ciia hp n i n g cao nhin thiifc v l blnh tat nol chung trong dfi cfi bfnh ly dpng kinh la rat d n thilt.
4.2. Trien khai mo hmh can thiep qudn /^ dieu tri binh dgng kinh tgi cdng dong
Trong qua trinh trien khai md hinh can thifp, vific huy ddng nhan vifin y t l x l v l y t l thon bin tham gia v i o md hinh II r i t hpp ly. bdi vl ho la nhyng ngudi tryc t i l p quin ly va d p thufic eho bfinh nhin nfin r i t thuan lpi cho vifc trien khai k l hoach thyc hien.
Vdi chUdng trinh hoat ddng Idng ghep, phfii hpp, nhiem vu eOa tram trudng y te v i nhin vtfn y te thdn b i n g i n thfim mpt phan trach nhifm nda trong cdng tic truyen thong giao due sUc khoi eho benh nhin dfing kinh v l ngufii n h i cua hp tren dia ban minh q u i n ly. dd l i giup eho hp hilu bilt t h i m v l d c yeu to nguy cd gay bfnh ddng kinh v i d c h phong chong thich hdp de l i m giim ty If mdi mle, ty lfi t i i p h i t t)/ lfi til vong d mdc thap nhat, gdp phin ning eao chit lupng cudc song eho ngUdi bfnh.
Trong q u i trinh thyc hifn, vifc t r i l n khai d c hoat dpng ciia md hinh vfii mye chi phi khdng nhilu, nhung d i l u quan trpng la phai duy tri cho md hinh dupc hoat ddng iifn tuc va Iiu dai. cic t i c g i i cung nhan thay md hinh q u i n ly dieu trj bfinh dpng kinh tai cfing dong cd tinh k h i thi v i dp ben vijfng cao, chiing tdi hy vpng trong nghiin cyu tiep theo se danh g i i dUoc hieu q u i hogt ddng ciia mfi hinh dupe rd net hdn.
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JOURNAL OF 108 - CLINICAL MEDICINE AND PHARMACY Vol7-N''4/2013
4.3. W l u qud Clio mfi hinh can thl^p qudn ly di(u trj benh dgng kinh
Sau mfit n i m t r i l n khai cic hogt dfing can t h i f p tgl phudng Thjnh D i n v l x i Quylt Thing, mdc dfi k i l n thdc kha cua b f n h n h i n dfing kinh v i ngUdI n h l t i n g hon so vdl trUdc can t h i f p l i 43,8 %. Cdn d nhdm dfii ehyng sau mpt n i m theo ddi mdc dfi k h i v l kiln thyc chl t i n g I l n l i 3,4 %, sy chenh Ifch giQa hai nhdm cfi y nghTa thfing k l vdi p < 0,05. Mye dfi y l u v l kiln thyc fi nhfim can t h i f p sau nghifin cdu d l g i i m dupc 85,4%, cdn d nhfim dfil chdng ehi g i i m dupe 4,5 % (p < 0,05).
V I t h l i dp ciia bfnh nhin v i ngufii n h i dfii vdl bfnh dpng kinh cung efi sy thay dfii nhilu, mdc dfi khi d nhfim can thif p d l t i n g dupc tQ 43,8% Iln d i n 71,9%, sy thay dfil cd y nghTa thfing kfi vdi p < 0,05. Cdn d nhfim dfil chimg chl t i n g dupe ty 48,9 % d i n 54,5 %, sy khic bift khfing cfi y nghia vfii p > 0,05. Myc y l u v l t h i i dfi fi nhfim can thifp sau nghifin cdu giim dupc t y 32,3% xufing d i n 6,2% (p <0,05), nhung d nhdm doi chUng ty" If n i y thay dfii khdng d i n g k l chl g i i m dUdc tQ 22,2 % xufing d i n 14,4%{ p > 0,05).
V l thye h i n h dfii vdi bfinh ddng kinh, fi nhdm can t h i f p myc dfi k h i t i n g dupc t y 3.1 % dfin 37,5% (p < 0,05).
Cdn d nhdm doi chUhg mye dp k h i tang t y 3,3% den 4,4% (p > 0,05; chi sfi hifu q u i 0,33)). Myc dp y l u v l thyc hanh d nhdm can thiep g i i m dupe 51,1% (p < 0.05), cfin d nhfim doi chyng ty' If nay chi g i i m dupe 7,8% (p > 0,05;
chl so hifiu q u i 110,12).
So sinh ve d c chi so giQa hai nhdm, chung tdi t h i y ring ed sU thay doi tUOng dfii ro r f t sau mdt n i m trien khai md hinh can thifip v l q u i n ly d i l u trj b l n h dfing kinh tgi cdng dfing, tai dja diem trien khai md hinh can t h i f p cic chl so ve KAP cd Uu the trfii hOn so vfii nhdm dfii chyng, sy khic b i f t cd y nghia thfing k l vdi p < 0.05.
Shaw v l cpng sy [6], d i tiln h i n h khio sit v l nhgn thyc ciia ngudi dan Anh v l b l n h ddng kinh tgi cfing dfing thay ring kien thyc v l b f n h ciia ngudi d i n r i t t h i p , ele t i e g i i da d l xuat thiet ke md hinh t y q u i n 1^ d c chUdng trinh giao due, dya v i o vifc t i n g cUdng sy h i l u b i l t v l b f n h ddng kinh thfing qua d c phUdng p h i p t i c dfing v i o t i m ly ciia ngufii d i n trong xa hfij. d l c6 the n i n g cao k i l n thyc ve benh dfing kinh, l i m thay doi h i n h vi, v i g l l m t i n so cdn dpng kinh.
Stokes v l cdng sy [7], d l dUa ra k i t luan; cic chUdng trinh giao due m l cung cap mfit so each thdc de d i o tgo cho trfi em tai d c trufing hpc pho thfing, cd the n i n g cao kien thye ve benh ddng kinh. Tuy n h i l n , dpa t r i n d c b i n g ehyng thyc t l , ele t i c g i i cung cho b i l t chda the xle dinh mdc dp h i f u q u i ciia md hinh.
Radhakrisman [5], cho b i l t , g i n h n|ng h i f n tai cOc b f n h dfing kinh d d c nudc nghfo cd t h i dUpc g l i m thl^i b i n g cich g i i o dpc cfing chiing v l d c tinh n i n g tich ciii;
ciia cufic sfing vdi b f n h dfing kinh, b i n g d c h thdng bio cho b i c si cfing t i c d d c trudng t i l u hpc v i trung hpc v^
xu hufing h i f n nay trong q u i n 1;^ b f n h dfing kinh l i xiy dyng mfi hinh c h i m sfic t o i n d i f n b f n h dfing kinh, xem x i t tinh khfing dfing n h i t ciia b f n h v i nhUng Inh hi/dng ciia nfi d i n gia dinh, b f n h n h i n v l cfing dfing.
Mfit sfi t i c g i i n g h i i n cyu v l b f n h dfing kinh da dua ra g i l l p h i p q u i n 1^ b f n h tfit n h i t dfi I I d i o tao cho nhdng ngUdI chfing hole vp v l ngUdI n h i ciia bfnh n h i n , khuyin khfch hp tham gia v i o cic Ifip t f p hulnvl bfnh, cich d y phfing b f n h t l i p h i t v i sdm t i i hoa nhSp cfing dfing sau khi bj b f n h , vi vifc c h i m sdc cho bfnh n h i n dfil hdi p h l i tiln h i n h l l u d i i , cho n l n d c h tfit nhit I I p h i i dya v i o cfing dfing [3], [4].
Qua thfii gian theo dfii t h d nghifm mfi hinh can thifp q u i n ly d i l u trj b f n h dfing kinh tai cfing dfing, chiing 16i nhfn t h i y vifc t r i l n khai hogt dfing phfii hpp vdi tram yte x l v l n h i n v i l n y t l thfin b i n , d l tfi chdc d c bufii tniyin thfing g i i o dye sdc k h o i giup cho ngudi d i n hilu rd hon v l b f n h l i mfit vifc l i m h i t sdc d n t h i l t , phu hpp vfi! i ^ d u ciia b f n h n h i n v l ngUdi n h l ciia hp, hogt dfing niy dupe Ifing g h i p v i o ele boat ddng chung cOa tram y tl, n l n d e t h i n h v i l n tham gia r i t t h u i n ldi. Tuy nhila muon cho mfi hinh hoat dfing dupe tfit va duy tri l l u d i i can phSi efi vai trfi nong cfit ciia trgm y te, dfing thdi cfi sp tham gia chi dao ciia cic d p chinh quyIn d dia phuong v i sU phfii hpp ciia cic ban n g i n h d p tren. Dfing thdi d n h5 trd t h f m cho n h i n v i f n Y t l tgi d c trgm y t l x l , phufing mot ngufin kinh phf n h i t dinh d l khuyin khfch hp dam gia tfch eye v i o vifc duy tri mfi hinh hogt dfing niy.
5. K i t l u i n
Qua mpt n i m t r i l n khai md hinh can thifp bing truy^i thfing giio dpc sdc khde, chiing tfil rut ra mfit sfi kit luan sau
- Kien thdc h i l u b i l t v l b f n h dpng kinh miJc dp khi d nhfim can t h i f p t i n g I I 43,8 % (chi sfi h i f u q u i 527%;p
< 0,05). Mdc dfi y l u v l k i l n thdc g i i m ddoc 85,4% (chl so hifu q u i 97%; p < 0,05)
- T h l i dfi dgt mdc k h i v l b f n h dfing kinh d nhom can t h i f p t i n g l i 28,1% (chi so h i f u q u i 64%; p < 0,05), Myc dfi y l u ve t h l i dp g i i m dUpc 26,1% (chi sfi hifu qui B%; p < 0,05)
- Thyc h i n h v l b f n h dfing kinh mdc dp khi sau can t h i f p t i n g la 34,4 % (chi sfi hieu q u i 110%; p < 0,05). MiJc dfi y l u v l thyc hanh g i i m dupe 51,1% (chl sfi hieu qui 73%; p < 0,05).
40
Tap 7-So 4/2012
Tai lieu t h a m k h i o
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Tap chi Y hgc Thdnh phd Ho Chi Minh, tr 25-28.
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3 Dilorio, C, et al. (2009), IVebfose: development of a Web- based epilepsy self-management intervention. Prev Chronic Dis. 6(1): p. A28.
4 Neligan, A., R. Renganathan, and BJ. Sweeney (2006), Management of epilepsy in the community, ir Med J. 99 (2): p. 52-4.
Radhakrishnan. K. (2009). Challenges in the management of epilepsy in resource-poor countries. Nat Rev Neurol.
5(6): p. 323-30.
Shaw, EJ., et al. (2007). Self-management education for adults with epilepsy. Cochrane Database Syst Rev. (2); p.
CD004723.
Stokes, T., et al. (2007), Self-management education for children with epilepsy. Cochrane Database Syst Rev, (2):
P.CD004724.
WHO (2001), £p/7epsy. 165(168), pp3-79.
