Abstract:

Objective To explore the application effect of health education based on gain and loss message framing on the treatment behavior intention and self-management of patients with high-risk diabetic foot. Methods From July to September 2024，convenience sampling was used to select patients with high-risk diabetic foot who were hospitalized in the endocrinology department of a tertiary general hospital in Guiyang as the study subjects. They were divided into 3 groups according to the admission time，with 30 patients in each group. The experimental group adopted health education based on gain message framing or framing loss message，while in the control group，health education was provided in a conventional manner. Before and after intervention，the differences of intervention effects among the 3 groups were compared by using diabetic foot pre-hospital delay intention questionnaire，diabetic foot care knowledge questionnaire and Chinese version of Nottingham foot care assessment scale（CNAFF）. Results Ultimately，29 cases in the gain framing group，29 cases in the loss framing group，and 29 cases in the control group completed the study. After intervention，the score of pre-hospital delay intention questionnaire of diabetic foot in the gain framing group was（21.48±4.32），and it was（24.31±2.49） in the loss framing group，and（17.76±5.03） in the control group. The difference among the 3 groups was statistically significant（F=18.725，P<0.001）；the loss framing group was superior to the gain framing group（P=0.01） and the control group（P<0.001）. After the intervention，the score of the CNAFF in the gain framing group was（55.83±3.06），and it was（59.14±2.90） in the loss framing group，and（48.66±2.58） in the control group. The difference between the 3 groups was statistically significant（F=102.245，P<0.001）. The loss framing group was superior to the gain framing group and the control group（all P<0.001）. Conclusion Health education based on the loss message framing is more conducive to improving patients’ intention to delay diabetic foot visits，leading to good foot care behaviors，and may provide an effective means of pre-hospital prevention and control of diabetic foot.

Key words: Message Framing, Diabetic Foot, Pre-Hospital Delay, Self-Management, Nursing

摘要：

目的 探讨基于收益与损失信息框架的健康教育对糖尿病高危足患者就诊行为意向及自我管理的应用效果。方法 于2024年7—9月，采用便利抽样法，选取在贵阳市某三级甲等综合医院内分泌科住院的糖尿病高危足患者作为研究对象，按入院时间将其分为三组，每组各30例。试验组采用基于收益信息框架或损失信息框架的健康教育，对照组采用常规方式进行健康教育。干预前后使用糖尿病足就诊延迟意向调查问卷、糖尿病患者足部护理知识问卷及诺丁汉足部护理评估量表比较三组干预效果的差异。结果 最终，收益框架组29例、损失框架组29例、对照组29例完成研究。干预后收益框架组糖尿病足就诊延迟意向调查问卷得分为（21.48±4.32）分，损失框架组为（24.31±2.49）分，对照组为（17.76±5.03）分，三组比较，差异具有统计学意义（F=18.725，P<0.001），且损失框架组优于收益框架组（P=0.01）及对照组（P<0.001）；收益框架组诺丁汉足部护理评估量表得分为（55.83±3.06）分，损失框架组为（59.14±2.90）分，对照组为（48.66±2.58）分，三组比较，差异具有统计学意义（F=102.245，P<0.001），且损失框架组优于收益框架组及对照组（均P<0.001）。结论 基于损失信息框架的健康教育更有利于改善糖尿病高危足患者的就诊延迟意向，促成良好足部护理行为，可为糖尿病足的院前防控提供有效手段。

关键词: 信息框架, 糖尿病足, 就诊延迟, 自我管理, 护理