通过多模式健康传播策略提高鼻腔冲洗依从性：一项分阶段改进研究

文献信息

中文摘要

慢性鼻炎患者对自我管理治疗的依从性通常很低，这往往给医疗保健带来重大挑战。慢性鼻炎患者对规律鼻腔冲洗卫生护理的依从性更低。因此，在本研究中，我们设计、实施并评估了一项以患者为中心的多模式健康传播策略干预，旨在提高过敏性鼻炎或慢性肥厚性鼻炎成年患者对鼻腔冲洗的依从性。这是一项医疗质量改进项目，于2025年1月至7月在一家医疗中心的耳鼻喉科门诊进行。该医疗质量改进干预分两个阶段进行。第一阶段干预引入了“多模式教育策略”，将视觉辅助工具、教学视频和一对一咨询与标准的简短口头指导相结合。第二阶段干预基于第一阶段的患者反馈，通过提供符合人体工程学的冲洗装置和可选的草药茶冲洗盐水溶液，进一步优化了用户体验。主要结局指标是鼻腔冲洗依从性从基线11.2%显著提高至第一阶段后的45.2%（p < 0.001），并在第二阶段后进一步提高至75.0%（p = 0.013）。与未接受多模式健康传播策略干预的患者相比，相对增加了569%（p < 0.001）。最后，接受多模式健康传播策略教育干预的患者知识掌握度从51%提高到93.8%，总体满意度也显著提高。该研究得出结论，鼻腔冲洗依从性低是一个可以克服的问题，而不是患者与医疗保健提供者之间不可逾越的沟通鸿沟。通过多模式健康传播策略进行的系统性以患者为中心的教育与自我鼻腔冲洗护理依从性的改善相关。

英文摘要

The adherence of chronic rhinitis patients to self-administered treatments is generally very low, which often presents a significant challenge in healthcare. The adherence of chronic rhinitis patients to regular nasal irrigation hygiene care is even lower. Therefore, in this study, we designed, implemented, and evaluated a patient-centered Multimodal Health Communication Strategy intervention, that aimed to improve the adherence to nasal irrigation of adult patients with allergic rhinitis or chronic hypertrophic rhinitis. This was a healthcare quality improvement project conducted from January to July 2025 in the otolaryngology outpatient department of a medical center. The healthcare quality improvement intervention evolved in two stages. The first-stage intervention introduced a "Multimodal Educational Strategy," combining visual aids, instructional videos, and one-on-one consultation with standard brief verbal instructions. The second-stage intervention, based on patient feedback from the first stage, further optimized the user experience by providing an ergonomic irrigation device and optionally available Herbal Tea Rinse saline solution. The primary outcome measure was that nasal irrigation adherence significantly increased from a baseline of 11.2% to 45.2% after the first stage (p < 0.001), and further increased to 75.0% after the second stage (p = 0.013). This represents a 569% relative increase (p < 0.001) compared to patients who had not undergone the Multimodal Health Communication Strategy intervention. Finally, patients who received the Multimodal Health Communication Strategy educational intervention showed an improvement in knowledge mastery from 51% to 93.8%, and overall satisfaction also significantly increased. The study concluded that low adherence to nasal irrigation is a problem that can be overcome, rather than an insurmountable communication gap between patients and healthcare providers. Systematic patient-centered education through the Multimodal Health Communication Strategy was associated with an improvement in self-nasal irrigation care adherence.