Health belief model on the adherence to regular postoperative follow-up of patients with intracranial aneurysms in rural areas

Abstract

Objective To explore the effect of health education based on health belief model (HBM) on the adherence to regular postoperative follow-up of patients with intracranial aneurysms (ICA) after surgery in rural areas. Methods A mixed research method was adopted in the study. In the first phase, purposive sampling method was used when conducting qualitative interviews in order to analyze the reasons for the in-adherence in the target population. In the second phase, non-synchronous controlled trial was carried out and 312 patients from rural areas who underwent ICA invasive surgery in Ji'ning No.1 People's Hospital from June 2015 to December 2016 were selected and put into control group. Routine health education was adopted for the group. A total of 268 patients who underwent ICA invasive surgery in The First People's Hospital of Ji'ning City from April 2017 to June 2018 were selected and assigned into the observation group. Based on the results from the qualitative interview, the HBM health education was applied in the observation group. The two groups were analyzed and compared in terms of their adherence to regular revisit after discharge. Results A total of 4 themes were extracted during the qualitative research phase: there is insufficient understanding of the possibility and harm of recurrence after ICA intervention, insufficient understanding of the necessity of angiographic review, concerns about hospitalization and hospitalization expenses for angiographic review, poor health care awareness and lack of attention to disease prevention. After implementing the intervention, the adherence to timely postoperative follow-up in the observation group (95.52%) was higher than that of the control group (62.82%) with statistical significance (χ2=89.64, P<0.01) . Conclusions Health education based on HBM can improve the adherence to regular postoperative review among rural patients with intracranial aneurysms. Health belief model should be applied as guidance into clinical health education. Key words: Intracranial aneurysm; Rural areas; Health belief model; Health education; Adherence; Regular follow-up; Intravenous invasive treatment