【作者】 赵玉兰；

【导师】 臧渝梨；

【作者基本信息】 山东大学 ， 护理学， 2018， 硕士

【摘要】 目的:探索开发面向在校中学生的规范化心肺复苏(Cardiopulmonary Resucitation,CRP)培训方法,分析评价包含CPR实操训练、过程考核和培训后继续学习强化在内的多元化教学法对低年级中学生及其紧密关系群体CPR知信行的影响,同时了解在校中学生CPR知信行现状及CPR培训经历与培训意愿,从而为信息化背景下尽早在青少年群体中普及推广CPR培训提供参考借鉴。方法:采用整群随机抽样法,以省内某城市中学初一、初二两个年级学生为目标研究群体,该校两个校区分别作为预试验场所和正式试验场所,事先规定采用抛硬币法,头像面代表试验组。预试验校区初一初二年级各选1个班,而主试验校区每年级各选2个班,同年级的2个班分别采用抛硬币法确定其组别。共有123名学生参加预试验,231名学生参加正式试验,试验组和对照组分别有115人、116人。试验组采用多元化新型教学法进行CPR知识技能集训,包括利用多媒体知识讲座、视频观看、技能实训、小测验过程考核及宣教手册自学,并提供基于微信平台的持续支持(即培训后学习强化)。对照组则仅给予理论知识课件自学并结合发放宣传手册自学、提供视频观看及持续微信平台支持,但不提供CPR技能实训。两组学生在集训后1周内均参加“CPR创新延伸培训竞赛”,并撰写反思日志,重点描述自己进行创新延伸培训的情况与感受,并附以图片或音视频实景予以佐证。采用“学生基本资料收集表”和“青少年CPR知信行调查问卷”收集相关信息,集训前(T1时点)、集训后1周(T2时点)及集训后1月(T3时点)各收集1次;调查问卷知识部分问题构成CPR小测试卷,于集训后进行测试检查;集训后1月,对定比(1/3)随机抽选的学生(n=74)进行CPR操作技能考核,根据“单人徒手心肺复苏操作考核评分标准”评分,并根据事先拟定的“CPR创新延伸培训竞赛细则(含反思日志评分标准)进行评分和评奖,并颁发相应证书予以激励。采用SPSS 23.0进行描述性统计分析,计量资料采用t检验或方差分析,计数资料采用卡方(X2)检验,以分析比较不同组别间的差异。结果:集训前、集训后1周及1月问卷均100%回收,有效率分别为99.1%(229/231)、97.4%(225/231)和 97.4%(225/231)。试验组集训后小测验成绩(18.38±1.47,x±s)高于对照组(17.77±2.01,P＜0.05)。重复测量方差分析显示,两组学生的CPR态度与知识得分的干预主效应和时间主效应均未见统计差异(P≥0.05)。进一步分析显示,两组在三个时点上的CPR知识得分未见统计差异(P＞0.05),知识得分在集训后均呈增加趋势,试验组知识平均分在集训后1周时和1月时均高于对照组知识平均分,尽管试验组在集训前的知识平均分略低于对照组。还发现,两组在集训后1月时的态度得分有统计差异(t=2.074,P<0.05),且在三个测量时点上,试验组态度平均分均略低于对照组,提示干预前的CPR态度可能影响培训效果。独立样本t检验显示,试验组CPR操作考核成绩(83.43±7.28)及延伸创新培训竞赛反思日志得分(39.02±5.17)均与对照组(操作成绩:73.07±12.22;日志得分:41.41±6.16)有显著统计差异(P＜0.05)。结论:结合采用包含CPR操作训练、过程考核(即小测试)及培训后的继续学习强化(如持续微信平台支持、创新延伸培训竞赛)的多元化新型教学法可改善低年级青少年中学生的CPR知信行水平,提高CPR实操能力,激发创新潜力,为今后在青少年群体及其紧密关系网络中广泛普及CPR知识技能提供良好的参考借鉴。更多还原

【Abstract】 Objectives:The main purpose of this study is to explore and develop standardized cardiopulmonary resuscitation training methods for middle school students,analyzing and evaluating the effects of diversified teaching methods—including CPR practice training,process assessment and intensive learning after training—on the knowledge,beliefs and behaviors of junior middle school students and their closely-related groups.In the meanwhile,this study aims at understanding the current status of CPR knowledge,belief and practice,training experience and training willingness of middle school students,which in turn will provide reference for popularizing CPR training among teenagers as soon as possible at information age.Methods:Samples used in this study are randomly chosen from students of Grade One and Grade Two of a Junior Middle school in a city of Shandong Province.The two campuses of the school serve as pre-test sites and formal test sites respectively.Students are chosen by flipping a coin.Choose one class from Grade One and Grade Two in the pre-test campus respectively.The head of coin is specified in advance to represent the test group.Two classes are chosen from each grade in the main experimental campus.Two classes in the same grade determine their test group by flipping a coin.A total of 123 students participated in the pre-test and 231 students participated in the formal test.The number of the students in the test group and the contrast group is 115 and 116 respectively.The experimental group enlisted a variety of new teaching methods to conduct CPR skills training,including multi-media conducted knowledge lectures,video viewing,skills training,quiz process assessment and self-study of the teaching manual,and provided continuous support based on Wechat platform(i.e.post-training learning enhancement).In comparison,the contrast group was only instructed to conduct self-study through theoretical materials,delivered manual,video-playing and continuous Wechat platform however,CPR skills training is not provided.Both groups of students participated in the CPR Innovation Extension Training Competition within one week after the intensive training and were asked to write a reflective journal which focused on describing the situation and feelings of their innovative extension training supported by pictures or audio-visual scenes.Relevant information was collected by using the "Information Data Collection Form"and the adolescent CPR questionnaire.The questionnaire was collected for 3 times:namely before face-to-face training(T1 o’clock),one week after face-to-face instruction(T2 o’clock)and one month after face-to-face instruction(T3 o’clock).One month after the face-to-face lecture,one-third of the students(n=74)were randomly selected for the CPR operation skill test.They were scored and awarded according to the "single hand CPR operation evaluation criteria" and the "CPR innovation and extension training competition rules(including reflective log scoring criteria)" which were drawn up in advance.All of these listed above can help the students get motivated and encouraged.SPSS 23.0 was used for descriptive statistical analysis,"t" test or variance analysis were used for measurement data,and chi-square(X2)test was used for counting data to analyze and compare the differences between different groups.Results:The questionnaires delivered before the face-to-face,1 week and 1 month after the face-to-face instruction were 100%recovered.The effective rates were 99.1%(229/231),97.4%(225/231)and 97.4%(225/231)respectively.Completing the intensive training,the test group’s results of the quiz(18.38± 1.47,x±s)were higher than the Contrast group(17.77±2.01,P<0.05).Repeated measures analysis of variance showed that there was no statistical difference between the two groups of students’ CPR attitudes and knowledge scores in the main intervention effect and main effect of time(P≥0.05).Further analysis showed that there was no statistical difference in the CPR knowledge scores at three time points(P>0.05),and the knowledge scores showed the similar increase after face-to-face training.The average score of the experimental group was higher than that of the contrast group at 1 week and 1 month after face-to-face teaching,although the average score of the test group before face-to-face teaching was slightly lower than that of the contrast group.It was also found that there were statistical differences in attitude scores between the two groups at 1 month after face-to-face instruction(t=2.074,P<0.05),and the average score of attitude in the experimental group was slightly lower than that in the control contrast group at three measuring points which indicates that the attitude of CPR before intervention may affect the training result.Independent sample "t" test showed that there were significant differences between CPR performance(83.43±7.28)and the extended innovation training competition reflection log score(39.02±5.17)and those of the contrast group(operation score:73.07±12.22;log score:41.41 ±6.16).Significant statistical differences.(P<0.05).Conclusion:Combining the diversified teaching method including CPR operation training,process assessment(i.e.mini-test)and continuous learning reinforcement after training(e.g.sustained Wechat platform support,innovative extension training contest)can improve the knowledge,belief and practice level of junior middle school students’ CPR,enhancing the practical ability of CPR and stimulating the innovative potential for the future.It is a good way to popularize CPR knowledge and skills among teenagers and people around them.更多还原