Effects of LEARNS model-based health education on rehabilitation outcomes in patients with stable pneumoconiosis

Meirui LIU; Baoping LI; Fuhai SHEN; Zhiping SUN; Qianqian LI; Haifeng CUI; Chunxi WANG; Jianxiang WANG; Qingchun CAO; Zhongdong YANG; Xiangyou LI; Jiayin ZHONG; Bowen HOU; Lini GAO; Chenyue HOU; Xuemei SUN

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Effects of LEARNS model-based health education on rehabilitation outcomes in patients with stable pneumoconiosis

VernacularTitle:基于LEARNS模式健康教育对稳定期尘肺患者康复效果的影响研究
Author: Meirui LIU ¹ ; Baoping LI ² ; Fuhai SHEN ³ ; Zhiping SUN ¹ ; Qianqian LI ¹ ; Haifeng CUI ⁴ ; Chunxi WANG ⁵ ; Jianxiang WANG ⁶ ; Qingchun CAO ⁴ ; Zhongdong YANG ⁴ ; Xiangyou LI ⁵ ; Jiayin ZHONG ⁶ ; Bowen HOU ¹ ; Lini GAO ¹ ; Chenyue HOU ¹ ; Xuemei SUN ¹
Author Information

1. Department of Occupational Disease, Emergency General Hospital, Beijing 100028, China.
2. Department of Occupational Disease, Emergency General Hospital, Beijing 100028, China;National Health Committee Key Laboratory of Pneumoconiosis, First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, China.
3. School of Public Health;Hebei Coal Mine Health and Safety Laboratory, North China University of Science and Technology, Tangshan, Hebei 063210, China.
4. Wuhai Occupational Disease Prevention and Treatment Hospital, Wuhai, Inner Mongolia 016040, China.
5. Ganzhou Dayu Mingde Hospital, Ganzhou, Jiangxi 341500, China.
6. Ganzhou Mingde Occupational Disease Hospital, Ganzhou, Jiangxi 341000, China.
Publication Type:Investigation
Keywords: pneumoconiosis; LEARNS model; health education; pulmonary rehabilitation; quality of life; health behavior
From: Journal of Environmental and Occupational Medicine 2026;43(9):1139-1145
CountryChina
Language:Chinese
Abstract: Background Patients with pneumoconiosis often have limited disease-related knowledge, insufficient access to health education, and substantial health management needs. Health education may help improve rehabilitation outcomes and quality of life in this population. Objective To evaluate the effects of health education based on the Listen-Establish-Adopt-Reinforce-Name-Strength (LEARNS) model on rehabilitation outcomes, health-related behaviors, and quality of life among pneumoconiosis patients, and provide effective intervention strategies for the rehabilitation management of patients with pneumoconiosis. Methods A randomized controlled trial was conducted. A total of 120 pneumoconiosis patients treated in the Department of Occupational Diseases, Beijing Emergency General Hospital, from November 2024 to February 2025 were enrolled. Participants were randomly assigned to a control group or an intervention group using a random number table method, with 60 patients in each group. The control group received routine pharmacotherapy, whereas the intervention group received a 12-week LEARNS model-based health-education intervention in addition to routine treatment. The 6-Minute Walk Test (6MWT) was used to assess exercise tolerance, and the modified Medical Research Council dyspnoea scale (mMRC) was used to evaluate dyspnoea. The Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) were applied for psychological status assessment. Pulmonary function, including forced expiratory volume in one second (FEV₁) and forced vital capacity (FVC), was measured using spirometry. A self-designed scale was used to evaluate eight health-related behaviors targeted by the health education program. The 36-Item Short-Form Health Survey (SF-36) and Chronic Obstructive Pulmonary Disease (COPD) Assessment Test (CAT) were used to assess quality of life, and the Pittsburgh Sleep Quality Index (PSQI) was adopted to evaluate sleep quality. Results After the 12-week intervention, the control group showed no statistically significant changes from baseline in the measured outcomes(P＞0.05). In the intervention group, exercise tolerance improved significantly, with the 6-minute walking distance increasing from (382.55±19.52) m to (426.84±33.59) m (P＜0.001). Dyspnoea was also alleviated, with the mMRC score decreasing from 1.37±0.66 to 0.96±0.54 (P＜0.001). The CAT score decreased from 18.95±7.03 to 10.67±3.64 (P＜0.001). Significant improvements were observed in anxiety and depression symptoms (P＜0.001), with the SAS score decreasing from 38.85±6.24 to 34.27±2.27, and the SDS score decreasing from 49.01±3.25 to 45.49±3.44. Sleep quality improved significantly, with the PSQI score dropping from 7.89±4.35 to 4.05±2.31 (P＜0.001). All eight health-related behaviors in the intervention group improved significantly after the intervention (P＜0.001), including acquisition of disease-related knowledge (1.87±0.34 vs. 3.13±0.45), participation in health education activities (1.89±0.52 vs. 3.61±0.38), and regular physical exercise (2.37±0.41 vs. 4.17±0.33). All SF-36 domain scores increased significantly (P＜0.05), with the most prominent improvements observed in physical functioning, general health, and vitality. At week 12, all SF-36 domain scores were significantly higher in the intervention group than in the control group (P＜0.05). No statistically significant between-group differences were detected in pulmonary function parameters (P＞0.05). Conclusion LEARNS model-based health education could improve exercise tolerance, dyspnea, psychological status, sleep quality, health-related behaviors, and quality of life among patients with pneumoconiosis, and therefore may be a useful adjunctive strategy for rehabilitation management in patients with pneumoconiosis.