延续护理对脑卒中患者康复效果的随机对照试验
Effect of extended care on the rehabilitation of discharged stroke patients:a randomized controlled trial
目的:探讨医院-社区-家庭延续康复护理干预对改善脑卒中患者身体功能和心理状态的临床效果。方法2014年1月1日至2015年4月30日,选择蚌埠市第三人民医院即将出院的脑卒中患者60例,采用随机数字表法将其分为干预组和对照组各30例,对干预组患者在日常生活活动、肢体锻炼、心理等方面进行医院-社区-家庭延续康复护理干预,对对照组患者进行常规护理,比较2组患者出院日和出院6个月后的Barthel指数评分、简式Fugl-Meyer运动功能评分和汉密尔顿抑郁量表(HAMD)的分值。结果干预前和干预6个月后,干预组患者的Barthel指数评分分别为(44.17±11.21)、(72.47±15.36)分,简式Fugl-Meyer运动功能评分分别为(43.47±16.22)、(62.39±15.41)分,HAMD得分分别为(26.81±8.24)、(17.42±6.29)分,差异有统计学意义(t=8.16、4.64、4.97,均P<0.01)。相比之下,对照组患者Barthel指数评分有统计学意义(t=1.94,P=0.03),HAMD评分差异有统计学意义(t=1.86,P=0.04),但变化幅度远不及干预组。2组间干预后Barthel指数评分、简式Fugl-Meyer运动功能评分和HAMD评分比较差异有统计学意义(t=5.81、3.55、2.35,均P=0.00)。结论延续康复护理干预对脑卒中出院患者在居住环境、日常生活活动能力、功能障碍和心理状态等方面的康复效果明显,具有一定的临床实践参考价值。
更多Objective To explore the effect of hospital-community-family integrated care on the physical and mental function of discharged stroke patients. Methods Sixty stroke patients discharged from the third people′s hospital of Bengbu were recruited from January 1, 2014 to April 30, 2015. The patients were divided into intervention group and control group by random number table, and 30 patients in each group. Rehabilitated nursing intervention including feeding, language, physical and psychological and psychological trainings were conducted in intervention group, while participants in control group only received routing nursing service. Then, the Barthel index scores, Fugl-Meyer motor function scores and Hanmilton Depression Scale (HAMD) scores were assessed in both two groups pre-intervention and six months after intervention. Results Intervened before and 6 months after the intervention group of patients with Barthel index score respectively (44.17 ± 11.21) points, (72.47 ± 15.36) points, Fugl-Meyer motor function scores were respectively (43.47±16.22) points, (62.39 ±15.41) points, HAMD scores were (26.81 ± 8.24) points, (17.42 ± 6.29). The difference was statistically significant (t=8.16, 4.64, 4.97, P <0.01). In contrast, the control group of patients with Barthel index score changes showed statistical significance (t=1.94, P=0.03), HAMD score also had differences (t=1.86, P=0.04) and the change was far less than the intervention group. Between the two groups after the intervention compared with Barthel index score, Fugl-Meyer motor function score and HAMD also had statistical significance (t=5.81, 3.55, 2.35, P = 0.00). Conclusions The rehabilitated nursing intervention has evident effects onliving environment,daily life, physical and mental function in discharged stroke patients, and the intervention approaches we used have certain clinical practice value.
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