脑卒中后遗症期“医-康-护-养”一体化管理模式探讨
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摘要
目的:探讨"医-康-护-养"一体化管理模式在提高养老机构脑卒中后遗症期病人生存质量和生活能力中的作用。方法:选取2015-2016年期间深圳市福田区3家养老机构的164例脑卒中后遗症期病人作为研究对象,随机将其分为观察组和对照组,每组82例。对照组病人给予常规脑卒中二级预防管理,观察组给予"医-康-护-养"一体化管理模式,分别于干预前及干预后3个月和6个月时对2组日常生活活动能力、生存质量以及运动功能等进行评估并对比。结果:观察组病人干预后较干预前的日常生活能力评分以及生存质量指数评分均明显提高,较对照组干预后也均明显提高(P<0.01),对照组干预前后日常生活能力评分差异无统计学意义(P>0.05);观察组病人干预后6个月Fugl-Meyer评分较干预前明显改善,亦较对照组明显改善(P<0.01)。结论:"医-康-护-养"一体化管理模式能够显著提高脑卒中后遗症期病人的日常生活活动能力、生存质量以及运动功能等,有利于病人的康复,值得进一步推广。
Objective:To explore the effects of integrated management mode of "medical service-rehabilitation-nursing-elderly care" in improving the life quality and living ability of patients with stroke sequela.Methods:One hundred and sixty-four patients with stroke sequelae in three pension agencies of Futian district of Shenzhen from the year 2015 to 2016 were randomly divided into the observation group and the control group(82 cases each group).The control group was nursed with the second level prevention and management,and the observation group was nursed with the integrated management mode of "medical service-rehabilitation-nursing-elderly care".The ability of daily living,quality of life and sport function between two groups before intervention and after 3 and 6 months were assessed and compared.Results:After intervention,the scores of daily life ability and quality of life index in observation group were significantly improved compared with before intervention,and control group after intervention(P<0.01).There was not statistical significance in the scores of daily life ability and quality of life index in control group between before and after intervention(P>0.05).The scores of Fugl-Meyer in two groups after intervention were better than that before intervention,and the improvement of which in observation group was significantly higher than that in control group(P<0.01).Conclusions:The integrated management mode of "medical service-rehabilitation-nursing-elderly care" can significantly improve the ability of daily living,quality of life and sport function of patients with stroke sequelae,which is helpful to the rehabilitation of patients,and worthy of further promotion.
Objective:To explore the effects of integrated management mode of "medical service-rehabilitation-nursing-elderly care" in improving the life quality and living ability of patients with stroke sequela.Methods:One hundred and sixty-four patients with stroke sequelae in three pension agencies of Futian district of Shenzhen from the year 2015 to 2016 were randomly divided into the observation group and the control group(82 cases each group).The control group was nursed with the second level prevention and management,and the observation group was nursed with the integrated management mode of "medical service-rehabilitation-nursing-elderly care".The ability of daily living,quality of life and sport function between two groups before intervention and after 3 and 6 months were assessed and compared.Results:After intervention,the scores of daily life ability and quality of life index in observation group were significantly improved compared with before intervention,and control group after intervention(P<0.01).There was not statistical significance in the scores of daily life ability and quality of life index in control group between before and after intervention(P>0.05).The scores of Fugl-Meyer in two groups after intervention were better than that before intervention,and the improvement of which in observation group was significantly higher than that in control group(P<0.01).Conclusions:The integrated management mode of "medical service-rehabilitation-nursing-elderly care" can significantly improve the ability of daily living,quality of life and sport function of patients with stroke sequelae,which is helpful to the rehabilitation of patients,and worthy of further promotion.
引文
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[3]洪艳群,方跃平.医养护一体化管理模式在社区老年慢性病患者管理中的应用[J].护理研究,2016,30(9):11023.
[4]刘薇,饶婷,尤彦菁,等.福州市脑卒中患者社区康复需求调查分析[J].中国康复医学杂志,2015,30(11):1165.
[5]章晓峰,高莹,周文娟,等.以奥马哈系统为基础构建全髋关节置换术后患者医院-社区一体化随访模式的效果观察[J].护士进修杂志,2016,31(5):449.
[6]中华神经科学会,中华神经外科学会.各类脑血管疾病诊断要点(1995)[J].临床和实验医学杂志,2013(7):559.
[7]郭钢花.康复护理学[M].郑州:河南科学技术出版社,2012.
[8]赵蒙,牟善芳,王庭敏,等.授权教育在脑卒中患者健康教育中应用的研究进展[J].现代临床护理,2016,15(7):78.
[9]陈赟,钟印芹,张广清,等.专人管理模式在脑卒中偏瘫后遗症家庭康复护理中应用的效果评价[J].中国实用护理杂志,2015,31(9):654.
[10]陈爱红,曹利民,裴静波.早期康复护理干预对急性缺血性脑卒中患者治疗依从性、神经和生活质量的影响[J].中国医药导报,2014(22):111.
[11]马书明,杨勇.康复理疗干预对脑卒中后遗症期患者生存质量的影响[J].检验医学与临床,2015,10(16):2384.
[12]王志娟.社区康复护理干预对提高脑卒中后遗症患者生存质量的影响[J].现代诊断与治疗,2017,28(9):1758.
[13]齐丹青,姚济荣,刘宇,等.首发脑卒中致残后抑郁影响因素调查[J].中国全科医学,2014,17(18):2115.
[14]张彩娟,张福英.延续性护理在脑卒中患者社区康复中应用的效果评价[J].吉林医学,2015,31(11):2403.
[15]任俊翠,袁修银,李娟,等.延续性护理在脑卒中患者康复中的应用[J].中国临床保健杂志,2015,18(1):99.
[16]周坤,王丽,李惠玲.有氧运动训练在脑卒中患者中的康复护理进展[J].护士进修杂志,2016,31(2):124.