认知行为护理对脑出血患者神经功能及生活质量的影响
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摘要
目的探讨认知行为护理对脑出血患者神经功能及生活质量的影响。方法选取2015年7月~2017年7月南通大学附属医院收治的脑出血住院患者110例,采用随机数字表法将其分为对照组和试验组,每组各55例。对照组给予常规护理干预,试验组在此基础上加用认知行为干预。比较两组患者护理干预前后运动功能、生活活动能力、神经功能及生活质量变化情况。结果护理干预后,两组Fugl-Meyer运动功能量表(FMA)评分及改良Barthel指数均明显改善(P<0.05),且试验组患者FMA评分及Barthel指数均明显高于对照组(P<0.05)。护理干预后,两组美国国立卫生研究院卒中量表(NIHSS)评分均明显降低(P<0.05),格拉斯哥预后评分(GOS)则明显升高(P<0.05),且干预后试验组患者NIHSS评分明显低于对照组(P<0.05),GOS评分则明显高于对照组(P<0.05)。护理干预后两组患者QLQ-30量表各项生活质量评分明显升高(P<0.05),且试验组躯体功能、角色功能、情绪功能、认知功能、社会功能及总体健康状况等QLQ-30量表评分均明显高于对照组(P<0.05)。结论认知行为护理能有效提高脑出血患者的疾病认知水平,帮助改善患者的用药依从性及神经功能状态,促进其运动功能及生活活动能力的恢复,为患者的生活质量恢复提供保障。
Objective To explore the effects of medical expulsive treatment combined with cognitive behavioral nursing on neurological function and the quality of life in patients with cerebral hemorrhage. Methods From July 2015 to July2017, in Affiliated Hospital of Nantong University, 110 cerebral hemorrhage patients were selected, according to random number table method, they were divided into control group and test group, with 55 cases in each group. The control group was given routine nursing intervention, and the test group was given cognitive behavior intervention on the basis of routine nursing intervention. The movement function, life activity, nervous function and quality of life changes of two groups before and after nursing intervention were compared. Results After nursing intervention, Fugl-Meyer assessment(FMA) score and life activity Barthel index of the patiens in two groups improved significantly(P < 0.05), and FMA score and modified Barthel index of the patients in test group were significantly higher than control group(P <0.05). After nursing intervention, the score of national institute of health stroke scale(NIHSS) of the patients in two groups reduced significantly(P < 0.05), Glasgow outcome score(GOS) incerased significantly(P < 0.05), and the NIHSS score in the test group was significantly lower than the control group(P < 0.05), the GOS score level was significantly higher than the control group(P < 0.05). After nursing intervention, the life scores of QLQ-30 rating scale of the patients in the two groups after intervention increased significantly(P < 0.05), and the physical function, role function, emotional function, cognitive function, social function and overall health of QLQ-30 rating scale of the patients in the test group were significantly higher than the control group(P < 0.05). Conclusion Medical expulsive treatment with cognitive behavioral nursing therapy can effectively improve the level of cognition, the patients' medication adherence and neurologic status, promote the recovery of motor function and activities of life skills, provide guarantee for recovery of the patients' life.
Objective To explore the effects of medical expulsive treatment combined with cognitive behavioral nursing on neurological function and the quality of life in patients with cerebral hemorrhage. Methods From July 2015 to July2017, in Affiliated Hospital of Nantong University, 110 cerebral hemorrhage patients were selected, according to random number table method, they were divided into control group and test group, with 55 cases in each group. The control group was given routine nursing intervention, and the test group was given cognitive behavior intervention on the basis of routine nursing intervention. The movement function, life activity, nervous function and quality of life changes of two groups before and after nursing intervention were compared. Results After nursing intervention, Fugl-Meyer assessment(FMA) score and life activity Barthel index of the patiens in two groups improved significantly(P < 0.05), and FMA score and modified Barthel index of the patients in test group were significantly higher than control group(P <0.05). After nursing intervention, the score of national institute of health stroke scale(NIHSS) of the patients in two groups reduced significantly(P < 0.05), Glasgow outcome score(GOS) incerased significantly(P < 0.05), and the NIHSS score in the test group was significantly lower than the control group(P < 0.05), the GOS score level was significantly higher than the control group(P < 0.05). After nursing intervention, the life scores of QLQ-30 rating scale of the patients in the two groups after intervention increased significantly(P < 0.05), and the physical function, role function, emotional function, cognitive function, social function and overall health of QLQ-30 rating scale of the patients in the test group were significantly higher than the control group(P < 0.05). Conclusion Medical expulsive treatment with cognitive behavioral nursing therapy can effectively improve the level of cognition, the patients' medication adherence and neurologic status, promote the recovery of motor function and activities of life skills, provide guarantee for recovery of the patients' life.
引文
[1]冯勤丽,姚明,张小平,等.基于奥马哈系统的延续护理在高血压性脑出血患者术后康复中的应用[J].中华现代护理杂志,2017,23(1):95-98.
[2]燕玉芹.脑出血保守治疗患者住院期间的护理方法分析[J].齐齐哈尔医学院学报,2013,34(3):458-459.
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[8]赵红红,陆晓红,朱缙伟.认知行为为主的护理干预对脑出血康复期患者焦虑情绪和血清中MIF和BDNF的影响[J].中国现代医生,2014,52(11):70-72.
[9]孙光群.探讨临床护理路径在脑出血中的应用效果[J].中国医药指南,2016,14(27):280-281.
[10]Waguchi H,Hidaka K,Shinoki K,et al.Coordination to assist with hospital-to-home discharge after cerebral hemorrhage--perspectives of a patient's family and nurse[J].Gan to Kagaku Ryoho,2013,40(Suppl 2):216-218.
[11]王翠娥,杨佩凤.认知行为护理对高血压脑出血患者生活质量及预后的影响[J].国际护理学杂志,2013,32(11):2582-2583.
[12]孙雪春.综合护理干预脑出血术后患者的疗效评价[J].实用心脑肺血管病杂志,2012,20(10):1714-1715.
[13]蒋兴荣,谭洁,胡建方,等.认知心理干预对脑卒中患者偏瘫肢体康复的影响[J].华夏医学,2013,26(5):955-958.
[14]Sims ME.Legal briefs:in utero cerebral hemorrhage and alloimmune thrombocytopenia:was it preventable?[J].Neoreviews,2016,17(7):e409-e411.
[15]史海燕.综合性护理对高血压脑出血患者神经功能及预后的影响[J].齐鲁护理杂志,2016,22(7):70-72.
[16]冯晓辉.脑出血保守治疗患者住院期间的护理体会[J].中国保健营养:下旬刊,2013,23(10):5985-5986.
[17]张轩,苏会涛,赵桂梅.丘脑卒中与认知功能改变的临床观察[J].中国冶金工业医学杂志,2012,29(2):149-150.
[18]Faigle R,Marsh EB,Llinas RH,et al.Novel score predicting gastrostomy tube placement in intracerebral hemorrhage[J].Stroke,2015,46(1):31-36.
[19]闫妍.临床护理路径应用于药物治疗脑出血患者护理的可行性研究[J].中国实用医药,2017,12(6):169-170.
[20]赵红红,陆晓红,朱缙伟.认知行为为主的护理干预对脑出血康复期患者焦虑情绪和血清中MIF和BDNF的影响[J].中国现代医生,2014,52(11):70-72.
[21]尹庆,黄云娟.认知行为疗法对颅内动脉瘤介入手术患者负性情绪的影响[J].中国医药导报,2017,14(29):147-150.
[2]燕玉芹.脑出血保守治疗患者住院期间的护理方法分析[J].齐齐哈尔医学院学报,2013,34(3):458-459.
[3]Li W,Gao J,Wei S,et al.Application values of clinical nursing pathway in patients with acute cerebral hemorrhage[J].Exp Ther Med,2016,11(2):490-494.
[4]饶桂珍.认知护理对高血压性脑出血患者药物治疗遵医行为的影响作用研究[J].中国实用医药,2017,12(13):164-166.
[5]皮英,唐丽君,周素珍,等.延续性护理辅助药物治疗对脑出血患者神经功能及生活质量的影响[J].实用医院临床杂志,2016,13(1):66-68.
[6]仲桂英,马丽萍.能全力行肠内营养支持配合综合性护理干预对出血昏迷患者的疗效[J].世界华人消化杂志,2014,22(19):2795-2799.
[7]钟琼瑶.认知护理对脑出血患者药物治疗遵医行为的影响[J].医药前沿,2012,2(6):65-65.
[8]赵红红,陆晓红,朱缙伟.认知行为为主的护理干预对脑出血康复期患者焦虑情绪和血清中MIF和BDNF的影响[J].中国现代医生,2014,52(11):70-72.
[9]孙光群.探讨临床护理路径在脑出血中的应用效果[J].中国医药指南,2016,14(27):280-281.
[10]Waguchi H,Hidaka K,Shinoki K,et al.Coordination to assist with hospital-to-home discharge after cerebral hemorrhage--perspectives of a patient's family and nurse[J].Gan to Kagaku Ryoho,2013,40(Suppl 2):216-218.
[11]王翠娥,杨佩凤.认知行为护理对高血压脑出血患者生活质量及预后的影响[J].国际护理学杂志,2013,32(11):2582-2583.
[12]孙雪春.综合护理干预脑出血术后患者的疗效评价[J].实用心脑肺血管病杂志,2012,20(10):1714-1715.
[13]蒋兴荣,谭洁,胡建方,等.认知心理干预对脑卒中患者偏瘫肢体康复的影响[J].华夏医学,2013,26(5):955-958.
[14]Sims ME.Legal briefs:in utero cerebral hemorrhage and alloimmune thrombocytopenia:was it preventable?[J].Neoreviews,2016,17(7):e409-e411.
[15]史海燕.综合性护理对高血压脑出血患者神经功能及预后的影响[J].齐鲁护理杂志,2016,22(7):70-72.
[16]冯晓辉.脑出血保守治疗患者住院期间的护理体会[J].中国保健营养:下旬刊,2013,23(10):5985-5986.
[17]张轩,苏会涛,赵桂梅.丘脑卒中与认知功能改变的临床观察[J].中国冶金工业医学杂志,2012,29(2):149-150.
[18]Faigle R,Marsh EB,Llinas RH,et al.Novel score predicting gastrostomy tube placement in intracerebral hemorrhage[J].Stroke,2015,46(1):31-36.
[19]闫妍.临床护理路径应用于药物治疗脑出血患者护理的可行性研究[J].中国实用医药,2017,12(6):169-170.
[20]赵红红,陆晓红,朱缙伟.认知行为为主的护理干预对脑出血康复期患者焦虑情绪和血清中MIF和BDNF的影响[J].中国现代医生,2014,52(11):70-72.
[21]尹庆,黄云娟.认知行为疗法对颅内动脉瘤介入手术患者负性情绪的影响[J].中国医药导报,2017,14(29):147-150.