基于ICF理论的作业治疗在脑卒中康复护理中的应用
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摘要
目的探讨基于《国际功能、残疾和健康分类》(ICF)理论的作业治疗在脑卒中康复护理中的效果。方法选取脑卒中患者35例,患者均留有不同程度的功能障碍。采用基于ICF理论的作业治疗。观察患者入院时、康复训练8周后改良Barthel指数(MBI)、功能综合评定量表(FCA)、Brunnstrom分期。结果康复训练8周后患者MBI、FCA总分均较入院时提高(P<0.01)。康复训练8周后患者Brunnstrom分期均较入院时改善(P<0.05)。结论在脑卒中伴有功能障碍患者的康复护理中,实施基于ICF理论的作业治疗,能够促进患者康复,改善患者肢体功能障碍,提高生活质量。
Objective To evaluate the occupational therapy based on International Classification of Functioning, Disability and Health(ICF) in rehabilitation nursing of stroke patients. Methods A total of 35 patients with post-stroke dysfunction were enrolled. Patients were treated with occupational therapy based on ICF in addition to the comprehensive treatment. The modified Barthel index(MBI), Functional Comprehensive Assessment(FCA) Scores and the Brunnstrom recovery stages were observed and compared on admission and 8 weeks after intervention. Results After the intervention, the MBI and FCA scores of patients were improved significantly(P<0.01). Patients receive a better outcome of Brunnstrom recovery stages at 8 weeks after intervention(P<0.01). Conclusion Occupational therapy based on ICF can significantly improve motor function and quality life in post-stroke patients with dysfunction
Objective To evaluate the occupational therapy based on International Classification of Functioning, Disability and Health(ICF) in rehabilitation nursing of stroke patients. Methods A total of 35 patients with post-stroke dysfunction were enrolled. Patients were treated with occupational therapy based on ICF in addition to the comprehensive treatment. The modified Barthel index(MBI), Functional Comprehensive Assessment(FCA) Scores and the Brunnstrom recovery stages were observed and compared on admission and 8 weeks after intervention. Results After the intervention, the MBI and FCA scores of patients were improved significantly(P<0.01). Patients receive a better outcome of Brunnstrom recovery stages at 8 weeks after intervention(P<0.01). Conclusion Occupational therapy based on ICF can significantly improve motor function and quality life in post-stroke patients with dysfunction
引文
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[2] RICHARDS C L,MALOUIN F,NADEAU S.Stroke rehabilitation:clinical picture,assessment,and therapeutic challenge[J].Prog Brain Res,2015,218:253-280.
[3] 吕慧颐,赵俊,武俊英,等.康复护士延伸作业治疗对脑卒中偏瘫病人康复效果的影响[J].护理研究,2017,31(32):4173-4175.
[4] CLARKE D J.Nursing practice in stroke rehabilitation:systematic review and meta-ethnography[J].J Clin Nurs,2014,23(9-10):1201-1226.
[5] 郝又国,陆伟伟,施海燕,等.中国版脑卒中简明ICF核心要素量表在康复中的应用[J].中国康复理论与实践,2014,20(3):279-281.
[6] 李洪艳,孙海云,胡智艳,等.ICF通用组合在脑卒中偏瘫患者康复护理中的应用效果[J].中华现代护理杂志,2016,22(17):2412-2415.
[7] 葛政卿,陈文华,郁嫣嫣,等.以国际功能、残疾和健康分类为指导的作业治疗在脑卒中患者中的应用[J].实用老年医学,2016,30(4):338-340.
[8] 胡永善,吴毅,范文可,等.功能综合评定量表的研究(一)量表设计[J].中国康复医学杂志,2002,17(1):35-38.
[9] 毛小杰,李红娟,饶高峰.传统和改良强制性运动疗法对脑卒中偏瘫患者上肢Brunnstrom分期的影响[J].中国医师杂志,2016,18(8):1229-1231.
[10] 袁海新,陈文华.ICF指导下的作业治疗对脑卒中偏瘫患者日常生活活动能力的效果[J].中国康复理论与实践,2017,23(2):151-154.
[11] REPSAITE V,VAINORAS A,BERSKIENE K,et al.The effect of differential training-based occupational therapy on hand and arm function in patients after stroke:Results of the pilot study[J].Neurol Neurochir Pol,2015,49(3):150-155.
[12] 王宏斌,龙华,袁华,等.低频重复经颅磁刺激联合以任务为导向作业疗法对脑卒中患者上肢运动功能的康复作用[J].中国现代神经疾病杂志,2017,17(4):254-260.
[13] 梁碧莹,唐强.作业治疗对脑卒中后上肢功能障碍的国内临床应用进展[J].中国康复医学杂志,2019,34(1):107-111.
[14] SILVA S M,CORR A F I,FARIA C D,et al.Evaluation of post-stroke functionality based on the International Classification of Functioning,Disability,and Health:a proposal for use of assessment tools[J].J Phys Ther Sci,2015,27(6):1665-1670.
[15] PTYUSHKIN P,CIEZA A,STUCKI G.Most common problems across health conditions as described by the International Classification of Functioning,Disability,and Health[J].Int J Rehabil Res,2015,38(3):253-262.
[16] PESCHKE D,SCHNITZER S,KUHLMEY A,et al.Physio-and occupational therapy pathways of stroke patients and stroke mortality[J].Rehabilitation (Stuttg),2014,53(4):224-229.
[17] FARIA-FORTINI I,MICHAELSEN S M,CASSIANO J G,et al.Upper extremity function in stroke subjects:relationships between the international classification of functioning,disability,and health domains[J].J Hand Ther,2011,24(3):257-265.
[18] 韩东,王金艳,孙李慧子,等.以ICF为指导的作业治疗对脑卒中患者ADL影响的临床研究[J].中国康复,2016,31(3):171-173.
[2] RICHARDS C L,MALOUIN F,NADEAU S.Stroke rehabilitation:clinical picture,assessment,and therapeutic challenge[J].Prog Brain Res,2015,218:253-280.
[3] 吕慧颐,赵俊,武俊英,等.康复护士延伸作业治疗对脑卒中偏瘫病人康复效果的影响[J].护理研究,2017,31(32):4173-4175.
[4] CLARKE D J.Nursing practice in stroke rehabilitation:systematic review and meta-ethnography[J].J Clin Nurs,2014,23(9-10):1201-1226.
[5] 郝又国,陆伟伟,施海燕,等.中国版脑卒中简明ICF核心要素量表在康复中的应用[J].中国康复理论与实践,2014,20(3):279-281.
[6] 李洪艳,孙海云,胡智艳,等.ICF通用组合在脑卒中偏瘫患者康复护理中的应用效果[J].中华现代护理杂志,2016,22(17):2412-2415.
[7] 葛政卿,陈文华,郁嫣嫣,等.以国际功能、残疾和健康分类为指导的作业治疗在脑卒中患者中的应用[J].实用老年医学,2016,30(4):338-340.
[8] 胡永善,吴毅,范文可,等.功能综合评定量表的研究(一)量表设计[J].中国康复医学杂志,2002,17(1):35-38.
[9] 毛小杰,李红娟,饶高峰.传统和改良强制性运动疗法对脑卒中偏瘫患者上肢Brunnstrom分期的影响[J].中国医师杂志,2016,18(8):1229-1231.
[10] 袁海新,陈文华.ICF指导下的作业治疗对脑卒中偏瘫患者日常生活活动能力的效果[J].中国康复理论与实践,2017,23(2):151-154.
[11] REPSAITE V,VAINORAS A,BERSKIENE K,et al.The effect of differential training-based occupational therapy on hand and arm function in patients after stroke:Results of the pilot study[J].Neurol Neurochir Pol,2015,49(3):150-155.
[12] 王宏斌,龙华,袁华,等.低频重复经颅磁刺激联合以任务为导向作业疗法对脑卒中患者上肢运动功能的康复作用[J].中国现代神经疾病杂志,2017,17(4):254-260.
[13] 梁碧莹,唐强.作业治疗对脑卒中后上肢功能障碍的国内临床应用进展[J].中国康复医学杂志,2019,34(1):107-111.
[14] SILVA S M,CORR A F I,FARIA C D,et al.Evaluation of post-stroke functionality based on the International Classification of Functioning,Disability,and Health:a proposal for use of assessment tools[J].J Phys Ther Sci,2015,27(6):1665-1670.
[15] PTYUSHKIN P,CIEZA A,STUCKI G.Most common problems across health conditions as described by the International Classification of Functioning,Disability,and Health[J].Int J Rehabil Res,2015,38(3):253-262.
[16] PESCHKE D,SCHNITZER S,KUHLMEY A,et al.Physio-and occupational therapy pathways of stroke patients and stroke mortality[J].Rehabilitation (Stuttg),2014,53(4):224-229.
[17] FARIA-FORTINI I,MICHAELSEN S M,CASSIANO J G,et al.Upper extremity function in stroke subjects:relationships between the international classification of functioning,disability,and health domains[J].J Hand Ther,2011,24(3):257-265.
[18] 韩东,王金艳,孙李慧子,等.以ICF为指导的作业治疗对脑卒中患者ADL影响的临床研究[J].中国康复,2016,31(3):171-173.