循证护理方案在缺血性脑卒中康复护理中的实践
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摘要
目的探讨循证护理方案在缺血性脑卒中康复护理中的实践效果。方法选择2015年2月-2016年11月本科收治的缺血性脑卒中患者84例,采用随机数字表法将其分为研究组和对照组,每组42例。研究组采用循证护理方案,对照组采用常规护理方案,连续随访6个月,比较两组患者依从性、日常生活能力和手活动能力。结果研究组患者出院后3个月在康复训练、生活作息、复诊随访等方面依从性得分及总分较对照组高;研究组患者出院后6个月日常生活能力较对照组好,手活动能力较对照组好,两组比较,差异具有统计学意义(均P<0.05)。结论循证护理方案进行干预能有效改善缺血性脑卒中患者出院后依从性及日常生活能力和手活动能力,值得临床推广应用。
Objective To explore the clinical effect of evidence-based nursing program in rehabilitation nursing of ischemic stroke. Methods Eighty-four patients with ischemic stroke admitted in our department from February 2015 to November 2016 were randomly divided into study group and control group(n=42). The evidence-based nursing program was adopted in the study group and in the control group conventional nursing program was used. In 6 months follow-up, the two groups were compared concerning compliance and daily life ability and hand function. Results The scores on rehabilitation training, life and rest, follow-up visits and the total score of compliance in the study group were significantly higher than those of the control group after 6 months follow-up( P<0.05). The Barthel index(BI) index of the study group was significantly higher than that of the control group, and the score on the ninehole column was significantly lower than that of the control group(P<0.05). Conclusion Evidence-based nursing can effectively improve the compliance of patients with ischemic stroke and daily life ability and hand function after discharge, so it is worthy of clinical application.
Objective To explore the clinical effect of evidence-based nursing program in rehabilitation nursing of ischemic stroke. Methods Eighty-four patients with ischemic stroke admitted in our department from February 2015 to November 2016 were randomly divided into study group and control group(n=42). The evidence-based nursing program was adopted in the study group and in the control group conventional nursing program was used. In 6 months follow-up, the two groups were compared concerning compliance and daily life ability and hand function. Results The scores on rehabilitation training, life and rest, follow-up visits and the total score of compliance in the study group were significantly higher than those of the control group after 6 months follow-up( P<0.05). The Barthel index(BI) index of the study group was significantly higher than that of the control group, and the score on the ninehole column was significantly lower than that of the control group(P<0.05). Conclusion Evidence-based nursing can effectively improve the compliance of patients with ischemic stroke and daily life ability and hand function after discharge, so it is worthy of clinical application.
引文
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[18]钱春荣,沈盈盈,钟代曲.手指操练习在缺血性脑卒中患者早期康复护理中的临床研究[J].护理与康复,2016,15(12):1165-1167.
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[21]田丽,窦金霞.循证护理在缺血性脑卒中治疗中的应用效果及对预防后的影响[J].职业与健康,2017,33(9):1294-1296.
[22]ALLEN K,HAZELETT S,JARJOURA D,et al.A randomized trial testing the superiority of a post-discharge care management model for stroke survivors[J].J Stroke Cerebrovasc Dis,2009,18(6):443-452.
[2]张润华,刘改芬,潘岳松,等.世界卒中流行趋势概况[J].中国卒中杂志,2014,9(9):770-771.
[3]吴亚哲,陈伟伟.中国脑卒中流行概况[J].心脑血管病防治,2016,12(16):410-414.
[4]朱仕绉,朱玲.循证护理干预预防老年脑卒中患者肺部感染价值及对生活质量、焦虑抑郁情绪的影响[J].现代中西医结合杂志,2017,26(8):901-903.
[5]李伟玲,伍娜,谢俊玲.循证护理提高慢性阻塞性肺疾病患者无创正压通气依从性的实践[J].现代临床护理,2015,14(12):51-55.
[6]陈丞鲜,张建丽,简媛,等.NZHSS评分分组护理模式对脑梗死患者神经康复及生活质量的影响[J].泰山医学院学报,2017,38(1):46-48.
[7]江恩恩,沈利萍,阮恒芳,等.脑卒中家庭功能与健康行为的调查研究[J].中华护理杂志,2014,49(7):849-853.
[8]BEAL C,FLANDERS S,BADER S.Can children reduce delayed hospital arrival for ischemic stroke?:a systematic review of school-based stroke education[J].Journal of Neuroscience Nursing,2016,48(3):E2-E13.
[9]王文志.中国脑血管病防治研究现状和发展方向[J].中国现代神经疾病杂志,2011,11(2):134-137.
[10]GEURTS M,POT J,SCHEPERS E,et al.The evaluation of an intervention based on the application of patient self-completion concordance forms in Dutch community pharmacies and the effect on adherence to chronic medication[J].Patient Educ Couns,2010,78(1):85-90.
[11]王耀娟,王淑娉.居家糖尿病患者记录糖尿病日记的效果观察[J].护理学报,2010,17(11):74-75.
[12]ELLIOT JR,DON AO,LNCIE B,et al.Ottawa panel evidence-based clinical practice guidelines for poststroke rehabilitation[J].Stroke Rehabilitation,2006,13(2):86-92.
[13]翁长水,毕胜,田哲,等.脑卒中患者偏瘫侧下肢肌力与运动功能、平衡、步行速度及ADL的关系[J].中国康复理论与实践,2004,10(11):694-696.
[14]BATES B,CHOI J Y,DUNCAN P W,et al.Veterans affairs/department of deferise clinical practice guideline for the management of adult stroke rehabilitation care:executive summary[J].Stroke,2005,36(9):2049-2056.
[15]Intercollegiate Stroke Working Pany.National clinical guidelines for stroke:second edition[M].Loudan:Royal College of Physicians of London,2004.
[16]National Stroke Foundation.Clinical guidelines for stroke rehabilitation and recovery[J].NHMRC,2005(8):2051-2052.
[17]张娟,曾丽吟,刘淑娟,等.增强型体外反搏治疗缺血性脑卒中患者的效果观察及护理[J].现代临床护理,2016,15(7):38-41.
[18]钱春荣,沈盈盈,钟代曲.手指操练习在缺血性脑卒中患者早期康复护理中的临床研究[J].护理与康复,2016,15(12):1165-1167.
[19]REKER D M,DUNCAN P W,HORNER R D,et al.Postacute stroke guideline compliance is associated with greater patient satisfaction[J].Arch Phys Med Rehabil,2002,83(6):750-756.
[20]李弋,石霞萍,刘湘菊,等.存在脑卒中危险因素社区人群的循证护理干预[J].护理研究,2017,31(10):1271-1274.
[21]田丽,窦金霞.循证护理在缺血性脑卒中治疗中的应用效果及对预防后的影响[J].职业与健康,2017,33(9):1294-1296.
[22]ALLEN K,HAZELETT S,JARJOURA D,et al.A randomized trial testing the superiority of a post-discharge care management model for stroke survivors[J].J Stroke Cerebrovasc Dis,2009,18(6):443-452.