认知康复护理介导的自我服药程序在卒中患者中的应用
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摘要
目的探讨认知康复护理介导的自我服药程序在卒中患者中的应用效果。方法对36例伴有轻-中度认知障碍的脑卒中患者(观察组)及42例非脑卒中患者(对照组)分别进行自我服药程序干预服药,观察组在此基础上进行认知康复训练,比较两组患者在应用自我服药程序过程中所经历的平均时间和最终实现自我服药程序的通过率。结果观察组自我服药程序第1～3阶段经历时间为(6.2±2.3)d、(4.2±1.3)d和(9.8±3.3)d,对照组为(9.7±3.2)d、(6.4±2.7)d和(4.7±2.3)d,观察组第1～2阶段时间显著短于对照组,第3阶段显著长于对照组(均P<0.01);观察组和对照组最终实现自我服药程序的通过率分别为83.3%(30/36)、35.7%(15/42),两组比较差异有统计学意义(P<0.01)。结论认知康复护理介导的自我服药程序应用于卒中后轻-中度认知障碍患者,可提高服药依从性成功率,改善患者的认知功能。
Objective To explore the effect of a nurse-led cognitive rehabilitation and self-medication program in stroke patients. Methods A total of 36 stroke patients with mild to moderate cognitive impairment were assigned into an observation group,re-ceiving nurse-led cognitive rehabilitation and self-medication intervention,while 42 nonstroke patients into a control group,being sujected to self-medication intervention only.The average time to achieve complete self-medication and the qualified rate of self-medication in the 2 groups were compared. Results It took the observation group(6.2±2.3)d,(4.2±1.3)d and(9.8±3.3)d respectively to cover the first,second,and third stages of the self-medication program,while it took the contro group(9.7±3.2)d,(6.4±2.7)d and(4.7±2.3)d to cover the same stages,with the observation group spending significantly shorter time in the first and second stages,and significantly longer time in the third stage,than the control group(P<0.01 for all).The qualified rate of self-medication in the observation group amounted to 83.3%(30/36),versus 35.7%(15/42) in the control group,with significant differences between the 2 groups(P<0.01). Conclusion The nurse-led cognitive rehabilitation and self-medication program enhances medication adherence of stroke patients with mild to moderate cognitive impairment,and also improves theri cognitive function.
Objective To explore the effect of a nurse-led cognitive rehabilitation and self-medication program in stroke patients. Methods A total of 36 stroke patients with mild to moderate cognitive impairment were assigned into an observation group,re-ceiving nurse-led cognitive rehabilitation and self-medication intervention,while 42 nonstroke patients into a control group,being sujected to self-medication intervention only.The average time to achieve complete self-medication and the qualified rate of self-medication in the 2 groups were compared. Results It took the observation group(6.2±2.3)d,(4.2±1.3)d and(9.8±3.3)d respectively to cover the first,second,and third stages of the self-medication program,while it took the contro group(9.7±3.2)d,(6.4±2.7)d and(4.7±2.3)d to cover the same stages,with the observation group spending significantly shorter time in the first and second stages,and significantly longer time in the third stage,than the control group(P<0.01 for all).The qualified rate of self-medication in the observation group amounted to 83.3%(30/36),versus 35.7%(15/42) in the control group,with significant differences between the 2 groups(P<0.01). Conclusion The nurse-led cognitive rehabilitation and self-medication program enhances medication adherence of stroke patients with mild to moderate cognitive impairment,and also improves theri cognitive function.
引文
[1]欧海宁,杨海芳,李盈盈,等.脑卒中认知康复的效果对运动功能和ADL的影响[J].广东医学,2007,28(8):1245-1247.
[2]高长云,胡喆,陈梅芳,等.急性脑卒中偏瘫患者的分期康复护理[J].实用临床医药杂志,2011,15(4):30-31,34.
[3]Schepers G P,Won H K,Bieliauskas L A,et al.A long-term-care setting pilot study evaluating predictors of suc-cess in medication self-administration[J].J Am Med DirAssoc,2000,1(3):103-108.
[4]Maddigan S L,Farris K B,Keating N,et al.Predictorsof older adults′capacity for medication management in aself-medication program:a retrospective chart review[J].J Aging Health,2003,15(2):332-352.
[5]Pereles L,Romonko L,Murzyn T,et al.Evaluation of aself-medication program[J].J Am Geriatr Soc,1996,44(2):161-165.
[6]Purdy M.Increasing stroke patients′success in self-medi-cation programs using an interdisciplinary cognitive reha-bilitation approach[J].Rehabil Nurs,2007,32(5):210-213,219.
[7]Corrigan P,Wallace C,Rezac M,et al.Learning medica-tion self-management skills in schizophrenia:relation-ships with cognitive deficits and psychiatric symptoms[J].Behavior Therapy,1994,25(1):5-15.
[8]孙静.>60岁卒中后认知功能障碍患者服药依从性的影响因素调查[J].临床合理用药杂志,2011,4(23):136-137.
[9]Branin J J.The role of memory strategies in medicationadherence among the elderly[J].Home Health Care ServQ,2001,20(2):1-16.
[2]高长云,胡喆,陈梅芳,等.急性脑卒中偏瘫患者的分期康复护理[J].实用临床医药杂志,2011,15(4):30-31,34.
[3]Schepers G P,Won H K,Bieliauskas L A,et al.A long-term-care setting pilot study evaluating predictors of suc-cess in medication self-administration[J].J Am Med DirAssoc,2000,1(3):103-108.
[4]Maddigan S L,Farris K B,Keating N,et al.Predictorsof older adults′capacity for medication management in aself-medication program:a retrospective chart review[J].J Aging Health,2003,15(2):332-352.
[5]Pereles L,Romonko L,Murzyn T,et al.Evaluation of aself-medication program[J].J Am Geriatr Soc,1996,44(2):161-165.
[6]Purdy M.Increasing stroke patients′success in self-medi-cation programs using an interdisciplinary cognitive reha-bilitation approach[J].Rehabil Nurs,2007,32(5):210-213,219.
[7]Corrigan P,Wallace C,Rezac M,et al.Learning medica-tion self-management skills in schizophrenia:relation-ships with cognitive deficits and psychiatric symptoms[J].Behavior Therapy,1994,25(1):5-15.
[8]孙静.>60岁卒中后认知功能障碍患者服药依从性的影响因素调查[J].临床合理用药杂志,2011,4(23):136-137.
[9]Branin J J.The role of memory strategies in medicationadherence among the elderly[J].Home Health Care ServQ,2001,20(2):1-16.