连续康复护理干预对脑卒中偏瘫患者的效果研究
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摘要
【目的】探讨护理人员对脑卒中偏瘫患者实施连续康复护理干预的效果,为今后护理干预提供指导和依据。
【方法】采用随机分组的方法将2007年6月至2007年12月在天津市环湖医院神经内科住院的85例脑卒中偏瘫患者分为干预组和对照组,两组患者均给予常规神经内科治疗和护理。干预组实施连续康复护理干预包括评估,康复护理教育和指导,出院前后持续教育和随访。分别在住院后一周内和干预后3个月进行资料收集,包括血甘油三酯、总胆固醇和同型半胱氨酸指标值;脑卒中偏瘫患者健康指导依从性;并采用Barthel指数(Barthel Index,B1)、健康调查见表(The MOS item short from health survey,SF-36)进行日常生活能力和生活质量的测评。全部数据采用SPSS10.0软件处理。
【结果】1.对比对照组,干预组患者血甘油三酯、总胆固醇和同型半胱氨酸水平均下降,并且具有统计学意义(P值＜0.05)。2.干预组Barthel Index得分显著高于对照组(P值＜0.05);并且干预组和对照组Barthel Index得分干预前后组内比较都具有显著性差异(P值＜0.05)。3.患者一般资料中合并疾病是患者生理健康的独立影响因素:同住亲友和照顾者是患者心理健康的独立影响因素。干预组患者干预后的生理健康和心理健康领域得分高于干预前(P值＜0.05)。在生理机能、生理职能、躯体疼痛、社会功能、情感职能、精神健康六个维度得分也高于干预前(P值＜0.05),但总体健康、精力两个维度得分的变化无统计学意义(P值＞0.05)。对照组患者干预后生理健康领域得分高于干预前(P值＜0.05),但心理健康领域得分的变化无统计学意义(P值＞0.05)。生理机能、生理职能干预后得分高于干预前,其他维度的得分无统计学意义(P值＞0.05)。4.干预组患者对脑卒中相关危险因素、康复护理、饮食、药物知识的理解水平高于对照组(P值＜0.05);饮食和药物依从性显著高于对照组(P值＜0.05)。
【结论】连续康复护理干预能够有效地降低脑卒中患者的血总胆固醇、甘油三酯、同型半胱氨酸水平;连续康复护理干预能够有效地提高脑卒中偏瘫患者的日常生活能力和生活质量;连续康复护理干预能够有效地提高脑卒中偏瘫患者对脑卒中相关知识的理解和依从性水平。
Objectives:To explore the effects of a continuous rehabilitation nursing intervention on the stroke patients with hemiplegia,so as to provide evidence for the future nursing intervention for stroke patients with hemiplegia.
Methods:85 stroke patients with hemiplegia who meet the inclusion criterion from the neurology deparement of Tianjin HuanHu Hospital since Jun 2007 to Dec 2007 were randomly assigned into the intervention group and the control group.All the patients received the routine neurologic medical therapy and the routine care.The patients in the intervention group also received a continuous rehabilitation nursing intervention including health assessment,rehabilitation consultation,health education before and after discharge and the follow-up.Data were collected when the patients were in hospital within the first week(the first evaluation)and the following 3 months after discharge hospital(the second evaluation)including the level of blood total cholesterol(TC),triglyeride(TG),homocysteine(Hcy),the compliance to the health guidance,the ability of daily living(BI),and the quality of life(SF-36).Data were analyzed with SPSS 10.0.
Results:1.Compared with the control group,the level of blood TC,TG;Hcy decreased in the intervention group(P＜0.05).2.The BI score in the intervention group was higher than that in the control group(P＜0.05),and the BI score after the intervention was higher than that before the intervention in the two groups(P＜0.05). 3.Multiple stepwise regression analyses revealed that(1)patients with more diseases was the independent factor to affect their physical health;(2)items of different members who living together with and different carers were the independent factors to affect the patients mental health in SF-36.In the intervention group,patients' scores of the physical health and mental health after the intervention were higher than those before the intervention(P＜0.05).All domains in SF-36 except general health and vitality after the intervention had higher score than those before the intervention (P＜0.05).In the control group,the results revealed after the intervention compaired with that before the intervention in SF-36(1)only the score of physical health was higher(P＜0.05);(2)the domains' scores of physical functioning and physical role were increased(P＜0.05),but the scores of other domains were found no different significantly(P＞0.05).4.Patients self-reported understanding of the basic knowledge about stroke risk factors,rehabilitation,diet,medication of the intervention group was significantly higher than that of the control group(P＜0.05).Similarly,the self-reproted compliances of diet and medication of the intervention group were significantly higher than those of the control group(P＜0.05).
Conclusions:A continuous rehabilition nursing intervention designed by the investigator in this study could effectively decrease the blood level of TC,TG,Hcy of the stroke patients.For the stroke patients with hemiplegia,the continuous rehabilition nursing intervention could effectively improve the quality of life,the ability of daily living,and the compliances to the diet and medication.
【方法】采用随机分组的方法将2007年6月至2007年12月在天津市环湖医院神经内科住院的85例脑卒中偏瘫患者分为干预组和对照组,两组患者均给予常规神经内科治疗和护理。干预组实施连续康复护理干预包括评估,康复护理教育和指导,出院前后持续教育和随访。分别在住院后一周内和干预后3个月进行资料收集,包括血甘油三酯、总胆固醇和同型半胱氨酸指标值;脑卒中偏瘫患者健康指导依从性;并采用Barthel指数(Barthel Index,B1)、健康调查见表(The MOS item short from health survey,SF-36)进行日常生活能力和生活质量的测评。全部数据采用SPSS10.0软件处理。
【结果】1.对比对照组,干预组患者血甘油三酯、总胆固醇和同型半胱氨酸水平均下降,并且具有统计学意义(P值＜0.05)。2.干预组Barthel Index得分显著高于对照组(P值＜0.05);并且干预组和对照组Barthel Index得分干预前后组内比较都具有显著性差异(P值＜0.05)。3.患者一般资料中合并疾病是患者生理健康的独立影响因素:同住亲友和照顾者是患者心理健康的独立影响因素。干预组患者干预后的生理健康和心理健康领域得分高于干预前(P值＜0.05)。在生理机能、生理职能、躯体疼痛、社会功能、情感职能、精神健康六个维度得分也高于干预前(P值＜0.05),但总体健康、精力两个维度得分的变化无统计学意义(P值＞0.05)。对照组患者干预后生理健康领域得分高于干预前(P值＜0.05),但心理健康领域得分的变化无统计学意义(P值＞0.05)。生理机能、生理职能干预后得分高于干预前,其他维度的得分无统计学意义(P值＞0.05)。4.干预组患者对脑卒中相关危险因素、康复护理、饮食、药物知识的理解水平高于对照组(P值＜0.05);饮食和药物依从性显著高于对照组(P值＜0.05)。
【结论】连续康复护理干预能够有效地降低脑卒中患者的血总胆固醇、甘油三酯、同型半胱氨酸水平;连续康复护理干预能够有效地提高脑卒中偏瘫患者的日常生活能力和生活质量;连续康复护理干预能够有效地提高脑卒中偏瘫患者对脑卒中相关知识的理解和依从性水平。
Objectives:To explore the effects of a continuous rehabilitation nursing intervention on the stroke patients with hemiplegia,so as to provide evidence for the future nursing intervention for stroke patients with hemiplegia.
Methods:85 stroke patients with hemiplegia who meet the inclusion criterion from the neurology deparement of Tianjin HuanHu Hospital since Jun 2007 to Dec 2007 were randomly assigned into the intervention group and the control group.All the patients received the routine neurologic medical therapy and the routine care.The patients in the intervention group also received a continuous rehabilitation nursing intervention including health assessment,rehabilitation consultation,health education before and after discharge and the follow-up.Data were collected when the patients were in hospital within the first week(the first evaluation)and the following 3 months after discharge hospital(the second evaluation)including the level of blood total cholesterol(TC),triglyeride(TG),homocysteine(Hcy),the compliance to the health guidance,the ability of daily living(BI),and the quality of life(SF-36).Data were analyzed with SPSS 10.0.
Results:1.Compared with the control group,the level of blood TC,TG;Hcy decreased in the intervention group(P＜0.05).2.The BI score in the intervention group was higher than that in the control group(P＜0.05),and the BI score after the intervention was higher than that before the intervention in the two groups(P＜0.05). 3.Multiple stepwise regression analyses revealed that(1)patients with more diseases was the independent factor to affect their physical health;(2)items of different members who living together with and different carers were the independent factors to affect the patients mental health in SF-36.In the intervention group,patients' scores of the physical health and mental health after the intervention were higher than those before the intervention(P＜0.05).All domains in SF-36 except general health and vitality after the intervention had higher score than those before the intervention (P＜0.05).In the control group,the results revealed after the intervention compaired with that before the intervention in SF-36(1)only the score of physical health was higher(P＜0.05);(2)the domains' scores of physical functioning and physical role were increased(P＜0.05),but the scores of other domains were found no different significantly(P＞0.05).4.Patients self-reported understanding of the basic knowledge about stroke risk factors,rehabilitation,diet,medication of the intervention group was significantly higher than that of the control group(P＜0.05).Similarly,the self-reproted compliances of diet and medication of the intervention group were significantly higher than those of the control group(P＜0.05).
Conclusions:A continuous rehabilition nursing intervention designed by the investigator in this study could effectively decrease the blood level of TC,TG,Hcy of the stroke patients.For the stroke patients with hemiplegia,the continuous rehabilition nursing intervention could effectively improve the quality of life,the ability of daily living,and the compliances to the diet and medication.
引文
[1]Vladimir Hachinski,Stroke in Chinese[J].stroke,2006,37:1347.
[2]Michael KM,Shaughnessy M.Stroke prevention and management in older adults[J].Cardiovasc Nurs,2006,21(5 Suppl 1):S21-26.
[3]黄为民,高展,冉春风,等.早期介入运动疗法脑中卒患者功能恢复的疗效评估[J].中国临床康复,2003,7(25):3484-3485.
[4]朱玉连,胡永善,吴毅,等.规范三级康复治疗中不同时期卒中患者运动功能改善规律的分析[J].中国运动医学杂志,2004,23:377-380.
[5]朱国行,胡永善,吴毅,等.规范的三级康复治疗对急性脑卒中偏瘫患者神经功能恢复的影响[J].中华医学杂志,2004,84:1955-1958.
[6]胡永善,吴毅,朱玉连,等.规范三级康复治疗促进脑卒中偏瘫患者综合功能的临床研究[J].中华物理医学与康复杂志,2005,27:105-107.
[7]李雅琴,余丽君,刘国英.脑卒中患者健康知识水平的调查分析[J].中华护理杂志,2004,39(8):578-579.
[8]Koenig KL,Whyte EM,Munin MC,et al.Stroke-related knowledge and health behaviors among poststroke patients in inpatient rehabilitation[J].Arch Phys Med Rehabil,2007,88(9):1214-1216.
[9]周成业,谷笑蓉,邹长林,等.脑卒中病人相关知识、态度及行为的调查[J].中华临床医学杂志,2004,5(6):103-105.
[10]Sit JW,Yip VY,Ko SK,et al.A quasi-experimental study on a community-based stroke prevention programme for clients with minor stroke[J].J Clin Nurs,2007,16(2):272-281.
[11]Reeves MJ,Rafferty AP,Aranha AA,et al.Changes in Knowledge of Stroke Risk Factors and Warning Signs among Michigan Adults[J].Cerebrovasc Dis,2008,25(5):385-391.
[12]Wall HK,Beagan BM,O'Neill J,et al.Addressing stroke signs and symptoms through public education:the Stroke Heroes Act FAST campaign[J].Prev Chronic Dis,2008,5(2):A49.
[13]Jiang X,Sit JW,Wong TK.A nurse-led cardiac rehabilitation programme improves health behaviours and cardiac physiological risk parameters:evidence from Chengdu,China[J].J Clin Nurs,2007,16(10):1886-1897.
[14]张翠兰,孙海嵩,李军,等.教育干预对高血压及脑卒中病人生存质量提高 的研究[J].现代康复,2001,5(6):31-32.
[15]Bravata DM,Kim N,Concato J,et al.Thrombolysis for acute stroke in routine clinical practice[J].Arch Intern Med,2002,162(17):1994-2001.
[16]倪朝民.急性脑卒中的早期康复及其功能训练时间[J].中国临床康复,2002,6(3):314.
[17]Hayes SH,Carroll SR.Early intervention care in the acute stroke patient[J].Arch Phys Med Rehabil,1986,67:3192321.
[18]Deborah T.Csatellucci.Perceptions of Autonomy in Poststroke Elderly Clients [J].Rehablitation Nursing,2004,29(1):24-29.
[19]岳静玲,陈长香,郭慧丽.脑卒中偏瘫患者早期系统康复训练的疗效观察[J].中国综合临床,2006,22(4):310-311.
[20]Nir Z,Zolotoogorsky Z,Sugarman H.Structured nursing intervention versus routine rehabilitation after stroke[J].Am J Phys Med Rehabil,2004,83(7):522-529.
[21]Naylor MD,Brooten D,Campbell R,et al.Comprehensive discharge planning and home follow-up of hospitalized elders:a randomized clinical trial[J].JAMA,1999,281(7):613-620.
[22]Coleman EA,Min SJ,Chomiak A,et al.Posthospital Care Transitions:Patterns,Complications,and Risk Identification[J].AM.Health Serv Res,2004,39(5):1449-1466.
[23]Coleman EA,Parry C,Chalmers S,et al.The care transitions intervention:results of a randomized controlled trial[J].Arch Intern Med.,2006,166(17):1822-1828.
[24]Burks KJ.Anursding practice model for chronic illness[J].Rehabil Nurs,1999,24(5):197-200.
[25]Timmins F,Horan p.A critical analysis of the potential contribution of Orem's (2001)self-care deficit nursing theory to contemporary coronary care nursing practice[J].Eur J Cardiovasc Nurs,2007,6(1):32-39.
[26]Timmins F.A critical review of appropriate conceptual models for use by coronary care nurses[J].Int Nurs Rev,2008,55(1):117-124.
[27]全国第四届脑血管病学术会议各类脑血管病诊断要点[J].中华神经科杂志,1996,29:379-380.
[28]常淑娟,刑晓红,上官琴苗.家庭康复训练对出院后脑卒中患者日常生活活动能力的影响[J].中华物理医学与康复医学杂志,2007,29(8):548-550.
[29]Burke LE,Dunbar-Jacob J.Adherence to medication,diet,and activity recommendations:from assessment to maintenance[J].J Cardiovasc Nurs,1995,9(2):62-79.
[30]Prado JC Jr,Kupek E,Mion D Jr.Validity of four indirect methods to measure adherence in primary care hypertensives[J].J Hum Hypertens,2007,21(7):579-84.
[31]吴明隆主编.SPSS统计实用应用[M].北京:中国铁道出版社,2000:7.
[32]余建英,何旭宏主编.数据统计分析与SPSS应用[M].北京:人民邮电出版社,2003:353-364.
[33]Dorman P,Slattery J,Farrell B,et al.Qualitative comparison of the reliability of health status assessments with the EuroQo1 and SF-36 questionnaires after stroke.United Kingdom Collaborators in the International Stroke Trial[J].Stroke,1998,29(1):63-68.
[34]Liu C,Li N,Ren X,et al.Feasibility of using short form 36 in Chinese population[J].Hua Xi Yi Ke Da Xue Xue Bao,2001,32(1):39-42.
[35]蔺勇,李鹏,刘世文.脑卒中患者日常生活能力评定[J].中国临床康复,2002,6(9):1249-1251
[36]Miyai I.Neuroscience based strategies for neurorehabilitation[J].Brain Nerve,2007.59:347-355.
[37]Nudo RJ.Plasticity[J].NeuroRx,2006,3:420-427.
[38]王拥军.卒中单元[M].北京科学技术文化出版社,2004,231.
[39]Jorgensen HS,Nakayama H,Raaschou HO,et al.Outcome and time course of recovery in spoke.Part Ⅱ:Time course of recovery.The Copenhagen Stroke Sdudy[J].Arch Phys Med Rehabili,1995,76:406-412.
[40]莫海花,钟美容,胡艳宁,等.急性脑卒中偏瘫患者早期康复的偱证护理[J].中国实用护理杂志,2006,22(4):9-10.
[41]武行华,倪朝民,韩瑞,等.早期康复对急性脑卒中偏瘫患者肌痉挛、ADL 与运动能力的影响[J].中国康复医学杂志,2006,21(6):494-496.
[42]解庆凡,史艳.综合康复护理对急性期脑卒中患者ADL的影响[J].中国康复医学杂志,2005,20(7):545-546.
[43]侯红,王彤,王红星,等.三级康复治疗对脑卒中偏瘫患者功能雨后的影响[J].中国康复医学,2006,21(1):61-63.
[44]Gert Kwakkel,Boudewijn Kollen,Jos Twisk.Impact of time on improvement of outcome after stroke[J].Stroke,2006,37:2348-2453.
[45]Jaracz K,Kozubski W.Quality of life in stroke patients[J].Acta Neurol Scand,2003,107(5):324-9.
[46]WHO.The development of the WHO quality of life assessment instrument[R].Geneva.1993.
[47]Teasdale TW,Engberg AW.Long-term psychosocial consequences of stroke[J].Ugeskr Laeger,2007,169(40):3401-3404.
[48]Vestling M,Ramel E,Iwarsson S.Quality of life after stroke:well-being,life satisfaction,and subjective aspects of work[J].Scand J Occup Ther.2005,12(2):89-95.
[49]Bluvol A,Ford-Gilboe M.Hope,health work and quality of life in families of stroke survivors[J].J Adv Nurs,2004,48(4):322-332.
[50]Wilma M,Hopman MA,Jane Vemer,et al.Quality of life during and after inpatient stroke rehabilitation[J].Stroke,2003,34:801-805.
[51]Studenski S,Duncan PW,Perera S,et al.Daily functioning and quality of life in a randomized controlled trial of therapeutic exercise for subacute stroke survivors[J].Stroke,2005,36(8):1764-1770.
[52]Leeds L,Meara J,Hobson P.The impact of discharge to a care home on longer term stroke outcomes[J].Clin Rehabil,2004,18(8):924-928.
[53]Patel MD,Tilling K,Lawrence E,et al.Relationships between long-term stroke disability,handicap and health-related quality of life[J].Age Ageing,2006,35(3):273-279.
[54]Rankin SH,Stallings KD.Patient education-principles&practice[M].Lippincott,Williams&Wilkins.2001,197-226.
[55]Emond MJ,Zareba W.Prognostic value of cholesterol in women of different ages[J].J Women Health,1997,6:195307.
[56]Fagot-Campagna A,Hanson RL,Narayan KM,et al.Serum cholesterol and mortality rates in a native American population with low cholesterol concentrations:a U-shaped association[J].Circulation,1997,96:1408-1415.
[57]Lepala JM,Virtamo J,Fogelholm R,et al.Different risk factors for different stroke subtypes:association of blood pressure,cholesterol,and antioxidants[J].Stroke.1999.30:2535-2540.
[58]武阳丰,赵冬,周北凡,等.中国人群血脂异常诊治和分层方案的研究[J].中华心血管病杂志,2007,5(35):428-433.
[59]国家九五攻关课题协作组.我国心血管病发病趋势预测及21世纪预防策略的研究[J].医学研究通讯,2003,32(1):2-5.
[60]王薇,赵冬,刘静,等.中国35～64岁人群胆固醇水平与10年心血管病发病危险的前瞻性研究[J].中华心血管病杂志,2006,34(2):169-173.
[61]Brown DF,Kineh SH,Doyle yr.Serum triglyerides in health and in ischemic heart disease[J].N Eng J Med,1965,273(18):947-952.
[62]王薇,赵冬,吴兆苏,等.中国11省市35-64岁人群血清甘油三酯分布特点及与其他心血管病危险因素关系的研究[J].中华流行病学杂志,2001,22(1):26-29.
[63]Scandianavian Simvastin Survival Study Group.Randomised trial of cholesterol lowering in 4444 patients with coronary heart diseases:the Scandianavian Simvastin Survival Study(4S)[J].Lancet,1994,344(8934):1383-1389.
[64]Sacks FM,Pfeffer MA,Moye LA,et al.The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels.Cholesterol and Recurrent Events Trial investigators[J].N Engl J Med,1996,335(14):1001-1009.
[65]Khot UN,Khot MB,Bajzer CT,et al.Prevalence of conventional risk factors in patients with coronary heart disease[J].JAMA,2003,290:898-904.
[66]Arnesen E,Refsum H,Bonaa KH,et al.Serum total homocysteine and coronary heart disease[J].Int J Epidemiol,1995,24:704-709.
[67]Bostom AG,Silbershatz H,Rosenberg IH,et al.Nonfasting plasma total homocysteine levels and all-cause and cardiovascular disease mortality in elderly Framingham men and women[J].Arch Intern Med,1999,59:1077-1080.
[68]祖衡兵,邬军峰,赵永飞,等.脑卒中患者高同型半胱氨酸血症B族维生素联合治疗的随机对照研究[J].中国临床医学,2006,13(4):556-558.
[69]Jayne VW,John WJY,Dorothy M,et al.Effect of B-group vitamins and antioxidant vitamins on hyperhomocysteinemia:a double-blind,randomized,factorial design,controlled trial[J].Am J Clin Nutr,1998,67(4):858.
[70]VITATOPS Trial Study Group.The VITATOPS(Vitamins to Prevent Stroke)Trial:rationale and design of an international,large,simple,randomized trial of homocysteine-lowering multivitamin therapy in patients with recent transient ischemic attack or stroke[J].Cerebrovasc Dis,2002,13:120-126.
[71]Rankin SH,Stallings KD.Patient education-principles&practice[M].Lippincott,Williarns&Wilkins,2001:197-226.
[72]Donna R.Falvo.Effective Patient Education:A Guide to Increased Compliance [M].Jones & Bartlett Publishers,2004:227.
[73]Choi JS,Seo YM,Kwon IS.Effects of education on knowledge and practice of caregivers of the stroke patient[J].Taehan Kanho Hakhoe Chi,2006,36(7):1175-1182.
[74]Louie SW,Liu PK,Man DW.The effectiveness of a stroke education group on persons with stroke and their caregivers[J].Int J Rehabil Res,2006,29(2):123-129.
[75]Nir Z,Weisel-Eichler A.Improving knowledge and skills for use of medication by patients after stroke:evaluation of a nursing intervention[J].Am J Phys Med Rehabil.2006,85(7):582-592.
[76]Rankin SH,Stallings KD.Patient education-principles&practice[M].Lippincott,Williams&Wilkins,2001:391-411.
[77]Park DC,Morrell RW,Frieske D,et al.Medication adherence behaviors in older adults:effects of external cognitive supports[J].Psychol Aging,1992,7(2):252-256.
[78]Kendrick R,Bayne JR.Compliance with prescribed medication by elderly patients[J].Can Med Assoc J,1982,127(10):961-962.
[79]Bittar N.Maintaining long-term control of blood pressure:the role in proved complaince[J].Cardiol,1995,18(suPP1):112.
[80]陈桂媛,李晓黎.家庭访视对脑卒中患者治疗依从性与运动功能及生活能力的影响[J].护理学杂志,2006,21(9):65-67.
[81]Zhao W,Chen J.Implications from and for food cultures for cardiovascular disease:diet,nutrition and cardiovascular diseases in China[J].Asia Pac J Clin Nutr,2001,10(2):146-52.
[82]Mare F,Kennedy Lees,J David Spence.Nutrition and stroke prevention[J].Stroke,2006,37:2430.
[83]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.多重心血管病危险综合防治建议[J].中华心血管病杂志,2006,34(12):1061-1071.
[84]Swartz J.Strategies to promote diet adherence by the elderly[J].Dinensions ins Health Service,59(7):14-15.
[85]Burke LE,Dunbar-Jacob J,Orchard TJ.Improving adherence to a cholesterol- lowering diet: a behavioral intervention study[J]. Patient Educ Couns, 2005, 57(1).134-42.
[1]Vladimir Hachinski,Stroke in Chinese[J].Stroke,2006,37:1347.
[2]Michael KM,Shaughnessy M.Stroke prevention and management in older adults[J].J Cardiovasc Nurs,2006,21(5 Suppl 1):S21-26.
[3]黄为民,高展,冉春风,等.早期介入运动疗法脑中卒患者功能恢复的疗效评估[J].中国临床康复,2003,7(25):3484-3485.
[4]Komitova M,Johansson BB,Eriksson PS.On neural plasticity,new neurons and the postischemic milieu:an integrated view on experimental rehabilitation[J].Exp Neurol,2006,199(1):42-55.
[5]Long AF,Kneafsey R,Ryan J,et al.The role of the nurse within the multi-professional rehabilitation team[J].J Adv Nurs,2002,37(1):70-78.
[6]Burton C,Gibbon B.Expanding the role of the stroke nurse:a pragmatic clinical trial[J].J Adv Nurs,2005,52(6):640-650.
[7]Burton CR.A description of the nursing role in stroke rehabilitation[J].J Adv Nurs,2000,32(1):174-181.
[8]解庆凡,史艳.综合康复护理对急性期脑卒中患者ADL的影响[J].中国康复医学杂志,2005,20(7):545-546.
[9]Eich HJ,Mach H,Werner C,et al.Aerobic treadmill plus Bobath training improves walking in subacute stroke:a randomized controlled trial[J].Clin Rehabil,2004,18(6):640-651.
[10]Nir Z,Zolotogorsky Z,Sugarman H.Structured nursing intervention versus routine rehabilitation after stroke[J].Am J Phys Med Rehabil,2004,83(7):522-529.
[11]Gellez-Leman MC,Colle F,Bonan I,et al,Yelnik A.Evaluation of the disabilities of hemiplegic patients[J].Ann Readapt Med Phys,2005,48(6):361-368.
[12]Hayes SH,Carroll SR.Early intervention care in the acute stroke patient[J].Arch Phys Med Rehabil,1986,67:3192321.
[13]倪朝民.急性脑卒中的早期康复及其功能训练时间[J].中国临床康复,2002,6(3):314.
[14]李红玲,贾子善,宋兰欣,等.脑卒中偏瘫早期康复疗效观察[J].中华物理医学杂志,1998,20(2):1092112.
[15]李泽锋,黄佩荣,赵爱社,等.脑卒中偏瘫患者急性期的综合康复治疗[J].中国康复,2001,16(3):1522153.
[16]司惠芳,郑建琴,吴海燕.实施康复“三阶段训练法”预防脑卒中后“二次损伤”[J].实用护理杂志,1999,15(7):12213.
[17]王拥军.卒中单元.北京:科学技术文化出版社[M],2004,231.
[18]罗利俊,陈国华,龚雪琴,等.卒中单元综合治疗对脑卒中患者运动功能康复的影响[J].中华物理医学与康复杂志,2005,27(9):534-536.
[19]Zhu GX,Hu YS,Wu Y,et al.Effects of standardized three-stage rehabilitation on recovery of neurological function in stroke patients with hemiplegia[J].Zhonghua Yi Xue Za Zhi,2004,84(23):1955-1958.
[20]刘岩,李友莲,黄建萍,等.脑卒中偏瘫病人肢体运动功能的康复护理训练[J].实用护理杂志,2002,18(4):11-12.
[21]Dobkin BH.Strategies for stroke rehabilitation[J].Lancet Neurol,2004,3(9):528-536.
[22]Fasoli SE,Krebs HI,Stein J,et al.Robotic therapy for chronic motor impairments after stroke:Follow-up results[J].Arch Phys Med Rehabil,2004,85(7):1106-1111.
[23]Lin JH,Hsieh CL,Lo SK,et al.Prelimunary study of the effect of low-intensity home-based physical therapy in chronic stroke patients[J].Kaohsiung J Med Sci,2004,20(1):18-23.
[24]Domka E,Myjkowska E,Kwolek A.Incidence of neuromedical complications during rehabilitation after stroke[J].Neurol Neurochir Pol,2005,39(4):300-309.
[25]Pinedo S,de la Villa FM.Complications in the hemiplegic patient in the first year after the stroke[J].Rev Neurol,2001,32(3):206-209.
[26]Horn AI,Fontes SV,de Carvalho SM,et al.Kinesiotherapy prevents shoulder pain in hemiplegic/pareticpatients on sub-acute stage post-stroke[J].Arq Neuropsiquiatr,2003,61(3B):768-771.
[27]Turner-Stokes L,Jackson D.Shoulder pain after stroke:a revuew of the evudence base to inform the development of an integrated care pathway[J].Clin Rehabil,2002,16(3):276-298.
[28]Vuagnat H,Chantraine A.Shoulder pain in hemiplegia revisited:contribution of functional electrical stimulation and other therapies[J].J Rehabil Med,2003,35(2):49-54.
[29]莫海花,钟美容,胡艳宁,等.急性脑卒中偏袒患者早期康复的循证护理[J].中国实用护理杂志,2006,22(4):9-10.
[30]Xu BH,Yu RQ,Yu W,et al.Effects of early rehabilitation on activities of daily living and complication in acute stroke patients[J].Beijing Da Xue Xue Bao,2004,36(1):75-78.
[31]Antai-Otong D.Poststroke depression:psychopharmaeological considerations[J].Perspect Psychiatr Care,2004,40(4):167-170.
[32]Williams LS.Depression and stroke:cause or consequence[J]? Semin Neurol,2005,25(4):396-409.
[33]Hackett ML,Yapa C,Parag V,et al.Frequency of depression after stroke:a systematic review of observational studies[J].Stroke,2005,36(6):1330-1340.
[34]张景莉,朱秀英,常永霞,等.脑卒中偏瘫患者的早期康复和心理护理[J].中国康复,2004,19(6):377-378.
[35]尹宗惠.老年脑卒中后抑郁状况的调查及护理对策[J].国际护理学杂志.2006,25(3):217-219.
[36]Yamakawa Y,Satoh S,Sawa S,et al.Efficacy of milnacipran on poststroke depression on inpatient rehabilitation[J].Psychiatry Clin Neurosci,2005,59(6):705-10.
[37]董永蓉.心理护理在脑卒中后抑郁病人功能康复中的作用[J].护理研究,2005,19(2):313-314.
[2]Michael KM,Shaughnessy M.Stroke prevention and management in older adults[J].Cardiovasc Nurs,2006,21(5 Suppl 1):S21-26.
[3]黄为民,高展,冉春风,等.早期介入运动疗法脑中卒患者功能恢复的疗效评估[J].中国临床康复,2003,7(25):3484-3485.
[4]朱玉连,胡永善,吴毅,等.规范三级康复治疗中不同时期卒中患者运动功能改善规律的分析[J].中国运动医学杂志,2004,23:377-380.
[5]朱国行,胡永善,吴毅,等.规范的三级康复治疗对急性脑卒中偏瘫患者神经功能恢复的影响[J].中华医学杂志,2004,84:1955-1958.
[6]胡永善,吴毅,朱玉连,等.规范三级康复治疗促进脑卒中偏瘫患者综合功能的临床研究[J].中华物理医学与康复杂志,2005,27:105-107.
[7]李雅琴,余丽君,刘国英.脑卒中患者健康知识水平的调查分析[J].中华护理杂志,2004,39(8):578-579.
[8]Koenig KL,Whyte EM,Munin MC,et al.Stroke-related knowledge and health behaviors among poststroke patients in inpatient rehabilitation[J].Arch Phys Med Rehabil,2007,88(9):1214-1216.
[9]周成业,谷笑蓉,邹长林,等.脑卒中病人相关知识、态度及行为的调查[J].中华临床医学杂志,2004,5(6):103-105.
[10]Sit JW,Yip VY,Ko SK,et al.A quasi-experimental study on a community-based stroke prevention programme for clients with minor stroke[J].J Clin Nurs,2007,16(2):272-281.
[11]Reeves MJ,Rafferty AP,Aranha AA,et al.Changes in Knowledge of Stroke Risk Factors and Warning Signs among Michigan Adults[J].Cerebrovasc Dis,2008,25(5):385-391.
[12]Wall HK,Beagan BM,O'Neill J,et al.Addressing stroke signs and symptoms through public education:the Stroke Heroes Act FAST campaign[J].Prev Chronic Dis,2008,5(2):A49.
[13]Jiang X,Sit JW,Wong TK.A nurse-led cardiac rehabilitation programme improves health behaviours and cardiac physiological risk parameters:evidence from Chengdu,China[J].J Clin Nurs,2007,16(10):1886-1897.
[14]张翠兰,孙海嵩,李军,等.教育干预对高血压及脑卒中病人生存质量提高 的研究[J].现代康复,2001,5(6):31-32.
[15]Bravata DM,Kim N,Concato J,et al.Thrombolysis for acute stroke in routine clinical practice[J].Arch Intern Med,2002,162(17):1994-2001.
[16]倪朝民.急性脑卒中的早期康复及其功能训练时间[J].中国临床康复,2002,6(3):314.
[17]Hayes SH,Carroll SR.Early intervention care in the acute stroke patient[J].Arch Phys Med Rehabil,1986,67:3192321.
[18]Deborah T.Csatellucci.Perceptions of Autonomy in Poststroke Elderly Clients [J].Rehablitation Nursing,2004,29(1):24-29.
[19]岳静玲,陈长香,郭慧丽.脑卒中偏瘫患者早期系统康复训练的疗效观察[J].中国综合临床,2006,22(4):310-311.
[20]Nir Z,Zolotoogorsky Z,Sugarman H.Structured nursing intervention versus routine rehabilitation after stroke[J].Am J Phys Med Rehabil,2004,83(7):522-529.
[21]Naylor MD,Brooten D,Campbell R,et al.Comprehensive discharge planning and home follow-up of hospitalized elders:a randomized clinical trial[J].JAMA,1999,281(7):613-620.
[22]Coleman EA,Min SJ,Chomiak A,et al.Posthospital Care Transitions:Patterns,Complications,and Risk Identification[J].AM.Health Serv Res,2004,39(5):1449-1466.
[23]Coleman EA,Parry C,Chalmers S,et al.The care transitions intervention:results of a randomized controlled trial[J].Arch Intern Med.,2006,166(17):1822-1828.
[24]Burks KJ.Anursding practice model for chronic illness[J].Rehabil Nurs,1999,24(5):197-200.
[25]Timmins F,Horan p.A critical analysis of the potential contribution of Orem's (2001)self-care deficit nursing theory to contemporary coronary care nursing practice[J].Eur J Cardiovasc Nurs,2007,6(1):32-39.
[26]Timmins F.A critical review of appropriate conceptual models for use by coronary care nurses[J].Int Nurs Rev,2008,55(1):117-124.
[27]全国第四届脑血管病学术会议各类脑血管病诊断要点[J].中华神经科杂志,1996,29:379-380.
[28]常淑娟,刑晓红,上官琴苗.家庭康复训练对出院后脑卒中患者日常生活活动能力的影响[J].中华物理医学与康复医学杂志,2007,29(8):548-550.
[29]Burke LE,Dunbar-Jacob J.Adherence to medication,diet,and activity recommendations:from assessment to maintenance[J].J Cardiovasc Nurs,1995,9(2):62-79.
[30]Prado JC Jr,Kupek E,Mion D Jr.Validity of four indirect methods to measure adherence in primary care hypertensives[J].J Hum Hypertens,2007,21(7):579-84.
[31]吴明隆主编.SPSS统计实用应用[M].北京:中国铁道出版社,2000:7.
[32]余建英,何旭宏主编.数据统计分析与SPSS应用[M].北京:人民邮电出版社,2003:353-364.
[33]Dorman P,Slattery J,Farrell B,et al.Qualitative comparison of the reliability of health status assessments with the EuroQo1 and SF-36 questionnaires after stroke.United Kingdom Collaborators in the International Stroke Trial[J].Stroke,1998,29(1):63-68.
[34]Liu C,Li N,Ren X,et al.Feasibility of using short form 36 in Chinese population[J].Hua Xi Yi Ke Da Xue Xue Bao,2001,32(1):39-42.
[35]蔺勇,李鹏,刘世文.脑卒中患者日常生活能力评定[J].中国临床康复,2002,6(9):1249-1251
[36]Miyai I.Neuroscience based strategies for neurorehabilitation[J].Brain Nerve,2007.59:347-355.
[37]Nudo RJ.Plasticity[J].NeuroRx,2006,3:420-427.
[38]王拥军.卒中单元[M].北京科学技术文化出版社,2004,231.
[39]Jorgensen HS,Nakayama H,Raaschou HO,et al.Outcome and time course of recovery in spoke.Part Ⅱ:Time course of recovery.The Copenhagen Stroke Sdudy[J].Arch Phys Med Rehabili,1995,76:406-412.
[40]莫海花,钟美容,胡艳宁,等.急性脑卒中偏瘫患者早期康复的偱证护理[J].中国实用护理杂志,2006,22(4):9-10.
[41]武行华,倪朝民,韩瑞,等.早期康复对急性脑卒中偏瘫患者肌痉挛、ADL 与运动能力的影响[J].中国康复医学杂志,2006,21(6):494-496.
[42]解庆凡,史艳.综合康复护理对急性期脑卒中患者ADL的影响[J].中国康复医学杂志,2005,20(7):545-546.
[43]侯红,王彤,王红星,等.三级康复治疗对脑卒中偏瘫患者功能雨后的影响[J].中国康复医学,2006,21(1):61-63.
[44]Gert Kwakkel,Boudewijn Kollen,Jos Twisk.Impact of time on improvement of outcome after stroke[J].Stroke,2006,37:2348-2453.
[45]Jaracz K,Kozubski W.Quality of life in stroke patients[J].Acta Neurol Scand,2003,107(5):324-9.
[46]WHO.The development of the WHO quality of life assessment instrument[R].Geneva.1993.
[47]Teasdale TW,Engberg AW.Long-term psychosocial consequences of stroke[J].Ugeskr Laeger,2007,169(40):3401-3404.
[48]Vestling M,Ramel E,Iwarsson S.Quality of life after stroke:well-being,life satisfaction,and subjective aspects of work[J].Scand J Occup Ther.2005,12(2):89-95.
[49]Bluvol A,Ford-Gilboe M.Hope,health work and quality of life in families of stroke survivors[J].J Adv Nurs,2004,48(4):322-332.
[50]Wilma M,Hopman MA,Jane Vemer,et al.Quality of life during and after inpatient stroke rehabilitation[J].Stroke,2003,34:801-805.
[51]Studenski S,Duncan PW,Perera S,et al.Daily functioning and quality of life in a randomized controlled trial of therapeutic exercise for subacute stroke survivors[J].Stroke,2005,36(8):1764-1770.
[52]Leeds L,Meara J,Hobson P.The impact of discharge to a care home on longer term stroke outcomes[J].Clin Rehabil,2004,18(8):924-928.
[53]Patel MD,Tilling K,Lawrence E,et al.Relationships between long-term stroke disability,handicap and health-related quality of life[J].Age Ageing,2006,35(3):273-279.
[54]Rankin SH,Stallings KD.Patient education-principles&practice[M].Lippincott,Williams&Wilkins.2001,197-226.
[55]Emond MJ,Zareba W.Prognostic value of cholesterol in women of different ages[J].J Women Health,1997,6:195307.
[56]Fagot-Campagna A,Hanson RL,Narayan KM,et al.Serum cholesterol and mortality rates in a native American population with low cholesterol concentrations:a U-shaped association[J].Circulation,1997,96:1408-1415.
[57]Lepala JM,Virtamo J,Fogelholm R,et al.Different risk factors for different stroke subtypes:association of blood pressure,cholesterol,and antioxidants[J].Stroke.1999.30:2535-2540.
[58]武阳丰,赵冬,周北凡,等.中国人群血脂异常诊治和分层方案的研究[J].中华心血管病杂志,2007,5(35):428-433.
[59]国家九五攻关课题协作组.我国心血管病发病趋势预测及21世纪预防策略的研究[J].医学研究通讯,2003,32(1):2-5.
[60]王薇,赵冬,刘静,等.中国35～64岁人群胆固醇水平与10年心血管病发病危险的前瞻性研究[J].中华心血管病杂志,2006,34(2):169-173.
[61]Brown DF,Kineh SH,Doyle yr.Serum triglyerides in health and in ischemic heart disease[J].N Eng J Med,1965,273(18):947-952.
[62]王薇,赵冬,吴兆苏,等.中国11省市35-64岁人群血清甘油三酯分布特点及与其他心血管病危险因素关系的研究[J].中华流行病学杂志,2001,22(1):26-29.
[63]Scandianavian Simvastin Survival Study Group.Randomised trial of cholesterol lowering in 4444 patients with coronary heart diseases:the Scandianavian Simvastin Survival Study(4S)[J].Lancet,1994,344(8934):1383-1389.
[64]Sacks FM,Pfeffer MA,Moye LA,et al.The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels.Cholesterol and Recurrent Events Trial investigators[J].N Engl J Med,1996,335(14):1001-1009.
[65]Khot UN,Khot MB,Bajzer CT,et al.Prevalence of conventional risk factors in patients with coronary heart disease[J].JAMA,2003,290:898-904.
[66]Arnesen E,Refsum H,Bonaa KH,et al.Serum total homocysteine and coronary heart disease[J].Int J Epidemiol,1995,24:704-709.
[67]Bostom AG,Silbershatz H,Rosenberg IH,et al.Nonfasting plasma total homocysteine levels and all-cause and cardiovascular disease mortality in elderly Framingham men and women[J].Arch Intern Med,1999,59:1077-1080.
[68]祖衡兵,邬军峰,赵永飞,等.脑卒中患者高同型半胱氨酸血症B族维生素联合治疗的随机对照研究[J].中国临床医学,2006,13(4):556-558.
[69]Jayne VW,John WJY,Dorothy M,et al.Effect of B-group vitamins and antioxidant vitamins on hyperhomocysteinemia:a double-blind,randomized,factorial design,controlled trial[J].Am J Clin Nutr,1998,67(4):858.
[70]VITATOPS Trial Study Group.The VITATOPS(Vitamins to Prevent Stroke)Trial:rationale and design of an international,large,simple,randomized trial of homocysteine-lowering multivitamin therapy in patients with recent transient ischemic attack or stroke[J].Cerebrovasc Dis,2002,13:120-126.
[71]Rankin SH,Stallings KD.Patient education-principles&practice[M].Lippincott,Williarns&Wilkins,2001:197-226.
[72]Donna R.Falvo.Effective Patient Education:A Guide to Increased Compliance [M].Jones & Bartlett Publishers,2004:227.
[73]Choi JS,Seo YM,Kwon IS.Effects of education on knowledge and practice of caregivers of the stroke patient[J].Taehan Kanho Hakhoe Chi,2006,36(7):1175-1182.
[74]Louie SW,Liu PK,Man DW.The effectiveness of a stroke education group on persons with stroke and their caregivers[J].Int J Rehabil Res,2006,29(2):123-129.
[75]Nir Z,Weisel-Eichler A.Improving knowledge and skills for use of medication by patients after stroke:evaluation of a nursing intervention[J].Am J Phys Med Rehabil.2006,85(7):582-592.
[76]Rankin SH,Stallings KD.Patient education-principles&practice[M].Lippincott,Williams&Wilkins,2001:391-411.
[77]Park DC,Morrell RW,Frieske D,et al.Medication adherence behaviors in older adults:effects of external cognitive supports[J].Psychol Aging,1992,7(2):252-256.
[78]Kendrick R,Bayne JR.Compliance with prescribed medication by elderly patients[J].Can Med Assoc J,1982,127(10):961-962.
[79]Bittar N.Maintaining long-term control of blood pressure:the role in proved complaince[J].Cardiol,1995,18(suPP1):112.
[80]陈桂媛,李晓黎.家庭访视对脑卒中患者治疗依从性与运动功能及生活能力的影响[J].护理学杂志,2006,21(9):65-67.
[81]Zhao W,Chen J.Implications from and for food cultures for cardiovascular disease:diet,nutrition and cardiovascular diseases in China[J].Asia Pac J Clin Nutr,2001,10(2):146-52.
[82]Mare F,Kennedy Lees,J David Spence.Nutrition and stroke prevention[J].Stroke,2006,37:2430.
[83]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.多重心血管病危险综合防治建议[J].中华心血管病杂志,2006,34(12):1061-1071.
[84]Swartz J.Strategies to promote diet adherence by the elderly[J].Dinensions ins Health Service,59(7):14-15.
[85]Burke LE,Dunbar-Jacob J,Orchard TJ.Improving adherence to a cholesterol- lowering diet: a behavioral intervention study[J]. Patient Educ Couns, 2005, 57(1).134-42.
[1]Vladimir Hachinski,Stroke in Chinese[J].Stroke,2006,37:1347.
[2]Michael KM,Shaughnessy M.Stroke prevention and management in older adults[J].J Cardiovasc Nurs,2006,21(5 Suppl 1):S21-26.
[3]黄为民,高展,冉春风,等.早期介入运动疗法脑中卒患者功能恢复的疗效评估[J].中国临床康复,2003,7(25):3484-3485.
[4]Komitova M,Johansson BB,Eriksson PS.On neural plasticity,new neurons and the postischemic milieu:an integrated view on experimental rehabilitation[J].Exp Neurol,2006,199(1):42-55.
[5]Long AF,Kneafsey R,Ryan J,et al.The role of the nurse within the multi-professional rehabilitation team[J].J Adv Nurs,2002,37(1):70-78.
[6]Burton C,Gibbon B.Expanding the role of the stroke nurse:a pragmatic clinical trial[J].J Adv Nurs,2005,52(6):640-650.
[7]Burton CR.A description of the nursing role in stroke rehabilitation[J].J Adv Nurs,2000,32(1):174-181.
[8]解庆凡,史艳.综合康复护理对急性期脑卒中患者ADL的影响[J].中国康复医学杂志,2005,20(7):545-546.
[9]Eich HJ,Mach H,Werner C,et al.Aerobic treadmill plus Bobath training improves walking in subacute stroke:a randomized controlled trial[J].Clin Rehabil,2004,18(6):640-651.
[10]Nir Z,Zolotogorsky Z,Sugarman H.Structured nursing intervention versus routine rehabilitation after stroke[J].Am J Phys Med Rehabil,2004,83(7):522-529.
[11]Gellez-Leman MC,Colle F,Bonan I,et al,Yelnik A.Evaluation of the disabilities of hemiplegic patients[J].Ann Readapt Med Phys,2005,48(6):361-368.
[12]Hayes SH,Carroll SR.Early intervention care in the acute stroke patient[J].Arch Phys Med Rehabil,1986,67:3192321.
[13]倪朝民.急性脑卒中的早期康复及其功能训练时间[J].中国临床康复,2002,6(3):314.
[14]李红玲,贾子善,宋兰欣,等.脑卒中偏瘫早期康复疗效观察[J].中华物理医学杂志,1998,20(2):1092112.
[15]李泽锋,黄佩荣,赵爱社,等.脑卒中偏瘫患者急性期的综合康复治疗[J].中国康复,2001,16(3):1522153.
[16]司惠芳,郑建琴,吴海燕.实施康复“三阶段训练法”预防脑卒中后“二次损伤”[J].实用护理杂志,1999,15(7):12213.
[17]王拥军.卒中单元.北京:科学技术文化出版社[M],2004,231.
[18]罗利俊,陈国华,龚雪琴,等.卒中单元综合治疗对脑卒中患者运动功能康复的影响[J].中华物理医学与康复杂志,2005,27(9):534-536.
[19]Zhu GX,Hu YS,Wu Y,et al.Effects of standardized three-stage rehabilitation on recovery of neurological function in stroke patients with hemiplegia[J].Zhonghua Yi Xue Za Zhi,2004,84(23):1955-1958.
[20]刘岩,李友莲,黄建萍,等.脑卒中偏瘫病人肢体运动功能的康复护理训练[J].实用护理杂志,2002,18(4):11-12.
[21]Dobkin BH.Strategies for stroke rehabilitation[J].Lancet Neurol,2004,3(9):528-536.
[22]Fasoli SE,Krebs HI,Stein J,et al.Robotic therapy for chronic motor impairments after stroke:Follow-up results[J].Arch Phys Med Rehabil,2004,85(7):1106-1111.
[23]Lin JH,Hsieh CL,Lo SK,et al.Prelimunary study of the effect of low-intensity home-based physical therapy in chronic stroke patients[J].Kaohsiung J Med Sci,2004,20(1):18-23.
[24]Domka E,Myjkowska E,Kwolek A.Incidence of neuromedical complications during rehabilitation after stroke[J].Neurol Neurochir Pol,2005,39(4):300-309.
[25]Pinedo S,de la Villa FM.Complications in the hemiplegic patient in the first year after the stroke[J].Rev Neurol,2001,32(3):206-209.
[26]Horn AI,Fontes SV,de Carvalho SM,et al.Kinesiotherapy prevents shoulder pain in hemiplegic/pareticpatients on sub-acute stage post-stroke[J].Arq Neuropsiquiatr,2003,61(3B):768-771.
[27]Turner-Stokes L,Jackson D.Shoulder pain after stroke:a revuew of the evudence base to inform the development of an integrated care pathway[J].Clin Rehabil,2002,16(3):276-298.
[28]Vuagnat H,Chantraine A.Shoulder pain in hemiplegia revisited:contribution of functional electrical stimulation and other therapies[J].J Rehabil Med,2003,35(2):49-54.
[29]莫海花,钟美容,胡艳宁,等.急性脑卒中偏袒患者早期康复的循证护理[J].中国实用护理杂志,2006,22(4):9-10.
[30]Xu BH,Yu RQ,Yu W,et al.Effects of early rehabilitation on activities of daily living and complication in acute stroke patients[J].Beijing Da Xue Xue Bao,2004,36(1):75-78.
[31]Antai-Otong D.Poststroke depression:psychopharmaeological considerations[J].Perspect Psychiatr Care,2004,40(4):167-170.
[32]Williams LS.Depression and stroke:cause or consequence[J]? Semin Neurol,2005,25(4):396-409.
[33]Hackett ML,Yapa C,Parag V,et al.Frequency of depression after stroke:a systematic review of observational studies[J].Stroke,2005,36(6):1330-1340.
[34]张景莉,朱秀英,常永霞,等.脑卒中偏瘫患者的早期康复和心理护理[J].中国康复,2004,19(6):377-378.
[35]尹宗惠.老年脑卒中后抑郁状况的调查及护理对策[J].国际护理学杂志.2006,25(3):217-219.
[36]Yamakawa Y,Satoh S,Sawa S,et al.Efficacy of milnacipran on poststroke depression on inpatient rehabilitation[J].Psychiatry Clin Neurosci,2005,59(6):705-10.
[37]董永蓉.心理护理在脑卒中后抑郁病人功能康复中的作用[J].护理研究,2005,19(2):313-314.