基于微信平台康复指导对脑卒中照护者照护能力和心理状况影响

Effects of rehabilitation guidance based on "WeChat platform" on the mental health status and care ability of caregivers for the stroke patients after discharge

目的探讨基于微信平台的康复指导,在脑卒中患者出院后,对患者照护者照护能力和心理状况的影响。方法选取2018-08-10-2019-12-30福建医科大学附属泉州第一医院神经内科、神经外科和康复医学科收治的120例脑卒中患者主要照护者为研究对象,按照年龄、性别和文化程度等组间匹配的原则,分为观察组(微信平台康复指导干预组)和对照组,各60例。2组照护者在出院前均进行出院后的用药指导、康复训练指导、饮食营养及心理支持。出院后对照组给予常规随访,观察组在此基础上,通过微信平台教育继续指导照护者3个月。比较2组照护者干预前后照护能力量表(FCTI)、抑郁自评量表(SDS)及焦虑自评量表(SAS)评分。结果干预3个月后,观察组照护者SAS评分为(37.56±4.70)分,低于对照组的(56.33±8.63)分,t=14.795,P<0.001;SDS评分为(37.42±6.69)分,低于对照组的(54.96±4.51)分,t=16.839,P<0.001。观察组照护者的适应照顾角色评分为(6.33±2.23)分,低于对照组的(8.36±4.23)分,t=3.288,P=0.001;处理个人情绪能力评分为(15.01±4.24)分,低于对照组的(16.91±5.24)分,t=2.183,P=0.031;应变需要及提供协助评分为(27.01±0.25)分,低于对照组的(29.03±5.24)分,t=2.983,P=0.004;评估家人及社会资源评分为(26.61±3.23)分,低于对照组的(29.32±4.24)分,t=3.938,P<0.001;调整生活满足照顾需要评分为(10.09±0.87)分,低于对照组的(13.32±4.16)分,t=5.887,P<0.001。结论基于微信平台的康复指导能够有效提高照护者照护能力,改善其心理状况,可以在临床中推广应用。

Objective To investigate the effects of continuing rehabilitation guidance based on WeChat platform on the mental health status and care ability of caregivers for the stroke patients after discharge.Methods Totally 120 caregivers of stroke patients in Department of Neurology,neurosurgery and rehabilitation Affiliated Quanzhou First Hospital were selected from August 10,2018 to December 30,2019,they were randomly divided into the WeChat platform rehabilitation guidance intervention group(observation group,n=60)and the control group(n=60)according to the random card method.The two groups were given the same medication guidance,rehabilitation training guidance,diet nutrition and psychological support before discharge.After discharge,both two groups were given routine follow-up,but the observation group continued to guide and help the caregivers for 3 months through WeChat platform education.Finally the mental health status and care ability of the caregivers before intervention and at 3 months after intervention were evaluated by self-rating anxiety scale(SAS),self-rating depression scale(SDS)and family caregiver task inventory(FCTI).Results After intervention 3 months,the SAS score of the patients in the observation group was(37.56±4.70),which was lower than that of the control group’s(56.33±8.63),t=14.795,P<0.001.The SDS score of the patients in the observation group was(37.42±6.69),which was lower than that of the control group’s(54.96±4.51),t=16.839,P<0.001.The adaptive care role score of the patients in the observation group was(6.33±2.23),which was lower than that of the control group’s(8.36±4.23),t=3.288,P=0.001.The score of personal emotional ability was(15.01±4.24),lower than that of control group’s(16.91±5.24),t=2.183,P=0.031.The score of coping with needs and providing assistance was(27.01±0.25),lower than the control group’s(29.03±5.24),t=2.983,P=0.004.The score of family and social resources was(26.61±3.23),lower than the control group’s(29.32±4.24),t=3.938,P<0.001.The score of adjusting life to meet care needs was(10.09±0.87),lower than the control group’s(13.32±4.16)in the control group,t=5.887,P<0.001.Conclusion WeChat platform can effectively improve the care ability of caregivers,improve psychological status,which is worthy of clinical application.