不同陪护类型对脊髓损伤患者功能恢复及心理状态的影响

Effect of different attending types on the recovery of physical reconstruction and mental health of spinal cord injury patients

目的了解不同陪护类型对脊髓损伤患者躯体功能恢复及心理的影响。方法2001年12月～2006年10月对不同陪护类型(家属、请专人陪护、护工陪护、无陪护)的87例脊髓损伤伴有躯体功能障碍患者在入院3d内、住院后1个月采用Zung忧郁自评量表(SDS)评估患者的心理状态,用功能独立性评价量表(Functional independent measures,FIM)评估患者躯体功能恢复情况。同时住院期间对患者及陪护者进行脊髓损伤相关知识及康复知识培训。结果入院时4组陪护的患者SDS、FIM得分比较,差异无统计学意义;入院后1个月由家属陪护的患者SDS得分下降,FIM得分提高,与其他陪护类型患者比较,差异有统计学意义(P<0.05);专人陪护、护工陪护、无陪护3种陪护类型患者SDS得分下降不明显,3组比较,差异无统计学意义(P>0.05);专人陪护、护工陪护、无陪护3种陪护类型患者FIM得分有提高,但3组比较,差异无统计学意义(P>0.05),有家属陪护的患者FIM得分较前3种陪护类型患者得分明显提高(P<0.05)。结论不同陪护类型对脊髓损伤患者功能恢复及心理状态有直接影响,家属陪护对患者更有安全感,在治疗中更能帮助、鼓励患者积极配合治疗,改善患者的心理状态,促进患者康复。

Objective To investigate the effect of different attending types on the recovery of physical reconstruction and mental health of spinal cord injury （SCI） patients. Methods SDS by Zung and functional independent measures （FIM） were used to assess the mental status and recovery of physical reconstruction among the attendants of all types （dependants, paid attendants, hospital attendants and no attendants） 87 SCI patients complicated with physical dysfunction in three days and one month after admission. The patients and their attendants were trained with SCI-related and rehabilitation knowledge during hospitalization. Results There were no differences in SDS and FIM between the four types. SDS went down but FIM did up among the patients attended by their dependants, the difference statistically significant compared to other attending types （P 〈 0.05）. For the other three types of attendance, SDS did not decrease significantly （P 〉 0.05） and FIM increased, without differences between the three types （P 〉 0.05）. FIM increased significantly in contrast of the type of dependant attendance and other three types of attendance （P 〈 0.05）. Conclusions All types of attendance affect the physical reconstruction and mental health of SCI patients. The attendance by dependants makes the best feeling of safety. During treatment, dependant attendance is good for helping and encouraging patients to be active in treatment and for developing their mental status, thus promoting their recovery.