健康教育对卒中后患者生活质量的影响

Effects of Education for Families of Patients on Qualities of Daily Living After Stroke

目的:观察对脑卒中偏瘫康复期患者家属进行健康教育对患者生活质量的影响。方法:选取2007年1月～2008年2月期间在我院接受现代康复和传统康复治疗的脑卒中康复期偏瘫病人。62例在入院时随机分成2组,同时接受现代康复及传统康复,其中观察组同时对患者至少一名陪护家属进行健康教育每周5次,每次20分钟,对照组在相同的时间内以相同的频度进行普通谈话。入院时和12周后由责任护士采用生活质量指数评定量表,分别对两组病人的生活质量进行评分,量表内容包括身体功能、角色功能、情绪功能社会功能及总体生活质量5个方面。用spss9.0软件进行统计学处理,同组内均数间比较用LSD法;两组间均数比较采用独立样本t检验。结果:第12周观察组五项生活质量观察指标与入院时自身比较,除社会功能一项指标无显著差异(p<0.05)外,其余四项指标与入院时比较,有显著性差异(均p<0.01)。对照组病人各个指标与入院时比较差异无显著性意义(均p<0.05)。入院时观察组和对照组病人五项生活质量观察指标比较,差异无显著性意义(p<0.05);出院后第12周观察组病人与对照组比较,身体功能、情绪功能及总体生活质量差异有显著性意义;而角色功能和社会功能无显著性差异(p<0.05)。结论:对脑卒中偏瘫康复期患者家属进行健康教育可以明显改善患者生活质量。

Objective： To evaluate the effect of education for families of patients on qualities of living （ QOL ）after stroke. Methods： 62 stroke patients consecutively admitted to the heilongjiang province rehabilitation hospital , from Jan. 2005 to Dec. 2005 , were randomly divided into two groups, admission as taking the courses of education for their families（group A ;n= 31） or not （group B; n= 31） . Both groups accept the same treatment , including daily physiotherapy, occupational therapy, traditional Chinese medicine and other therapy according to individual needs. Group B＇s families take the course of healthy education including general knowledge of stroke , how to control the risk factor , how to help patients for raining, exercises for activities of daily living and psychology care, and Group A＇s families synchronously do some simple talk. Both group＇s families have courses or talk 20 min per time and 5 time per week. The quality of life index （QOLI） was used to assess patients＇ QOL. Assessment was done upon admission to rehabilitation and 12 weeks later. Statistic software is SPSS9.0 to compare mean value of two groups. Results. Mean MBI scores at admission were 28. 61±11, 32 and 31. 42±13.71 in groups A and B, respectively. At this point, the difference between the groups did not show statistical significance （t= 1.87, p〉. 05）. After 8 weeks of intensive rehabilitation treatment, the MBI scores of both groups improved significantly （t=3.11, p 〈. 01） and the average score of group A was lower than that of group B （group A.43.23±10. 82, group B.62.73±15. 611 p 〈 . 05） . Conclusion, The existence of proprioception disturbance affects significantly the functional outcome of stroke patients. In view of the importance of this factor, there is place for an effort to develop means for quantitative evaluation of the magnitude of the proprioception disturbance, and therapeutic means aimed specifically to restore this sensory deficit.