照顾者教育对改善脑卒中患者及其照顾者健康状况的效果

Effect of Caregiver Education on Health of Stroke Patients and Their Caregivers

目的探讨健康教育和技能培训对家庭照顾者的健康状况及脑卒中患者康复治疗效果的影响。方法脑卒中住院患者分为干预组38例,对照组36例,住院1个月均接受正规康复训练。对干预组家庭照顾者采用适时干预模式(Timing It Right)分阶段进行有针对性的知识教育和技能培训。干预前及出院3个月后对患者采用欧洲脑卒中量表(ESS)、简易精神状态检查(MMSE)、简易Fugl-Meyer评定(FMA)、改良Barthel指数(MBI)进行评定,对照顾者采用一般健康问卷(GHQ-12)进行评定。结果治疗后,干预组患者ESS、FMA、MBI均较对照组改善更多(P<0.05),照顾者在角色、紧张感、克服困难、面对问题、抑郁、失去信心、自我价值、日常活动范围项较对照组改善更多(P<0.05)。结论对家庭照顾者的教育和培训,能有效提高家庭照顾者的心理状况和护理技巧,继而进一步提高患者的康复效果。

Objective To observe the effect of the health education and skills training for caregivers on health status of stroke patients and their family caregivers. Methods Hospitalized stroke patients were divided into the intervention group （n=38） and the control group （n= 36）. Both groups received rehabilitation training for 1 month in hospital. The family caregivers of intervention group received Timing It Right education and skills training in addition. All the patients were assessed with the European Stroke Scale （ESS）, Mini-Mental State Ex- amination （MMSE）, simple Fugl-Meyer Assessment （FMA）, modified Barthel Index （MBI）, and the caregivers were assessed with the Gen- eral Health Questionnaire （GHQ-12） before and 3 months after intervention. Results The scores of ESS, FMA, MBI improved more in inter- vention group than in the control group after intervention （P〈0.05）, as well as their caregivers in the items of playing a useful part, under stress, overcoming difficulties, enjoying normal activities, facing up to problems, feeling unhappy and depressed, lossing confidence, think- ing of self as worth of GHQ-12 （P〈0.05）. Conclusion Health education and skills training for family caregivers can improve the health of caregivers, and further improve the function outcome of stroke patients.