社区护理干预对脑卒中后注意力障碍患者康复效果的影响

Effects of community nursing interventions on rehabilitation of stroke patients with attention disorders

目的探讨社区护理干预对脑卒中后注意力障碍患者康复效果的影响。方法将2010年12月至2012年2月间60例符合标准的脑卒中后注意力障碍患者按区组随机法分为两组。干预组患者30例由社区护士进行注意力训练，对照组30例由家属自行进行训练。分别在入组时、干预2个月后采用简单反应时测验、数字划销测验评定注意力，用改良Barthel指数评定日常生活活动能力。结果人组时对照组和干预组患者简单反应时平均值分别为（0．71±0．25）s和（0．69±0．19）S、数字划销时间分别为（662．8±152．7）S和（652．7±131．0）S、改良Barthel指数分别为31±8和30±8，两组差异均无统计学意义（P〉0．05）。干预2个月后，对照组和干预组患者简单反应时平均值分别为（0．68±0．20）s和（0．56±0．16）S、数字划销时间分别为（637．4±151．7）S和（540．3±125．9）S、改良Barthel指数分别为33±8和37±8，两组差异有统计学意义（均P〈0．01）。日常生活活动能力评分差异亦有统计学意义（P〈0．05）。结论对合并注意力障碍的脑卒中患者加强社区护理干预有利于注意力的改善和日常生活活动能力的提高。

Objective To study the effects of community nursing interventions on stroke patients with attention disorders. Methods A total of 60 stroke patients fulfilling eligibility were divided randomly into two groups. Their data were collected between December 2010 and February 2012. The intervention group was treated by community nurses while the control group trained by family members. Attention was assessed by simple reaction time （SRT） and number cancellation test （NCT）. Modified Barthel index was used to assess the activities of daily living （ADL）. Both groups were evaluated before and after a 2-month intervention. Results Before treatment, the control group had（0. 71 ±0. 25）, （662.8 ± 152.7） and（31 ± 8） scores at SRT, NCT and MBI respectively. And the intervention group yielded（0. 69 ±0. 19） , （652. 7 ± 131.0）and （30± 8）scores at SRT, NCT and MBI respectively. There were no significant differences in average value of SRT, NCT and MBI between training and control groups at pre-treatment （ P 〉 0. 05 ）. After 2 months, the control group had（0. 68 ±0. 20） ,（637.4 ± 151.7）and（33±8） scores at SRT, NCT and MBI respectively. And the intervention group yielded（0. 56 ± 0. 16）, （540. 3 ± 125.9） and（37 ± 8） scores at SRT, NCT and MBI respectively. Very significant difference existed in attention scale scores at Month 2 （P 〈 0. 01 ） and the difference in ADL scale scores was also significant （P 〈 O. 05 ）. Conclusion For stroke patients with attention disorders, strengthening community nursing interventions may help to improve attention and boost activity of daily living.