首发脑卒中患者延续性护理需求调查分析

Explore the continuous care needs of stroke patients and the influenced factors

目的调查首发脑卒中患者延续性护理需求，为制订护理对策提供依据。方法采用脑卒中延续性护理需求调查问卷对102例首发脑卒中患者在出院时进行调查；采用美国国立卫生研究院卒中量表（thenationalinstitutesofhealthstrokeseale，NIHSS）和生活自理能力Barthel指数（barthelindex，BI）量表分别评估脑卒中患者在人院和出院时神经功能缺损及生活自理能力情况，并分析患者延续性护理需求与其NIHSS、BI评分的相关性。结果首发脑卒中患者延续性护理需求排列前5位分别是‘脑卒中知识”、“安全用药知识”、“康复锻炼知识”、“血压控制及自我监测知识”、“饮食知识”，需求比例在94．11％～87．25％。首发脑卒中患者延续性护理需求评分与其NIHSS评分呈正相关（r=0．271，P〈0．05），与BI评分呈负相关（r=-0．226，P〈0．05）。结论首发脑卒中患者对延续性护理需求普遍存在，内容是多方面的；首发脑卒中患者神经功能缺损越严重、生活自理能力越低，其对延续性护理需求越高。

Objective To explore the continuous care needs of stroke patients when discharge, and analyze the related influenced factors. Methods One hundred and twenty eases with first stroke attack were selected, and their continuous care needs were investigated by methods of filling in questionnaires when discharged. The National Institutes of Health Stroke Scale and Barthel Index were applied to assess the severity of acute stroke and their ability of daily life when cases were admitted and discharged, respectively. We investigated the continuous care needs of stroke patients, and analyzed the relationship of that with the severity of acute stroke and their ability of daily life. Results The top five continuous care needs were knowledge of stroke, safety administration, methods of rehabilitation, self control and monitoring blood pressure, and diet direction. Those ratios of needs ranged from 87.25% to 94.12%. The score of continuous care needs had a positive relationship with that of NIHSS （r = 0.271, 〈 0.05）, and had a negative relationship with that of BI both at the time of discharge （r = -0.226, 〈 0.05）. Conclusion The various continuous care needs are very common in patients with first stroke attack for varied reasons. More serious the neurological dysfunction and lower ability of daily life, higher the level of needs for continuous care.