契约学习对脑卒中患者自我效能和康复的影响

Effect of Contract Learning on Self-efficiency and Rehabilitation of Stroke Patients

目的探讨契约学习对脑卒中患者自我效能和康复的影响。方法将120例脑卒中患者运用随机数字表法随机分为对照组(60例)和观察组(60例),观察组给予契约学习联合神经内科常规护理,对照组予神经内科常规护理,比较两组患者自我效能、日常生活活动能力和肢体运动能力得分的差异。结果观察组比对照组自我效能得分高(F=107.15,P=0.00),其中,出院时和出院后6个月这两个时点差异有统计学意义(P均<0.01)。观察组日常生活活动能力得分高于对照组(F=37.31,P=0.00),其中出院后1个月、出院后6个月两组间差异有统计学意义(P均<0.01)。观察组比对照组患者肢体运动能力得分高(F=32.16,P=0.00),其中出院时、出院后1个月、出院后6个月两组间差异有统计学意义(P均<0.01),观察组肢体运动能力均高于对照组。结论在临床护理中应用契约学习干预,能够提高脑卒中患者自我效能、日常生活活动能力和肢体运动能力,改善患者的预后。

Objective To evaluate the effect of contract learning on the self-efficiency and rehabilitation of stroke patients. Methods Totally 120 cases were randomly divided into test group and control group with each 60 cases in each group. Patients in both groups accepted the same neurology routine nursing and those in test group were given a package of nursing interventions besides routine nursing. All were given follow-up visit and telephone follow-up for the first month and sixth months after discharge to compare two groups’ self-efficiency and activities of daily living meanwhile patients’ limb movement function was assessed with questionnaires. Results There was a higher self-efficiency score in test group than that in control group （F=107.15,P=0.00）, and there was significant difference between two groups at the discharge and six months after discharge （all P〈0.01）. The score of activities of daily living in test group was higher than that in control group （F=37.31,P=0.00） and statistical significance was found in activities of daily living at discharge, one month and six months after discharge （all P〈0.01）.The score of limb movement function in test group was higher than that in control group （F=32.16,P=0.00） and statistical significance was found in limb movement function at discharge, one month and six months after discharge （all P〈0.01）. Conclusion Contract learning could enhance stroke patients ’ self-efficiency and activities of daily living and limb movement function, and could improve patients ’ prognosis.