延续护理干预对脑卒中患者出院后的影响

Influence of extended nursing intervention on stroke patients after discharge

目的：观察延续护理干预对脑卒中患者出院后的影响,探讨提高脑卒中患者护理质量的措施。方法选择2010年5月—2012年10月收治的脑卒中患者72例,按照随机数字表法随机分为对照组36例和观察组36例,对照组出院后未给予护理干预,观察组出院后给予延续护理干预,比较两组患者出院后日常生活能力（ADL）评分、遵医行为、并发症及再次入院情况。结果两组患者出院时 Barthel指数比较差异无统计学意义（P＞0.05）。观察组出院后1个月、3个月、6个月 Barthel 指数分别为（49.8±11.3）,（57.5±13.7）,（60.6±14.6）,与对照组比较差异有统计学意义（ t 值分别为2.017,2.115,2.096；P＜0.05）。出院 6个月后观察组患者按计划康复训练、坚持合理饮食及作息、按时复诊随访的遵医行为优于对照组,差异有统计学意义（χ2值分别为4.963,4.531,5.573；P＜0.05）。出院 6个月后观察组出现并发症4例,对照组11例,两组比较差异有统计学意义（χ2=4.32,P＜0.05）；观察组再次入院 1例,对照组 6例,两组比较差异有统计学意义（χ2=3.956,P＜0.05）。结论脑卒中患者出院后积极施行延续护理干预措施,可促进患者日常生活能力的恢复,提高患者遵医行为,减少并发症及再次入院的发生。

Corresponding author：Zhang Hongmei, Email：z126hm@ 126. com Objective To observe the clinical influence of extended nursing intervention in the stroke patients after discharge, and explore the measures to improve the quality of nursing for stroke patients.Methods A total of 72 discharged stroke patients were randomly divided into control group （ n = 36 ） undergoing no nursing intervention and observation group （ n = 36 ） which receiving extended nursing intervention. We compared the Activities of Daily Living （ ADL） scores, medical compliance behavior, complications and re-hospitalization of the two groups. Results Barthel index of patients in the two groups had no statistically significance （P 〉 0. 05）. After discharge 1 month, 3 months and 6 months, the Barthel index in the observation group were （49. 8 ± 11. 3）, （57. 5 ± 13. 7） and （60. 6 ± 14. 6） ,which were statistically significant with those of the control group （t = 2. 017, 2. 115, 2. 096,respectively;P 〈 0. 05）. After 6 months of discharge, the training according to rehabilitation plan, insisting reasonable diet and rest, following medical compliance behavior in the intervention group were better than those of the control group （χ2 = 4. 963, 4. 531, 5. 573, respectively;P 〈 0. 05）. The incidences of complication were 4 cases in the intervention group compared with 11 cases in the control group （ χ2 = 4. 32,P 〈 0. 05）, and there were 1 case of re-hospitalization in the intervention group and 6 cases in the control group （ χ2 = 3. 956, P 〈 0. 05） after 6 months discharged.Conclusions The stroke patients should be actively given the extended nursing intervention after discharge, since it can promote the recovery of activities of daily living, patients′ medical compliance behavior and reduce the incidence of complications and re-hospitalization.