医护患一体化自我管理教育在脑卒中患者居家康复中的应用

Application of Doctor-nurse-patient Integration model in Self-management Education on the Home Rehabilitation of Stroke Patients

目的探讨医护患一体化自我管理教育在脑卒中患者居家康复中的应用效果。方法便利抽样选取2014年1-6月在本院治疗并出院的脑卒中患者40例为观察组,2013年1-6月出院的脑卒中患者40例为对照组。对照组给予常规人院宣教及出院康复指导,观察组在接受常规护理的基础上,在出院居家期间实施医护患一体化自我管理教育3个月,对两组患者出院时及出院后3个月的相关指标进行比较分析。结果出院后3个月,观察组患者居家功能锻炼依从性、自我管理能力、日常生活活动能力、患侧手关节总主动活动度(total activemovement,TAM)均优于对照组,跌倒/坠床发生率低于对照组,差异均有统计学意义(均P<0.05)。结论医护患一体化自我管理教育提高了患者居家康复锻炼的依从性、自我管理水平及日常生活活动能力,降低了跌倒/坠床发生率,有效改善了患者的生活质量,可推广应用于脑卒中二级预防。

Objective To access the application effect of doctor-nurse-patient integration model in selfmanagement education on the home rehabilitation of stroke patients.Methods By convenience sampling,40 patients which were admitted from January to June in 2014 were selected as observation group,and other 40 cases which were admitted from January to June in 2013 were selected as control group.Patients in control group received admission education and discharge rehabilitation guidance,while the observation group received 3 months of doctor-nurse-patient integration model in self-management education on the basis of routine nursing.The relevant indexes of two groups of patients on the time of discharge and 3 months after discharge were compared.Results After 3 months of discharge,the athome functional exercise compliance,ability of self-management,activities of daily-life,and the total activemovement of side joints of hand in observation group were all better than which in control group,while the incidence rate of fall-off the bed was lower than that of the control group（all P〈0.05）.ConclusionThe implementation of doctor-nurse-patient integration mode in self-management education can improve patients＇ at-home functional exercise compliance,ability of self-management,activities of daily-life and reduce the incidence rate of fall-off the bed,it can also improve patients＇ quality of life,which can be applied to the prevention of stroke.