农村脑卒中患者居家康复模式探索及成效分析

Study of home rehabilitation model and effectiveness analysis on stroke patients in rural area

目的:探索农村脑卒中患者居家康复的模式及其对日常生活活动能力、生活质量、焦虑和抑郁情绪的影响。方法:随机选择100例脑卒中偏瘫患者分为观察组(48例)与对照组(52例)。2组患者均接受常规药物治疗及乡村医生的健康宣教和康复咨询,观察组在此基础上增加医务人员的综合康复治疗及心理辅导,时间为3个月,治疗前后均采用改良Barthel指数(MBI)、生活质量指数(QLI)、Zung焦虑自评量表(SAS)及Zung抑郁自评量表(SDS)进行评定。结果:观察组治疗后与治疗前比较,MBI评分和QLI评分明显提高,SAS和SDS评分明显降低(P<0.05);对照组治疗3个月后与治疗前比较,MBI评分明显提高(P<0.05)。治疗后,与对照组比较,观察组MBI评分和QLI评分明显提高,SDS和SAS评分明显降低(P<0.05)。结论:居家综合康复治疗及心理辅导对农村脑卒中患者的日常生活活动能力、生活质量、焦虑和抑郁情绪具有明显的改善作用,值得进一步深入推广。

Objective：To explore the effective home rehabilitation model for patients after stroke in rural area of Enping city and its influence on their activities of daily living,quality of life,anxiety and depression.Methods：100patients with hemiplegia after stroke were randomly divided into home rehabilitation group（48cases）and control group（52cases）.Two groups of patients received conventional drug therapy,health education and rehabilitation counseling by village doctors,and the home rehabilitation group was given comprehensive rehabilitation treatments and psychological counseling by general physicians,therapists,nurse practitioner and medical social workers for 3months,additionally.Before and after treatments,the activities of daily living（Modified Barthel Index,MBI）,quality of life index（QLI）,Zung Self-Rating Anxiety Scale（SAS）and Zung Self-Rating Depression Scale（SDS）were evaluated respectively.Results：After three months of treatments,in the home rehabilitation group,the scores of MBI and QLI were significantly increased,and the scores of SAS and SDS were significantly decreased（P〈0.05）;in the control group,the scores of MBI were significantly increased（P〈0.05）.After three months of treatments,as compared with the control group,the MBI and QLI scores in the home rehabilitation group were significantly increased,and the SAS and SDS scores were significantly decreased（P〈0.05）.Conclusion：Home comprehensive rehabilitation treatments and psychological counseling can obviously improve the activities of daily life,quality of life and decrease the anxiety and depression of patients after stroke in rural areas,and it is worth of further promotion.