脑卒中患者延续护理方案的建立及效果评价

Establishment and effects evaluation of extended care plan for stroke patients

目的：探讨以循证护理建立的脑卒中患者延续护理方案的应用效果。方法将符合纳入标准的130例患者配对分组。观察组执行循证后延续性护理方案，对照组出院后1个月实施电话随访。比较两组患者出院时、出院后1个月、3个月、6个月和12个月的日常生活能力（ Barthel指数）和健康行为（ HPLPⅡ）的差异。结果两组患者出院后3个月、6个月和12个月的Barthel指数评分差异具有统计学意义（ F时间＝13.389，P〈0.05；F组间＝19.352，P〈0.05；F交互＝3.416，P〈0.05）；两组患者出院后3个月、6个月和12个月的HPLPⅡ评分差异具有统计学意义（ F时间＝12.187，P〈0.05；F组间＝36.512，P〈0.01；F交互＝6.692，P〈0.05）；出院后3个月、6个月和12个月的观察组再发作率为3.33％、10.00％、18.33％，对照组再发作率为3.57％、17.85％、33.93％，差异具有统计学意义（ P〈0.01）。结论应用循证方法制定科学、规范的延续护理方案，可以提高脑卒中患者日常生活能力和健康行为，减少复发。

Objective To investigate the application effects of extended care plan in patients with stroke based on evidence-based nursing. Methods A total of 130 patients who met inclusion criteria were selected and received matched groups. The patients of observation group were given the implementation of evidence-based extended nursing plan, while the patients of control group were provided telephone follow-up 1 month after discharge. We compared differences in the ability of daily life （ Barthel index） and health behavior （ HPLP Ⅱ） between two groups at the patients discharged from hospital 1 month, 3 months, 6 months and 12 months. Results Compared between two groups at patients discharged from hospital 3 months, 6 months and 12 months, the differences of Barthel index score were statistically significant （ Ftime=13.389,P〈0.05; Fgroup=19.352,P〈0.05;Ftime？group=3.416,P〈0.05）; patients discharged from hospital after 3 months, 6 months and 12 months, the differences of HPLP Ⅱ score were statistically significant between two groups （Ftime=12.187, P〈0.05;Fgroup=36.512,P〈0.01; Ftime？group=6.692,P〈0.01）; 3 months, 6 months and 12 months after discharge, the incidences of recurrence were 3. 33%, 10. 00%, 18. 33% in observation group while they were 3.57%, 17.85%, 33.93% in the control group （P〈0.01）.Conclusions Taking the evidence-based nursing method to develop scientific and normative extended care plan can improve the ability of stroke patients′ daily life and health behavior and reduce the recurrence, which is worth of clinical practice recommendations.