团队护理模式在脑卒中吞咽功能障碍患者住院护理及延续性护理中的应用效果

Application effect of team nursing model on hospital nursing and continuing nursing in stroke patients with deglutition dysfunction

目的 探讨团队护理在脑卒中吞咽障碍患者住院护理及延续性护理中的应用,为吞咽困难护理提供理论依据.方法 选取2014年11月—2015年6月间在康复科住院的78例脑卒中吞咽功能障碍患者,随机分为干预组和对照组,对照组患者实行常规护理模式,干预组实行团队护理模式,在患者入院前和出院时分别进行洼田饮水试验和汉密尔顿焦虑量表的调查,比较两组患者之间有无差异;在患者出院后6个月、12个月时对患者进行随访,比较两组患者的洼田饮水试验等级变化.结果 出院时,干预组患者吞咽困难好转率为66.7%,高于对照组的35.9%,差异有统计学意义（P〈0.05）;同时,干预组患者的心理状况评分明显优于对照组,差异有统计学意义（P〈0.05）;在出院后6个月的随访中,两组患者洼田试验分级及好转率均无统计学意义（P〉0.05）;在出院后12个月的随访中,洼田试验分级存在差异,且干预组的恶化率低于对照组,差异有统计学意义（P〈0.05）.结论 在脑卒中吞咽功能障碍患者中运用团队护理模式能巩固康复训练效果,提高患者出院后的生活质量.

Objective To explore the application of the model of team nursing in hospital nursing and continuing nursing in stroke patients with deglutition dysfunction.Methods A total of 78 stroke inpatients with deglutition dysfunction of department of rehabilitation from November 2014 to June 2015 were randomly divided into the intervention group and the control group. Patients in the control group received routine nursing method,while patients in the intervention group received team nursing method. The water-swallowing test and the investigation with Hamilton anxiety scale （HAMA） were carried out before admission and at discharge. The results of patients were compared between two groups. The changes of classification of water-swallowing test were compared between two groups 6 and 12 months after discharge.Results At discharge,the improvement rate of deglutition dysfunction in the intervention group （66.7%） was higher than that in the control group （35.9%） with a significant difference （P〈0.05）;the score of HAMA in the intervention group was better than that in the control group with a significant difference （P〈0.05）. There was no statistically significant difference in the classification of water-swallowing test and the improvement rate between two groups 6 months after discharge （P〉0.05）. There were significant differences in the classification of water-swallowing test and the improvement rate （the deterioration rate of the intervention group was lower than that of the control group） between two groups 12 months after discharge （P〈0.05）.Conclusions The application of team nursing model in stroke patients with deglutition dysfunction can strengthen the rehabilitation training effect and can improve the quality of life of patients after discharge.