综合干预对脑卒中照护者及患者的影响

Effect of Comprehensive Intervention on Caregivers and Stroke patients

目的探讨综合干预对脑卒中照护者及患者的影响。方法以2014年1月—2015年9月间在石河子大学医学院第一附属医院住院的脑卒中主要照护者为研究对象,共84人,随机分为实验组(综合干预组)和对照组两组。对照组照护者在患者出院后给予常规指导;实验组照护者接受多专业团队提供的综合干预。干预前及干预后第2周用Bakas照护结局量表(BCOS)、世界卫生组织生存质量测定量表(WHOQOL-Bref)及汉密尔顿抑郁量表(HAMD)对所有照护者进行测评,用改良Barthel指数量表对脑卒中患者进行测评。结果组内比较结果表明,实验组中,BCOS后测分数高于前测、HAMD后测分数低于前测,差异均有统计学意义(P=0.012;P=0.032);对照组中,HAMD后测分数高于前测,差异有统计学意义(P=0.012)。组间比较结果表明,BCOS分数实验组高于对照组,差异有统计学意义(P=0.019)、HAMD评分实验组低于对照组,差异有统计学意义(P<0.001)、实验组患者能自理人数较对照组多,差异有统计学意义(P=0.046)。结论以健康教育与团体心理辅导为主要内容的综合干预能够有效减轻脑卒中照护者的照护负担及抑郁情绪,提高脑卒中患者的自理能力,值得推广应用。

Objectlve To analyze the effect of comprehensive intervention on caregivers and stroke patients. Methods Eighty -four subjects, who were main caregivers of stroke patients from January 2014 to September 2015 were collected. Subjects were randomly divided into experimental group and control group. The participants in control group were received routine rehabilitation instructions, the participants in experimental group were given comprehensive intervention provided by a Multi-profession team. All subjects were assessed at pre- and 2 weeks pest-treatment through Bakas caregiving outcome scale （BCOS）, The World Health Organization Quality of Life-Bref Scale （WHOQOL-Bref） and Hamilton Depression Scale （HAMD）. All stroke patients were assessed at pre- and 2 weeks post-treatment with Modified Barthel Index （MBI）. Results In experimental group, BCOS and HAMD scores had significant difference between before and after comprehensive intervention （P=0.012;P=0.032）; In control group, HAMD score was significant higher in post-intervention than that in pre-intervention （P=0.012）. Experimental group had a greater increase than control group in BCOS score （P =0.019）; Experimental group had significant reduction than control group in HAMD score （P〈0.001）; More stroke patients in experimental group had seE-care abilities than that in control group, （P〈0.046） Conclusion The comprehensive intervention which consisted of healthy education and psychological guidance can reduce burden and depression symptonrs of caregivers, and improve the seE-care ability of stroke patients. It is effective and is worthy of popularization.