二级医院的卒中患者延续护理体系构建

Construction of Continuous Nursing Care for Patients with Stroke in Second-Level Hospitals

目的针对卒中后残疾患者出院后的随访和护理干预对康复的影响,构建延续护理体系,提高患者自理能力和生存质量。方法通过抽取3家社区卫生服务中心为主要调查点,以脑卒中后残疾患者为调查对象,对服务现状进行分析,提出上海市某二级医院构建延续护理体系的建议。结果 (1)患者依从性:出院指导依从性总分(t=6.011,P=0.000<0.05)及其中的3个单项依从性康复训练(t=5.255,P=0.000<0.05)、生活作息(t=5.156,P=0.000<0.05)、复诊随访(t=3.476,P=0.010<0.05)显著高于对照组;均衡饮食(t=0.967,P=0.337>0.05)和正规服药(t=0.845,P=0.401>0.05)2个单项无显著差异。(2)卫生服务利用率:干预组门诊访问率显著高于对照组(χ2=9.053,P=0.029<0.05);两组的再次住院率(χ2=0.278,P=0.870>0.05)和急诊访问率(χ2=1.036,P=0.596>0.05)无显著差异。结论二级医院脑卒中患者延续护理体系的构建显示出积极效果,达到方案设计的目的。

Objective Continuing nursing care was constructed to improve patient self-care ability and quality of life on the basis of the follow-up and nursing intervention in patients with post-stroke disability after discharge influence on rehabilitation.Methods Three community health service centers were taken as the main points to study the present care for the post-stroke disability patients and suggestions were put forwardfor the continuous care of stroke patients in second-level hospitals.Results Patient compliance guide compliance total discharge（t=6.011, P=0.000＆lt;0.05） and the 3 individual compliance of rehabilitation training（t=5.255, P=0.000＆lt;0.05）, lifestyle（t=5.156, P=0.000＆lt;0.05）, for follow-up（t=3.476, P=0.010＆lt;0.05） were significantly higher than the control group（a balanced diet;t=0.967, P=0.337＆gt;0.05） and regular medication（t=0.845, P=0.401＆gt;0.05） there was no significant difference between the 2 events.Health service utilization： Outpatient visits intervention group was significantly higher than the control group（χ2=9.053, P=0.029＆lt;0.05）;the readmission rate of two groups（χ2=0.278, P=0.870＆gt;0.05） and emergency access rate（χ2=1.036, P=0.596＆gt;0.05） no significant difference.Conclusion Construction of continuous nursing system for stroke patients in second-level hospitals can significantly improve patients＆#39; discharge guidance compliance and their subjective feelings towards their health, and reduce the return rate and emergency visit rate.