医护一体化模式干预对预防脑卒中吞咽功能障碍发生的作用及生存质量的影响

Effects of Integrated Medical Care Intervention on Prevention of Swallowing Dysfunction and Quality of Life in Stroke

目的:探讨医护一体化模式干预对预防脑卒中吞咽功能障碍发生的作用及对生存质量的影响。方法:将80例脑卒中患者按照入院顺序分为对照组和观察组各40例,对照组给予传统医护模式干预,观察组实施医护一体化模式干预;干预1个月后,比较两组吞咽相关并发症(吞咽功能障碍、营养不良、吸入性肺炎)的发生率、吞咽功能(洼田饮水试验)评分,干预前、干预1个月后,比较两组生存质量[采用生存质量测定量表(QOL-100)]、负性情绪状况[采用Zung抑郁自评量表(SDS)、焦虑自评量表(SAS)]。结果:干预1个月后,观察组吞咽功能障碍、营养不良、并发症总发生率明显低于对照组(P <0. 01),洼田饮水试验评分明显低于对照组(P <0. 01);干预1个月后,两组QOL-100中生理状态、心理状态、社会关系、生活状况、独立能力5个方面评分均较干预前明显提高(P <0. 01),且观察组高于对照组(P <0. 01,P <0. 05);干预1个月后,两组SDS评分和SAS评分均较干预前降低(P <0. 01),且观察组降低于对照组(P <0. 01,P <0. 05)。结论:医护一体化模式干预可预防脑卒中患者吞咽功能障碍的发生,缓解其焦虑、抑郁情绪,改善患者生存质量,值得临床推广。

Objective To explore the effect of integrated medical care intervention on prevention of swallowing dysfunction in stroke andits impact on quality of life. Methods： A total of 80 patients with stroke were divided into the control group and the observation group according to the order of admission, 40 cases in each group. The control group was given the traditional medical model intervention, and theobservation group implemented the medical integration model intervention. One month after the intervention, the incidence of swallowing -related complications（ swallowing dysfunction, malnutrition, aspiration pneumonia） and swallowing function （ putian drinking water test）scores were compared between the two groups. Quality of life [ QOL100]and negative emotional status [ Zung SelfRating DepressionScale（ SDS） and SelfRating Anxiety Scale（ SAS） ]were compared before and one month after intervention. Results： One month after intervention, the incidence of dysphagia, malnutrition and complication in the observation group was significantly lower than that in the controlgroup（ P 〈 0. 01） . The putian drinking water test score was significantly lower than the control group（ P 〈 0. 01） . After 1 month of intervention, the scores of physiological status, mental state, social relationship, living status and independent ability of QOL100 were significantly higher than those before intervention（ P 〈 0. 01） , and the observation group was higher than the control group（ P 〈 0. 01, P 〈 0. 05） ;After 1 month of intervention, the SDS and SAS scores of the two groups were lower than those before the intervention（ P 〈 0. 01） , and theobservation group was lower than the control group（ P 〈 0. 01, P 〈 0. 05） . Conclusion： Integration of medical care model intervention canprevent the occurrence of swallowing dysfunction in stroke patients, relieve their anxiety and depression, and improve the quality of life ofpatients. It is worthy of clinical promotion.