医护康一体化延续管理预防老年卧床患者出院后压力性损伤效果分析

The effect analysis of integration of medical care and rehabilitation in continuity management of preventing elderly bedridden patients stress injury after discharge

目的分析医护康一体化延续管理预防老年卧床患者出院后压力性损伤效果。方法选取2015年10月～2017年5月我院老年卧床患者60例,根据患者出院顺序分为观察组和对照组,每组各30例。对照组对患者进行常规出院宣教及出院后电话随访,观察组采用医护康一体化延续管理模式,由医护康组成的小组评估老年卧床患者出院后压力性损伤危险因素、并制定预防压力性损伤的康复计划、管理及远程护理和家庭访视,定时跟进措施实施情况并对其效果进行检查。采用WHO生存质量简表和压力性损伤管理,比较两组出院时、出院后6个月及9个月的生活质量及9个月压力性损伤的发生率。结果观察组压力性损伤发生率为9.99%较对照组(33.33%)低,差异有统计学意义(P <0.05);观察组出院后6个月、9个月生存质量量表中的生理领域和心理领域分值均较对照组高,差异有统计学意义(P <0.05);而社会关系领域和环境领域的分值与对照组相比,差异无统计学意义(P> 0.05);观察组居家照顾者对压力性损伤相关知识水平的了解高于对照组,差异有统计学意义(P <0.05)。结论医护康一体化延续管理可有效的提高老年卧床患者居家照顾者对压力性损伤的认知水平,降低压力性损伤的发生率,同时提高老年卧床患者的生存质量。

Objective To analyze the effect of integration of medical care and rehabilitation in continuity management of preventing elderly bedridden patients stress injury after discharge.Methods Sixty elderly bedridden patients in our hospital from October2015to May2017were selected,and they were divided into observation group and control group according to the discharge order,each group had30cases.The control group was received routine discharge education and telephone follow-up after discharge,the observation group was received continuity management of integration of medical care and rehabilitation.The risk factors and rehabilitation plans of stress injuries in elderly bedridden patients after discharge were assessed and formulated,tele-care and home visits were managed,the implementation of the measures were regularly followed up and the effects were checked by medical care and rehabilitation team.WHO Quality of Life Brief Form and Stress Damage Management were used to compare the quality of life at discharge,6months and9months after discharge and the incidence of stress injury in9months of the two groups.Results The incidence of stress injury in the observation group was9.99%,which was lower than the control group(33.33%),the difference was statistically significant(P<0.05).There was no significant difference in the scores of social relations and environmental fields between the two groups(P>0.05).The knowledge level of family caregivers about stress injury in the observation group was higher than the control group,the difference was statistically significant(P<0.05).Conclusion Continuity management of medical care and rehabilitation integration can effectively improve the stress injury cognition level of family caregivers for elderly bedridden patients,reduce the incidence of stress injury,and improve the quality of life of elderly bedridden patients.