脑卒中后遗症期“医-康-护-养”一体化管理模式探讨

Effect of the integrated management mode of "medical service-rehabilitation-nursing-elderly care" in the sequela period of stroke

目的:探讨"医-康-护-养"一体化管理模式在提高养老机构脑卒中后遗症期病人生存质量和生活能力中的作用。方法:选取2015-2016年期间深圳市福田区3家养老机构的164例脑卒中后遗症期病人作为研究对象,随机将其分为观察组和对照组,每组82例。对照组病人给予常规脑卒中二级预防管理,观察组给予"医-康-护-养"一体化管理模式,分别于干预前及干预后3个月和6个月时对2组日常生活活动能力、生存质量以及运动功能等进行评估并对比。结果:观察组病人干预后较干预前的日常生活能力评分以及生存质量指数评分均明显提高,较对照组干预后也均明显提高(P<0.01),对照组干预前后日常生活能力评分差异无统计学意义(P>0.05);观察组病人干预后6个月Fugl-Meyer评分较干预前明显改善,亦较对照组明显改善(P<0.01)。结论:"医-康-护-养"一体化管理模式能够显著提高脑卒中后遗症期病人的日常生活活动能力、生存质量以及运动功能等,有利于病人的康复,值得进一步推广。

Objective:To explore the effects of integrated management mode of"medical service-rehabilitation-nursing-elderly care"in improving the life quality and living ability of patients with stroke sequela.Methods:One hundred and sixty-four patients with stroke sequelae in three pension agencies of Futian district of Shenzhen from the year 2015 to 2016 were randomly divided into the observation group and the control group(82 cases each group).The control group was nursed with the second level prevention and management,and the observation group was nursed with the integrated management mode of"medical service-rehabilitation-nursing-elderly care".The ability of daily living,quality of life and sport function between two groups before intervention and after 3 and 6 months were assessed and compared.Results:After intervention,the scores of daily life ability and quality of life index in observation group were significantly improved compared with before intervention,and control group after intervention(P<0.01).There was not statistical significance in the scores of daily life ability and quality of life index in control group between before and after intervention(P>0.05).The scores of Fugl-Meyer in two groups after intervention were better than that before intervention,and the improvement of which in observation group was significantly higher than that in control group(P<0.01).Conclusions:The integrated management mode of"medical service-rehabilitation-nursing-elderly care"can significantly improve the ability of daily living,quality of life and sport function of patients with stroke sequelae,which is helpful to the rehabilitation of patients,and worthy of further promotion.