以护理团队为主导的多学科协作干预训练在缺血性脑卒中术后患者认知功能康复中的应用

Application of nursing team led multidisciplinary cooperative intervention in postoperative cognitive rehabilitation of patients with ischemic stroke

目的探讨以护理团队为主导的多学科协作干预训练在缺血性脑卒中术后患者认知功能康复中的应用效果.方法于2016年5月-2017年6月在北京市某三级甲等医院选取80例缺血性脑卒中术后认知功能障碍患者,采用随机数字表法随机分为观察组和对照组,每组40例.对照组采用常规护理方法.观察组在对照组的基础上采用以护理团队为主导的多学科协作干预训练.分别于干预前、干预后6个月采用简易智能精神状态检查表(MMSE)、蒙特利尔认知评估量表(MoCA)及WHO生存质量测定表简表(WHOQOL-BREF)对两组患者进行认知功能及生活质量评估.结果干预后6个月,观察组的MMSE、MoCA评分为(29.35±0.58)、(26.70±2.03)分,与对照组评分比较,差异有统计学意义(t=5.64、4.15;P<0.01);观察组患者生活质量中的总分、生理领域、心理领域、社会领域评分为(64.59±5.14)、(16.94±1.43)、(17.10±1.55)、(15.60±1.07)分,高于对照组(t=4.82、5.60、7.41、3.23;P<0.01).结论以护理团队为主导的多学科协作干预训练能够改善缺血性脑卒中术后患者的认知功能及生活质量,加快术后康复以形成良性循环.

Objective To explore the application effects of the nursing team led multidisciplinary cooperative intervention in postoperative cognitive rehabilitation of patients with ischemic stroke. Methods From May 2016 to June 2017,80 patients with cognitive dysfunction after ischemic stroke in a ClassⅢ Grade A hospital in Beijing were selected and randomly divided into observation group and control group based on random number table,with 40 patients in each group. The control group received the routine nursing care and on the basis of that, the observation group received the nursing team led multidisciplinary cooperative intervention. The cognitive function and quality of life in two groups were assessed by the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and World Health Organization Quality of Life in Brief Version (WHOQOL-BRIEF) before and 6 months after intervention. Results Six months after intervention,the MMSE and MoCA scores of the observation group were (29.35±0.58) and (26.70±2.03) scores, which were statistically different from the control group (t=5.64, 4.15;P<0.05). The total score,scores of physiological field,psychological field and social field in the quality of life of the observation group were (64.59±5.14),(16.94±1.43),(17.10±1.55), and (15.60±1.07)scores,which were significantly higher than the control group (t=4.82, 5.60,7.41,3.23;P<0.01). Conclusions The nursing team led multidisciplinary cooperative intervention can improve the cognitive function and quality of life in the patients after ischemic stroke and accelerate postoperative recovery forming a virtuous circle.