医、护、社工三位一体护理模式对卒中患者自我管理能力和社会卫生服务利用的影响

Effects of long time nursing care established by doctors, nurses and social workers on the self-management ability and health service utilization of stroke patients

目的探讨医、护、社工三位一体护理模式对卒中患者自我管理能力和社会卫生服务利用次数的影响。方法采用便利抽样法,选择2016年7月—2017年7月在佛山市某三级甲等综合医院住院治疗,诊断为脑卒中(首发)康复期的出院患者104例,分为对照组51例和实验组53例,其中对照组采用社区常规的长期护理模式,实验组实施医、护、社工三位一体的护理服务方案,比较两组患者在干预后3个月、6个月的自我管理能力,同时记录干预期间患者急诊次数、再入院次数等卫生服务利用情况。结果干预3个月、6个月时实验组患者自我管理能力高于对照组,差异有统计学意义(P<0.05)。干预3个月时两组患者卫生服务利用方面比较,差异无统计学意义(P>0.05);干预6个月时实验组患者的卫生服务利用次数少于对照组,差异有统计学意义(P<0.05)。结论医、护、社工三位一体长期护理模式提高卒中患者的自我管理能力,还能减少患者急诊次数和再入院次数,是患者慢性病管理的一种有效方法。

Objective To explore the effects of long time nursing care management established by doctors,nurses and social workers on the self-management ability and health service utilization of stroke patients.Methods 104 patients diagnosed with first stroke were divided into control group(51cases)and experimental group(53 cases)according to the random number table.The control group received community regular long-term care plan,the experimental group received the long time nursing care established by doctors,nurses and social workers together.The self-management scale of stroke disease was used to investigate the self-management status of patients three months,six months after intervention.The times of emergency services and the times of re-hospitalization were also recorded.Results The self-management ability of patients at the third month,sixth month after intervention in the intervention group was improved compared with the control group(P<0.05).There was no significant difference in the aspect of health service utilization at the third month after intervention between two groups(P>0.05);the times of health service utilization in the intervention group at the sixth month after intervention were less than that of the control group(P<0.05).Conclusion The long time nursing care established by doctors,nurses and social workers can improve the stroke patients'self-management ability and health service utilization of stroke patients.