二元应对在脑卒中偏瘫患者家庭康复中的应用研究

The application of“dyadic coping”in the family rehabilitation of stroke patients with hemiplegia

目的探讨"二元应对"在脑卒中偏瘫患者家庭康复中的应用效果。方法随机抽取2018年1月-2019年10月本社区范围内的脑卒中康复期患者80例作为研究对象,采用随机数表法分为观察组与对照组两组,每组各40例。对照组患者给予常规家庭康复,观察组患者给予基于"二元应对"理论指导的家庭康复。分析比较两组患者入组时和进行家庭康复6个月后的功能综合评定量表和二元支持应对量表评分。结果对照组和观察组经过6个月的家庭康复治疗后的功能综合评定评分均显著高于进行家庭康复前。观察组家庭康复后的功能综合评定评分为(94.13±9.63)分,显著高于对照组患者的(67.59±8.42)分,其差异有统计学意义(P<0.05)。经过6个月的家庭康复,对照组和观察组的压力沟通、积极应对以及消极应对程度均有显著改善,且治疗后观察组患者压力沟通评分为(12.23±1.89)分,积极应对评分为(16.89±2.68)分,显著高于对照组患者的(9.33±2.07)分与(12.38±4.51)分,消极应对评分观察组患者为(3.66±0.87)分,显著低于对照组的(3.19±0.58)分,差异具具有统计学意义(P均<0.05),观察组患者配偶在压力沟通、积极应对、消极应对的改善情况也显著优于对照组患者配偶(P<0.05)。结论基于"二元应对"的家庭康复可以有效缓解脑卒中偏瘫患者的不良情绪及压力,提升患者配偶的照护能力,增加患者及其配偶的支持性行为,从而提高脑卒中偏瘫患者家庭康复的效果。

Objective To study the application effect of"dyadic coping"in the family rehabilitation of stroke patients with hemiplegia.Methods A total of 80 cases of stroke patients with hemiplegia,those in the recure period from January 2018 to October 2019,were randomly selected as study subjects in this study.Using a random number table,the 80 patients were randomly divided into observation group and control group with 40 patients in each group.Patients in the control group were given conventional family rehabilitation,while patients in the observation group were given family rehabilitation guided by the"dyadic coping"theory.The scores of comprehensive functional rating scale and the binary support response scale were compared between the two groups at the time of enrolling and after 6 months of home rehabilitation.Results After 6 months of family rehabilitation treatment,the functional comprehensive assessment scores of the control group and the observation group were significantly higher than those before the family rehabilitation treatment.The comprehensive functional assessment score of the observation group(94.13±9.63)was significantly higher than that of the control group(67.59±8.42),and the difference was statistically significant(P<0.05).After six months of family rehabilitation,the pressure communication,positive coping and negative coping of the control group and observation group were improved significantly,and the pressure communication grade(12.23±1.89)and positive coping(16.89±2.68)communication of observation group after treatment was significantly higher than pressure grade(9.33±2.07)and positive coping(12.38±4.51)in the control group;negative coping score of patients in observation group(3.66±0.87)was significantly lower than control group(3.19±0.58),all the differences above were statistically significant(P<0.05).In the observation group,the spouse's improvement in stress communication,positive coping and negative coping were also significantly better than that in the control group(P<0.05).Conclusions Family rehabilitation based on"dyadic coping"could effectively alleviate the bad mood and pressure of stroke patients with hemiplegia,improve the care ability of patients'spouses,increase the supportive behaviors of patients and their spouses,and thus improve the effect of family rehabilitation of stroke patients with hemiplegia.