基于混合方法的脑卒中患者支持性照护需求的研究

Study on the supportive care needs of stroke patients:a mixed-methods study

目的采用混合方法研究,探究病情稳定的急性期脑卒中患者支持性照护需求,为制订有效的支持性照护方案提供指导。方法采用一致性平行设计的混合方法研究,应用便利抽样法,抽取神经内科住院患者进行问卷调查,同时采用目的性抽样,对15名脑卒中患者进行半结构式访谈。结果回收有效问卷176份,支持性照护需求总分为(2.17±0.37)分,各维度前3位依次为疾病相关信息需求(2.75±0.40)分、生活护理需求(2.28±0.51)分、社会支持需求(2.26±0.28)分;知晓脑卒中常见的病因居各条目首位。质性访谈析出主题:协助日常活动、功能受损管理、早期功能康复、疾病相关知识、心理社会支持、出院指导。结论脑卒中患者支持性照护需求内容丰富、程度较高;基于患者需求,提供相应的信息需求;落实早期二级预防指导,预防疾病复发;协同多学科团队,提供早期康复,减轻功能受损;及时识别患者负性情绪,联合家属共同为患者提供心理支持;实施个案管理模式,推进脑卒中疾病全程护理服务。

Objective To explore supportive care needs of patients with stable stroke in the acute phase and provide guidance for effective supportive care through mixed-methods.Methods A mixed-method study with convergent parallel design was used.A convenient sampling method was used to select neurological inpatients for questionnaire survey.At the same time,a purposive sampling was used to conduct semi-structured interviews with 15 stroke patients.Results A total of 176 valid questionnaires were collected,and the average score of supportive care needs were 2.17±0.37,The top 3 were disease-related information needs(2.75±0.40),daily life care needs(2.28±0.51),and social support needs(2.26±0.28).Knowing the causes of stroke ranked first in each entry.The theme of qualitative interviews included:assisting daily activities,management of impaired functions,early functional rehabilitation,disease-related knowledge,psychosocial support,and discharge guidance.Conclusions Stroke patients have rich and high-level supportive care needs,and provide corresponding information needs based on patient needs.Implement early secondary prevention guidance to prevent stroke recurrence;cooperate with multidisciplinary teams to provide early rehabilitation,reduce functional impairment;timely identify negative emotions of patients,and jointly provide family with patients psychological support.Implement a case management model to promote full-course care for stroke patients.