医护治一体化模式在脑外伤康复期患者中的应用研究

Study on the application of Doctor-Nurse-Therapist integrated model in the care of patients with traumatic brain injury

目的探讨医护治一体化模式对脑外伤康复期患者的应用效果。方法采用历史对照研究法,选取上海市养志康复医院神经康复四科在2016年1月至2017年10月收治的脑外伤患者60例作为对照组,按照传统医护治工作模式,进行治疗、护理及康复训练;选取2018年1月至2019年10月脑外伤患者56例作为观察组,采用医护治一体化模式,共同评估、诊断,进行治疗、护理及康复训练。比较2组患者运动功能状态、日常生活能力及焦虑抑郁评分等指标的差异性。结果通过6周的干预,观察组患者的运动功能得分为(80.27±18.20)分、日常生活活动能力得分为(73.14±19.18)分,对照组分别为(67.32±19.70)、(64.59±20.33)分,2组比较差异均有统计学意义(t值为3.491、2.105,均P<0.05);观察组患者的焦虑心理评分为(44.68±12.29)分、抑郁心理评分为(42.61±17.95)分,对照组分别为(52.25±12.95)、(50.84±18.14)分,2组比较差异均有统计学意义(t值为-2.965、-2.236,均P<0.05)。结论医护治一体化模式下,医生、护士与治疗师共同评估、讨论、制订、实施该模式流程方案,能够显著提高脑外伤康复期患者运动功能状态及日常生活能力,改善焦虑抑郁情绪,提升医疗服务质量,减轻家庭及社会的负担。

Objective To explore the application effects of the Doctor-nurse-therapist integrated Model on the patients with brain injury in the rehabilitation period.Methods A total of 60 patients with brain injury from January 2016 to October 2017 were selected as the control group underwent interventions based on traditional treatment model involving medical treatment,nursing and rehabilitation,and then 56 patients with brain injury from January 2018 to October 2019 were aselected as the experimental group followed Doctor-Nurse-Therapist integrated model for rehabilitation treatment.All subjects were recruited from inpatients hospitalized in the Forth Department of Neurological Rehabilitation,Shanghai Yangzhi Rehabilitation Hospital(Shanghai Sunshine Rehabilitation Center).The differences of motor function,activities of daily life(ADLs),anxiety and depression scores between the two groups were compared.Results After 6 weeks of interventions,the scores of motor function were 80.27±18.20 and 67.32±19.71,and ADLs scores were 73.14±19.18 and 64.59±20.33 for the experimental group and the control group,respectively.The differences of the motor function and ADLs scores showed statistical significance between the experimental group and the control group(t values were 3.491,2.105,P<0.05).The anxiety and depression scores were 44.68±12.29 and 42.61±17.95 in the experimental group,while 52.25±12.95 and 50.84±18.14 in the control group,respectively.Statistical significance was found according to differences of anxiety and depression scores between the experimental group and the control group(t values were 2.965,-2.236,P<0.05).Conclusions Under the integrated model,doctors,nurses and therapists can evaluate,discuss,formulate and implement the flow scheme of the model,which can significantly improve the motor function and daily life ability of patients with brain injury in the rehabilitation period as well as anxiety,depression and the quality of medical services,and reduce the burden of family and society.