职业重建训练营对脊髓损伤患者回归社会疗效观察

Effect of Vocational Rehabilitation Training Camp on Patients with Spinal Cord InjuryReturning to Society

目的:观察职业重建训练营对脊髓损伤患者回归社会的疗效观察。方法:选取2017年10月—2019年10月在湘雅博爱康复医院住院的康复期脊髓损伤(SCI)患者34例,按照随机数字表法分为对照组16例和观察组18例。对照组采用常规康复治疗,包括基础性训练、日常生活能力训练、中医疗法等,每天6 h,每周5 d,共12周。观察组在常规康复治疗的基础上增加2周职业重建训练营,每天10 h,每周5 d,连续2周,共14周。2组SCI患者分别于治疗前和治疗后进行一般自我效能感(GSES)量表、社区融入问卷(CIQ)、林氏就业准备量表(LASER)评估。出院半年后进行电话回访复工状态。结果:2组治疗前GSES、CIQ评分进行组间比较,差异均无统计学意义(P>0.05)。治疗前后,观察组GSES评分(20.89±4.86∶31.44±3.42)、CIQ-家庭融入评分(4.39±1.24∶10.50±1.72)、CIQ-社交融入评分(2.78±0.94∶8.06±1.86)、CIQ-生产活动评分(0.50±0.62∶3.06±0.80)以及LASER比较,差异均有统计学意义(P<0.05);对照组GSES评分(22.06±5.53∶28.63±4.54)、CIQ-家庭融入评分(4.69±1.14∶6.69±1.49)、CIQ-社交融入评分(3.75±0.93∶6.19±1.17)、CIQ-生产活动评分(0.75±0.68∶2.13±0.62)以及LASER比较,差异均有统计学意义(P<0.05)。治疗后观察组与对照组比较,GSES评分(31.44±3.42∶28.63±4.54)、CIQ-家庭融入评分(10.50±1.72∶6.69±1.49)、CIQ-社交融入评分(8.06±1.86∶6.19±1.17)、CIQ-生产活动评分(3.06±0.80∶2.13±0.62)以及LASER比较,差异均有统计学意义(P<0.05)。出院半年后电话回访SCI患者复工状态,观察组的复工率显著高于对照组(P<0.05)。结论:职业重建训练营可显著提升SCI患者一般自我效能感、社区融入程度、就业意愿以及复工率。

Objectives:To investigate the therapeutic effect of vocational rehabilitation training camp on patients with spinal cord injury(SCI)returning to society.Methods:A total of 34 patients with spinal cord injury who were hospitalized and received rehabilitation treatments in Xiangya Boai Rehabilitation Hospital from October 2017 to October 2019 were recruited and randomly divided into control group(16 cases)and observation group(18 cases)according to the random number table method.The control group received conventional rehabilitation treatment(including basic training,daily life activity training,traditional Chinese medicine therapy,etc.)for 6 hours a day,5 days a week,for 12 weeks.The observation group added 2 weeks of vocational rehabilitation training camp on the basis of conventional rehabilitation treatment,10 hours a day,5 days a week,for 2 consecutive weeks,a total of 14 weeks.Patients in two groups were evaluated using general self-efficacy scale(GSES),community integration questionnaire(CIQ),and the lam assessment of stages of employment readiness(LASER)before and after treatment.The statuses of returning to work of patients were followed up by telephone six months after discharge.Results:There were no statistically significant differences between the two groups in GSES scores and CIQ scores before treatment(P>0.05).There were statistically significant differences in GSES scores(20.89±4.86∶31.44±3.42),CIQ-family integration scores(4.39±1.24∶10.50±1.72),CIQ-social integration scores(2.78±0.94∶8.06±1.86),CIQ-production activity scores(0.50±0.62∶3.06±0.80)and LASER scores of the observation group before and after treatment(P<0.05).There were statistically significant differences in GSES scores(22.06±5.53∶28.63±4.54),CIQ-family integration scores(4.69±1.14∶6.69±1.49),CIQ-social integration scores(3.75±0.93∶6.19±1.17),CIQ-production activity scores(0.75±0.68∶2.13±0.62)and LASER scores of the control group before and after treatment(P<0.05).After treatment,there were statistically significant differences in GSES scores(31.44±3.42∶28.63±4.54),CIQ-family integration scores(10.50±1.72∶6.69±1.49),CIQ-social integration scores(8.06±1.86∶6.19±1.17),CIQ-production activity scores(3.06±0.80∶2.13±0.62),and LASER scores between the two groups(P<0.05).Six months after discharge,the rate of returning to work of SCI patients in the observation group was significantly higher than that of the control group(P<0.05).Conclusion:Vocational rehabilitation training camp can significantly improve the general self-efficacy,community integration,willingness to work and the rate of returning to work of patients with spinal cord injury.