脑卒中吞咽障碍康复干预现状的田野调查

Rehabilitation nursing for dysphagia after stroke:a field study

目的了解脑卒中后吞咽障碍康复干预现状,为针对性干预提供参考。方法选取武汉市1所三级甲等综合医院的卒中重症病房、神经内科和康复科作为田野地,通过田野观察和非正式访谈收集资料。结果脑卒中后吞咽障碍护理包括吞咽障碍筛查、营养管理、健康教育及辅助康复治疗4个方面;存在吞咽障碍筛查、健康教育不到位,营养管理未达指南要求,康复治疗参与度低等问题。结论脑卒中后吞咽障碍康复干预欠佳,应针对护士进行专项培训,提升专科知识水平,构建循证管理方案,促进多团队协作,全面提高吞咽障碍康复干预水平。

Objective To understand the current status of rehabilitation intervention for dysphagia after stroke,and to provide reference for targeted intervention.Methods A neurological intensive care unit,a neurological department and a rehabilitation department of a grade-A tertiary general hospital in Wuhan were selected as field study sites,and data were collected through field observation and informal interview.Results Nursing care related to dysphagia after stroke included dysphagia screening,nutritional management,health education,and rehabilitation assistance.There were some problems in rehabilitation nursing:poor implementation of dysphagia screening,insufficient health education,nutritional management failing to meet the requirements of guidelines,and low participation in rehabilitation therapies.Conclusion The rehabilitation intervention on dysphagia after stroke was not satisfactory,so we should carry out special training for nurses,improve specialty-specific knowledge,develop evidence-based management protocol,and strengthen multidisciplinary collaboration.