医院社区一体化脑卒中神经康复护理模式研究

Research on hospital-community integrated stroke neurorehabilitation nursing model

目的探讨医院社区一体化神经康复护理模式对脑卒中患者神经康复的效果。方法选取2017年7月—2019年6月在深圳市某综合三级医院住院首次诊断为脑卒中的患者109例,随机分为观察组53例和对照组56例,住院期间对两组患者给予同质化的常规护理和出院宣教,对照组根据患者情况告知其复诊时间、康复治疗途径,观察组给予医院社区一体化神经康复护理模式。比较干预前、干预6、12个月后两组患者的日常生活能力、生活质量、神经功能缺损程度。结果干预6、12个月后,观察组BI评分均高于对照组,NIHSS评分均明显低于对照组,差异均有统计学意义(P<0.05);干预12个月后,观察组NHP各项评分明显低于对照组,差异均有统计学意义(P<0.05)。结论整合医院社区资源,实施医院社区一体化护理模式,为脑卒中患者建立个性化神经康复护理方案,有助于促进患者肢体、语言与进食功能的恢复,提高患者生活自理能力和生活质量,值得临床推广应用。

Objective To investigate the effect of hospital-community integrated neurorehabilitation nursing mode for the neurorehabilitation of stroke patients. Methods From July 2017 to June 2019, 109 patients with stroke diagnosed for the first time in a tertiary general hospital in Shenzhen were selected and randomly divided into 53 cases in the observation group and 56 cases in the control group. During hospitalization, the two groups of patients were given homogeneous routine nursing and discharge education. The control group informed the patients of the follow-up time and the way of rehabilitation treatment according to the situation of the patients, and the observation group was given the hospital-community integrated neurorehabilitation nursing mode. Before and after 6 and 12 months of intervention, the activities of daily living, quality of life and degree of neurological deficit of patients in two groups were compared. Results After 6 and 12 months of intervention, the BI scores of the observation group were higher than those of the control group, and and the NIHSS scores were significantly lower than those of the control group, and the differences were statistically significant(P <0.05);after 12 months of intervention, the NHP each score of the observation group were significantly lower than those of the control group, and the difference was statistically significant(P<0.05).Conclusion The integration of hospital and community resources and the implementation of hospital-community integrated nursing model would help to establish a personalized neurorehabilitation nursing scheme for stroke patients, promote the recovery of patients’ limb, language and eating functions, and improve patients’ self-care ability and quality of life. It was worthy of clinical promotion and application.