个案管理的延伸护理模式对成年癫痫患者院外遵医行为、自护能力及癫痫院外发作时意外损伤的影响

Influence of extended nursing model of case management on out-of-hospital compliance behaviors,self-care ability and accidental injury during epilepsy out-of-hospital seizure of adult patients with epilepsy

目的:探究个案管理的延伸护理模式对成年癫痫患者院外遵医行为、自护能力及癫痫院外发作时意外损伤的影响。方法:选取179例成年癫痫患者为研究对象,根据护理方式不同分为观察组(n=90)和对照组(n=89)。对照组实施常规院内干预并设立院外咨询;观察组对照组基础上实施个案管理的延伸护理模式,干预时间均为3个月。比较两组患者院外遵医行为(坚持服药、定期检查、规避诱发因素、心理障碍遵医率)、自我护理能力(ESCA评分)、生活质量(GQOLI-7评分)及干预3个月内癫痫院外发作时意外损伤情况。结果:干预后,观察组患者坚持服药、定期检查、规避诱发因素、心理障碍遵医率高于对照组(P<0.05)。两组患者ESCA及GQOLI-74各项评分均升高(P<0.05),且观察组高于对照组(P<0.05)。干预3个月内,观察组患者癫痫院外发作时意外损伤总发生率低于对照组(P<0.05)。结论:个案管理的延伸护理模式可改善成年癫痫患者院外遵医行为、自护能力及生活质量,且可减少癫痫院外发作时意外损伤。

Objective:To explore the effect of extended nursing model of case management on out-of-hospital compliance behaviors,self-care ability and accidental injury during epilepsy out-of-hospital seizure of adult patients with epilepsy.Methods:179 adult patients with epilepsy were divided into observation group(n=90)and control group(n=89)according to different nursing methods.The control group implemented routine in-hospital intervention and set up out-of-hospital consultation,and the observation group was given extended nursing model intervention of case management on this basis.The compliance behavior(medication adherence,regular checkups,avoidance of predisposing factors and psychological disorders),Exercise of Self-Care Agency Scale(ESCA score),quality of life(GQOLI-74)and accidental injury during epilepsy attack outside the hospital within 3 months after intervention were compared between the two groups.Results:After 3 months of intervention,the compliance rates of medication adherence,regular checkups,avoidance of predisposing factors and psychological disorders in observation group were higher than those in control group(P<0.05).The scores of dimensions of ESCA and GQOLI-74 in the two groups were increased compared to before intervention(P<0.05),and the scores of observation group were higher than those of control group(P<0.05).Within 3 months of intervention,the total incidence rate of various accidental injuries during epilepsy out-of-hospital seizure was lower in observation group compared with that in control group(P<0.05).Conclusion:Extended nursing model of case management can improve the out-of-hospital compliance behaviors,self-care ability and quality of life of adult patients with epilepsy.In addition,it can reduce accidental injury during epilepsy out-of-hospital seizure.