医院-家庭联合多学科5E康复模式对重症肌无力患者的应用效果研究

Effects of hospital-family multidisciplinary 5E rehabilitation model on patients with myasthenia gravis

目的探究医院-家庭联合多学科5E康复模式对重症肌无力患者的临床状况、运动功能、呼吸肌肉力量、生命质量及心理状态的影响。方法本研究为类实验研究。采用便利抽样,选取2020年1月至2021年9月于哈尔滨医科大学附属第一医院就诊的重症肌无力Ⅱ型患者,根据病区不同将患者分为干预组与对照组。对照组采用常规护理方法,干预组采用医院-家庭联合多学科5E康复模式,进行为期12周的干预。运用重症肌无力复合量表(MGC)、6MWT、最大吸气压(MIP)、疲劳量表-14,重症肌无力生命质量量表(MGQOL-15)、Herth希望水平量表、慢性病自我效能量表,比较患者干预前后的效果差异。结果干预后12周,干预组6MWT、生命质量评分分别为(477.95±29.23)、(6.25±3.40)分,对照组分别为(435.85±19.82)、(9.95±3.22)分,差异均有统计学意义(t=4.51、-3.58,均P<0.05);干预组MIP得分、疲劳量表-14得分、慢性病自我效能量表得分、希望水平量表得分分别为(102.09±19.56)、(2.56±1.31)、(34.78±8.68)、(33.43±6.39)分,对照组分别为(90.85±12.25)、(4.65±2.50)、(24.15±6.62)、(25.90±8.30)分,差异均有统计学意义(t值为-4.46~3.35,均P<0.05);2组患者生命质量评分的时间与交互效应比较差异均有统计学意义(F=28.28、22.01,均P<0.05);2组患者6MWT的组间、时间与交互效应比较差异均有统计学意义(F=13.94、8.24、12.85,均P<0.05)。结论医院-家庭联合多学科5E康复模式对重症肌无力患者康复有促进效果,应进一步加强细化研究,为患者重症肌无力康复指南的出台奠定数据基础。

Objective To explore the effects of hospital-family multidisciplinary 5E rehabilitation model on clinical status,athletic ability,respiratory muscle strength,quality of life and psychological states of patients with myasthenia gravis(MG).Methods This was a quasi-experimental study.According to the convenient sampling method,patients with type 2 MG treated in the First Affiliated Hospital of Harbin Medical University from January 2020 to September 2021 were divided into intervention group and control group.The control group was treated with routine nursing methods,and the intervention group was treated with hospital-family multidisciplinary 5E rehabilitation model for 12 weeks.The effects of intervention were compared by using Myasthenia Gravis Composite(MGC),6-minute walking test(6MWT),maximum inspiratory pressure(MIP),Fatigue Scale-14(FS-14),Myasthenia Gravis Quality of Life-15(MGQOL-15),Herth Hope Level Scale(HHI)and Self-Efficacy for Managing Chronic Disease 6-Item Scale(SES6C).Results Repeated measurement analysis of variance showed that there were significant differences between 6MWT score and MGQOL-15 score twelve weeks after intervention,the intervention group scores were(477.95±29.23),(6.25±3.40)points,the control group scores were(435.85±19.82),(9.95±3.22)points,the differences were statistically significant(t=4.51,-3.58,both P<0.05).Besides,the differences of MIP,FS-14 score,SES6C score and HHI score were also statistically significant,the intervention group scores were(102.09±19.56),(2.56±1.31),(34.78±8.68),(33.43±6.39)points,the control group scores were(90.85±12.25),(4.65±2.50),(24.15±6.62),(25.90±8.30)points,the differences were statistically significant(t values were-4.46-3.35,all P<0.05).Repeated measurement analysis of variance showed that there were significant differences in the time effect and interaction effect of MGQOL-15 score between the two groups(F=28.28,22.01,both P<0.05),there were also significant differences in the group effect,time effect,and interaction effect of 6MWT between the two groups(F=13.94,8.24,12.85,all P<0.05).Conclusions The rehabilitation of patients with MG could be promoted by the hospital-family multidisciplinary 5E rehabilitation model.Detailed research should be further strengthened to lay a foundation for the development of rehabilitation guidelines for patients with MG.