基于互动达标理论的出院准备服务在首发缺血性脑卒中后吞咽障碍患者中的应用效果研究

Application Effect of Discharge Preparation Service Based on Interactive Attainment Theory in Patients with Deglutition Disorders after First-Episode Ischemic Stroke

目的分析基于互动达标理论的出院准备服务在首发缺血性脑卒中后吞咽障碍患者中的应用效果。方法采用方便抽样法选取江苏省苏北人民医院2021年9月至2022年2月收治的首发缺血性脑卒中后吞咽障碍患者40例作为对照组,2022年3—8月收治的首发缺血性脑卒中后吞咽障碍患者40例作为干预组。对照组患者采用常规吞咽障碍管理方案,干预组患者在对照组的基础上采用基于互动达标理论的出院准备服务管理方案。收集患者一般资料,比较两组出院时出院准备度量表(RHDS)各维度得分及其总分,出院时、出院后1个月吞咽功能恢复效果,住院期间、出院后1个月内吞咽障碍相关并发症发生率,出院后3个月内非计划再入院率。结果研究结束时,对照组失访3例,干预组失访1例、中途拒绝干预1例,最终对照组纳入37例、干预组纳入38例患者。出院时,干预组个人状态、适应能力、预期性支持维度得分及RHDS总分高于对照组(P<0.05)。出院时、出院后1个月,干预组吞咽功能恢复效果优于对照组(P<0.05)。住院期间,两组吞咽障碍相关并发症总发生率比较,差异无统计学意义(P>0.05);出院后1个月内,干预组吞咽障碍相关并发症总发生率低于对照组(P<0.05)。出院后3个月内,干预组与对照组非计划再入院率比较,差异无统计学意义(P>0.05)。结论基于互动达标理论的出院准备服务能有效提高首发缺血性脑卒中后吞咽障碍患者的出院准备度、吞咽功能恢复效果,且安全性较好,具有一定临床应用价值。

Objective To explore the application effect of discharge preparation service based on interactive attainment theory in patients with deglutition disorders after first-episode ischemic stroke.Methods Using the convenience sampling method,40 patients with deglutition disorders after first-episode ischemic stroke admitted to Northern Jiangsu People's Hospital from September 2021 to February 2022 were selected as the control group,and 40 patients with deglutition disorders after first-episode ischemic stroke admitted from March to August 2022 were selected as the intervention group.Patients in the control group were treated with the conventional deglutition disorders management scheme,and patients in the intervention group were treated with the discharge preparation service management scheme based on the interactive attainment theory on the basis of the control group.The general data of patients were collected.The scores of various dimensions and total score of Readiness for Hospital Discharge Scale(RHDS)at discharge,the effect of swallowing function recovery at discharge and 1 month after discharge,the incidence of complications related to deglutition disorders during hospitalization and within 1 month after discharge,the rate of unplanned readmission within 3 months after discharge were compared between the two groups.Results At the end of the study,3 cases were lost to follow-up in the control group,1 case was lost to follow-up,and 1 case refused intervention midway in the intervention group.Finally,37 patients were included in the control group and 38 patients were included in the intervention group.At discharge,scores of individual status,adaptability and anticipatory support dimensions and total score of RHDS in the intervention group were higher than those in the control group(P<0.05).At discharge and 1 month after discharge,the effect of swallowing function recovery in the intervention group was better than that in the control group(P<0.05).There was no significant difference in the total incidence of deglutition disorders related complications between the two groups during hospitalization(P>0.05).Within 1 month after discharge,the total incidence of deglutition disorders related complications in the intervention group was lower than that in the control group(P<0.05).Within 3 months after discharge,there was no significant difference in the rate of unplanned readmission between the intervention group and the control group(P>0.05).Conclusion The discharge preparation service based on interactive attainment theory can effectively improve the discharge preparation and swallowing function recovery effect of patients with deglutition disorders after first-episode ischemic stroke,and has good safety and clinical application value.