分阶段健康教育对脑卒中后偏瘫合并下肢深静脉血栓患者健康行为、自护能力的影响

Effect of staged health education on health behavior and self-care ability in patients with post-stroke hemiplegia complicated with lower limb deep vein thrombosis

目的探讨以患者需求为导向的分阶段健康教育在脑卒中后偏瘫合并下肢深静脉血栓(DVT)患者中的应用价值。方法选取2021年1月至2022年7月在郑州大学第一附属医院神经内科就诊的128例脑卒中后偏瘫合并DVT患者开展前瞻性研究,根据入院时间分组,2021年1~10月就诊的64例患者纳入常规组,2021年11月至2022年7月就诊的64例患者纳入研究组。常规组患者给予常规护理干预,研究组患者在常规组基础上联合以患者需求为导向的分阶段健康教育,两组患者均连续干预3个月,比较两组患者干预3个月后的健康行为及干预前、干预3个月后自护能力[自我护理能力测定表(ESCA)]、负性情绪[焦虑自评量表(SAS)、抑郁自评量表(SDS)]、应对方式、患肢肿胀度、生活质量[生活质量综合评定问卷-74(GQOL-74)]。结果干预后,研究组患者的健康行为优良率为84.38%,明显高于常规组的65.63%,差异有统计学意义(P<0.05);干预后,研究组患者的ESCA、GQOL-74评分分别为(159.67±5.07)分、(91.02±2.47)分,明显高于常规组的(138.25±7.68)分、(85.39±5.21)分,SAS、SDS评分分别为(38.63±4.86)分、(35.24±4.27)分,明显低于常规组的(47.29±5.07)分、(43.87±5.10)分,差异均有统计学意义(P<0.05);干预后,研究组患者的积极应对评分为(31.83±1.10)分,明显高于常规组的(24.39±2.42)分,差异有统计学意义(P<0.05);研究组患者干预前后患侧小腿周径差值为(2.62±0.42)cm,明显大于常规组的(1.94±0.41)cm,差异有统计学意义(P<0.05)。结论以患者需求为导向的分阶段健康教育可提升脑卒中后偏瘫合并下肢DVT患者健康行为水平及自护能力,改善患者负性情绪及生活质量,减轻患肢肿胀度,调节患者应对方式。

Objective To explore the application value of patient demand-oriented staged health education in patients with post-stroke hemiplegia complicated with lower limb deep vein thrombosis(DVT).Methods A total of 128 patients with post-stroke hemiplegia combined with DVT treated in the Department of Neurology,the First Affiliated Hospital of Zhengzhou University from January 2021 to July 2022 were selected for the prospective study.According to the time of admission,64 patients from January 2021 to October 2021 were included in the conventional group,and 64 patients from November 2021 to July 2022 were included in the study group.The patients in the conventional group were given routine nursing intervention,while the patients in the study group received a combination of patient demandoriented staged health education on the basis of the conventional group,continuously for 3 months.The health behaviors of the two groups after 3 months of intervention,the self-care ability[self-care ability scale(ESCA)],negative emotions[self-rating anxiety scale(SAS),self-rating depression scale(SDS)],coping style,limb swelling,quality of life[comprehensive quality of life questionnaire-74(GQOL-74)]before intervention and 3 months after intervention were compared between the two groups.Results After the intervention,the excellent and good rate of health behavior in the study group was 84.38%,which was significantly higher than 65.63%in the conventional group(P<0.05).After intervention,the ESCA and GQOL-74 scores in the study group were(159.67±5.07)points and(91.02±2.47)points,respectively,which were significantly higher than(138.25±7.68)points and(85.39±5.21)points in the conventional group(P<0.05),and the SAS and SDS scores were(38.63±4.86)points and(35.24±4.27)points,respectively,significantly lower than(47.29±5.07)points and(43.87±5.10)points in the conventional group(P<0.05).After intervention,the positive coping score in the study group was(31.83±1.10)points,which was significantly higher than(24.39±2.42)points in the conventional group(P<0.05).The difference in the circumference of the affected leg in the study group before and after intervention was(2.62±0.42)cm,which was significantly higher than(1.94±0.41)cm in the control group(P<0.05).Conclusion Patient demand-oriented staged health education can improve the health behavior level and self-care ability of patients with hemiplegia combined with lower limb DVT after stroke,improve negative emotions and quality of life,reduce limb swelling,and regulate patient coping styles.