基于广州市长期护理保险制度的“互联网+”延续护理模式在脑卒中患者中的探索实践

"Internet+ " continuous nursing care based on Guangzhou long-term care insurance systemfor stroke patients

目的探讨基于长期护理保险制度的“互联网+”延续护理服务模式在脑卒中患者的应用成效。方法回顾性研究广州中医药大学第二附属医院2020年3月至2021年9月接受基于长期护理保险制度的“互联网+”延续护理服务模式的脑卒中患者,最终31名脑卒中患者纳入研究,其中,男性18例,女性13例,年龄(74.29±6.70)岁;缺血性脑卒中23例,出血性脑卒中8例。比较患者接受该服务前后的基本生活自理能力(BADL)、改良Rankin(mRS)评分、卒中复发、死亡、再入院率和满意度情况。统计学方法采用t检验。结果参与基于长期护理保险制度的“互联网+”延续护理服务后3个月脑卒中患者的BADL评分较出院时提高[(49.68±11.47)分比(46.13±9.81)分],差异有统计学意义(t=4.573,P<0.05);出院后3个月脑卒中患者的mRS评分较出院时下降[(3.68±0.60)分比(3.84±0.58)分],差异有统计学意义(t=-2.402,P<0.05)。31例脑卒中患者在出院后3个月内居家过程中均未发生卒中复发、再入院治疗或死亡。脑卒中患者和家属对基于长护险的“互联网+”延续护理服务的满意度评分为(96.84±7.51)分,医护人员对该服务的满意度评分为(91.04±8.27)分,67.74%(21/31)的患者自觉症状改善或缓解,96.77%(30/31)的患者表示愿意将该服务推荐给同类患者。结论开展基于长期护理保险制度的“互联网+”延续护理服务模式可以满足脑卒中患者居家康复需求,提高患者日常生活自理能力和生活质量,减轻家属照护负担和经济负担,提升医护人员职业成就感。

Objective To explore the effect of"internet+"continuous nursing care based on Guangzhou long-term nursing insurance system for stroke patients.Methods This was a retrospective study.From March 2020 to September 2021,31 stroke patients who received"internet+"continuous nursing care based on Guangzhou long-term nursing insurance system in The Second Affiliated Hospital of Guangzhou University of Chinese Medicine were included into this study,including 18 males and 13 females who were(74.29±6.70)years old.There were 23 cases of ischemic stroke and 8 cases of hemorrhagic stroke.The scores of Basic Activities of Daily Living(BADL)and modified Rankin Score(mRS),stroke recurrence,death rates,readmission rates,and satisfaction before and after the continuous nursing care were compared.t test was applied.Results The score of BADL 3 months after the continuous nursing care was higher than that at discharge[(49.68±11.47)vs.(46.13±9.81)],with a statistical difference(t=4.573,P<0.05).The score of mRS 3 months after the continuous nursing care was higher than that at discharge[(3.68±0.60)vs.(3.84±0.58)],with a statistical difference(t=-2.402,P<0.05).None of the 31 stroke patients had stroke recurrence,readmission,or death within the 3 months after discharge.The satisfaction score of stroke patients and their family members was(96.84+7.51);the satisfaction of the medical staff was(91.04+8.27).Among the patients,66.67%felt that their symptoms improved or relieved,and 96.67%expressed their willingness to recommend this service to similar patients.Conclusion"Internet+"continuous nursing care based on Guangzhou long-term nursing insurance system for stroke patients can meet their needs in home care,improve their BADL score and quality of life,reduce the burden of care and finance,and increase the medical staff's career achievement.