以健康行为改变整合理论为导向的护理模式联合叙事护理在急性脑卒中患者中的应用效果

Application effect of nursing mode guided by health behavior change integration theory combined with narrative nursing in patients with acute stroke

目的:探讨以健康行为改变整合理论(ITHBC)为导向的护理模式与叙事护理在急性脑卒中患者中的联合应用效果。方法:将126例急性脑卒中患者按照护理方式不同分为3组,每组各42例。A组实施常规急诊护理;B组实施常规急诊护理+叙事护理;C组在B组基础上施以ITHBC为导向的护理模式,各组均连续护理14 d,随访1个月。比较各组患者自我效能感、自我管理能力与神经功能恢复情况。结果:护理14 d、随访1个月时,各组患者GSES评分比较:C组>B组>A组(P<0.05);随访1个月时,B组、C组患者SSSMQ中各维度评分及总分均高于护理前,且C组>B组>A组(P<0.05);各组患者美国国立卫生研究院卒中量表(NIHSS)评分均低于护理前,且C组<B组<A组(P<0.05)。结论:以ITHBC为导向的护理模式联合叙事护理能提高急性脑卒中患者自我效能感与自我管理能力,有助于促进患者神经功能恢复,该护理模式值得在临床推广使用。

Objective:To explore the combined application effect of integrated theory of health behavior change(ITHBC)oriented nursing model and narrative nursing in patients with acute stroke.Methods:126 patients with acute stroke were divided into three groups according to different nursing methods,with 42 cases in each group.Group A was given routine emergency nursing,group B was given routine emergency nursing+narrative nursing,and group C was given ITHBC-oriented nursing mode on the basis of group B.Continuous nursing for 14 days and follow-up for 1 month.The self-efficacy,self-management ability and neurological function recovery were compared between the groups.Results:At 14 days of nursing and 1 month follow-up,the general self-efficacy scale(GSES)scores of group C was the highest,and the group A was the lowest(P<0.05).The scores of stroke self-management ability scale(SSSMQ)in groups were higher than those before nursing,and group C was the highest and group A was the lowest(P<0.05).The National Institutes of Health Stroke Scale(NIHSS)scores of the groups were lower than those before nursing,and the lowest in group C and the highest in group A(P<0.05).Conclusion:The ITHBC-oriented nursing model combined with narrative nursing can improve the self-efficacy and self-management ability of patients with acute stroke,and help to promote the recovery of neurological function,which provides a reference for the clinical application of this nursing model.