慢性病自我管理方案对社区脑梗死患者康复锻炼依从性和自我管理行为的影响

The Influence of Chronic Disease Self-management Program in Patients with Cerebral Infarction Convalescence on Rehabilitation Exercise Compliance and Self-management Ability

目的:探讨慢性病自我管理方案对社区脑梗死恢复期患者康复锻炼依从性和自我管理行为的影响。方法:选取上海市浦东新区北蔡社区卫生服务中心出院的126例脑梗死恢复期患者作为研究对象,按随机数表法将其随机分为对照组(n=63)和观察组(n=63)。对照组:对患者实施常规管理模式,观察组:对患者实施慢性病自我管理方案。干预6个月后对两组患者的康复锻炼依从性、自我管理能力及运动功能及生活质量进行评价。结果:干预后观察组患者康复锻炼总依从率(95.24%)显著高于对照组(73.02%),差异有统计学意义(Z=9.553,P<0.01);观察组患者自我管理能力评估指标疾病知识、配合康复训练、自我心理调节、自我监控症状行为、自我处置药物行为5个维度评分改善程度均高于对照组,差异有统计学意义(t值分别为5.563、6.664、7.310、6.171、8.535,P值均<0.05);观察组患者肢体运动功能和生活质量各指标评分改善程度均高于对照组,差异有统计学意义(P<0.05)。结论:对脑梗死恢复期患者实施慢性病自我管理方案可提高其康复锻炼的依从性、自我管理能力,促进患者肢体功能的恢复。

OBJECTIVE To explore the influence of chronic disease self-management program in patients with cerebral infarc⁃tion convalescence on rehabilitation exercise compliance and self-management ability.METHODS 126 cases of cerebral infarction convalescence were divided into control group(n=63)and observation group(n=63).The patients of control group were given rou⁃tine management mode,while the patients of observation group were intervened according to chronic disease self-management pro⁃gram.After 6 months,the effect of two groups were analyzed.RESULTS The total of rehabilitation exercise compliance of observation group(95.24%)was higher than in the control group(73.02%),the difference was statistically significant(Z=9.553,P<0.001).In the assessment index of the observation group,the disease knowledge,rehabilitation training,self-psychological regulation,self-moni⁃toring symptom behavior and self-treatment drug behavior were higher than that of the control group,and the difference was statisti⁃cally significant(t=5.563,6.664,7.310,6.171,8.535,P<0.05);the improvement of body movement function and quality of life in the observation group was higher than that of the control group(P<0.05).CONCLUSION The self-management program intervention in cerebral infarction convalescence can their improve rehabilitation exercise compliance and self-management ability,and promote the recovery of limb function.