基于信息-动机-行为技巧模型理论的脑卒中吞咽障碍护理方案对老年脑卒中吞咽障碍病人的干预效果

Intervention effect of post-stroke dysphagia nursing program based on information-motivation-behavioral skills model theory in elderly patients

目的构建基于信息-动机-行为技巧模型(information-motivation-behavioral skills model,IMB)理论的脑卒中吞咽障碍护理方案,并探讨其对老年脑卒中吞咽障碍病人的干预效果。方法采用便利抽样法,选取2022年5~9月广西医科大学第三附属医院神经内科住院的100例老年缺血性脑卒中吞咽障碍病人作为研究对象,按随机数表法分为观察组(n=50)和对照组(n=50)。成立IMB护理干预多核心团队,文献回顾后形成脑卒中吞咽障碍护理方案初稿,经专家小组会议形成最终护理方案。观察组实施基于IMB理论的脑卒中吞咽障碍护理方案,对照组实施常规护理。比较2组干预4周后的吞咽障碍程度、吞咽特异性生活质量量表(SWAL-QOL)评分变化及吸入性肺炎的发生率。结果干预4周后,观察组的吞咽障碍程度轻于对照组,SWAL-QOL各维度评分及总分均优于对照组,吸入性肺炎的发生率低于对照组,差异均有统计学意义(P<0.05或P<0.01)。结论基于IMB理论的脑卒中吞咽障碍护理方案,既可以显著改善老年脑卒中吞咽障碍病人的生活质量和吞咽功能,又能够有效降低吸入性肺炎的发生率。

Objective To construct a post-stroke dysphagia nursing program based on the theory of information-motivation-behavioral skills model(IMB),and to explore its intervention effect in the elderly patients with post-stroke dysphagia.Methods By convenience sampling methods,100 elderly patients with post-stroke dysphagia hospitalized in Department of Neurology of the Third Affiliated Hospital of Guangxi Medical University from May to September 2022 were selected,and they were divided into observation group(n=50)and control group(n=50)according to random number table.First,A multi-core team of IMB nursing intervention was established,and then the first draft of the post-stroke dysphagia nursing program was formed after the literature review.Finally,the final nursing plan was formed after the expert group meeting.The observation group received the post-stroke dysphagia nursing program based on IMB theory,and the control group received regular care.The degree of dysphagia,changes in Swallow-Specific Quality of Life(SWAL-QOL)scores,and the incidence rate of aspiration pneumonia after four weeks of intervention were compared between the two groups.Results After 4 weeks of intervention,the degree of dysphagia in the observation group was lower than that in the control group,and the total score of SWAL-QOL and the scores in all dimensions were higher than those in the control group,and the incidence rate of aspiration pneumonia was lower than that in the control group(P<0.05 or P<0.01).Conclusions The post-stroke dysphagia nursing program based on IMB theory can not only significantly improve the quality of life and swallowing function in the elderly patients with post-stroke dysphagia,but also effectively reduce the incidence of aspiration pneumonia.