基于循证的多学科协作照护模式对急性缺血性脑卒中照顾者的影响

Impact of an evidence-based multidisciplinary collaborative care model on acute ischemic stroke caregivers

目的:探索基于循证的多学科协作照护模式对急性缺血性脑卒中照顾者的影响。方法:选取2019年12月至2023年5月在丽水市中心医院住院治疗的急性缺血性脑卒中患者及其照顾者119对,采用随机数字表法分为多学科协作照护组(n=62)和对照组(n=57),其中多学科协作照护组采用基于循证的多学科协作照护模式,对照组采用常规护理模式。针对两组患者的照顾者,收集出院后3个月Zarit照顾者负担量表、抑郁自评量表和SF-36简明健康调查量表数据,分析护理模式对照顾者照顾负担、抑郁水平、生活质量的影响。结果:出院后3个月,两组照顾者的Zarit照顾者负担量表和抑郁自评量表得分均下降(P<0.001),多学科协作照护组照顾者的Zarit照顾者负担量表得分显著低于对照组(P<0.001),中度及以上照顾负担的照顾者比例较低(χ^(2)=16.384,P<0.001);多学科协作照护组照顾者的抑郁自评量表得分显著低于对照组(P<0.001),划定为抑郁的照顾者比例较低(χ^(2)=4.449,P=0.035)。两组照顾者的生活质量评分均提高,多学科协作照护组照顾者的生理健康和心理健康总分显著高于对照组(均P<0.001)。结论:基于循证的多学科协作照护组模式应用于急性缺血性脑卒中照顾者有助于减轻照顾负担,改善心理素质,提高生活质量。

Objective:To investigate and elucidate the impact of a collaborative multidisciplinary care model on acute ischemic stroke caregivers.Methods:Using the random number table method,a total of 119 pairs of patients with acute ischemic stroke and their caregivers who were hospitalized in Lishui Central Hospital from December 2019 to May 2023 were selected and divided as the multidisciplinary collaborative care group(n=62)by an evidence-based multidisciplinary collaborative nursing model and the control group(n=57)by a conventional nursing care model.At the time of 3 months after discharge,the Zarit caregiver burden interview(ZBI),self-rating depression scale(SDS),and the Mos 36-item short form health survey(SF-36)were used to evaluate,with analysis made,the impact of two different nursing modes on the care burden,depression level and life quality of caregivers.Results:The scores of Zarit caregiver burden scale and self-rating depression scale of both groups of caregivers decreased three months after discharge(P<0.001).The scores of Zarit caregiver burden scale in the multidisciplinary collaborative care group were significantly lower than those of the caregivers in the control group(P<0.001),and the proportion of caregivers with moderate or greater care burden was lower(χ^(2)=16.384,P<0.001).The self-rating depression scale scores of the caregivers in the multidisciplinary collaborative care group were significantly lower than those of the caregivers in the control group(P<0.001),and the proportion of caregivers classified as depressed was significantly lower(χ^(2)=4.449,P=0.035).The life quality scores of caregivers in both groups improved,and the total physical and mental health scores of caregivers in the multidisciplinary collaborative care group were significantly higher than those in the control group(all P<0.001).Conclusion:The evidence-based multidisciplinary collaborative nursing model is helpful for the acute ischemic stroke caregivers by reducing their care burden,making them psychologically stronger and enhancing their quality of life,therefore,it merits clinical implementation and promotion.