医院—家庭一体式护理在脑卒中后认知障碍患者中的应用效果

Application effect of hospital-family integrated nursing in patients with cognitive impairment after stroke

目的探究医院-家庭一体式护理在脑卒中后认知障碍患者中的应用效果。方法选择2023年1—6月本院收治的100例脑卒中后认知障碍患者及照顾者作为研究对象,采用随机数表法将患者分为干预组与对照组两组,每组各50例。对照组实施常规护理,干预组实施医院-家庭一体式护理。比较两组患者的蒙特利尔认知评估量表(MOCA)评分、简易精神状态评价量表(MMSE)评分、运动功能Fugl-Meyer评分、Barthel指数(BI)、世界卫生组织生存质量简表(WHOQOL-BREF,以下简称W-B),照顾者的Zarit照顾者负担量表(ZBI)评分、照顾者照顾能力测量表(FCTI)评分。结果护理前,两组患者的认知功能MOCA评分、智力状态MMSE评分比较,差异均无统计学意义(P>0.05);护理后,干预组患者的MOCA、MMSE评分均高于对照组,差异具有统计学意义(P<0.05);护理前,两组患者的运动功能Fugl-Meyer、活动能力BI评分进行比较,差异均无统计学意义(P>0.05);护理后,干预组患者的Fugl-Meyer、BI评分均高于对照组,差异具有统计学意义(P<0.05);护理前,两组患者照顾者的负担程度ZBI及照顾能力FCTI评分进行比较,差异均无统计学意义(P>0.05);护理后,干预组照顾者的ZBI、FCTI评分均低于对照组,差异具有统计学意义(P<0.05);护理前,两组患者的生存质量W-B评分进行比较,差异均无统计学意义(P>0.05);护理后,干预组患者的心理、生理、环境、社会关系评分均高于对照组,差异具有统计学意义(P<0.05)。结论脑卒中后认知障碍患者中实施医院-家庭一体式护理,能有效改善患者的认知功能,增强患者的运动功能、自主活动能力,减轻照顾者的照顾负担并提升其照顾能力,进而提升患者的生存质量。

Objective To explore the application effect of the integrated model of pre-hospital and in-hospital first aid in the emergency first aid of patients with acute cerebral infarction.Methods The subjects of the study were all patients with acute cerebral infarction those were admitted to the emergency department of Zhoukou dongxin hospital during January and December 2022.The 30 cases be admitted to the hospital from January to June 2022 were enrolled in the reference group,they were escorted to the hospital by their family members and receive routine in-hospital first aid;the 30 cases be admitted to the hospital from July to December 2022 were enrolled in the research group,all of received integrated pre-hospital and in-hospital first aid.The emergency first aid effects of the two groups were compared.Results The rescue success rate(96.67%),efficacy of first aid(96.67%)and patients'satisfaction with medical services(96.67%)in the study group were higher than those in the reference group(80.00%,73.33%,76.67%),however,the incidence of complications(10.00%)was lower than that of the reference group(33.33%).The time needed for admission-emergency doctor consultation,CT report,intravenous thrombolysis,successful arterial sheath placement and sheath placement-vascular recanalization(7.14±2.33min,22.45±2.79min,49.71±7.68min,77.38±7.51min,65.38±5.91min)in the study group were shorter than those of the reference group(10.05±2.41min,31.87±3.54min,83.34±9.79min,96.84±9.97min,74.84±5.97min).At 6h,24h and 7d after treatment,the neurological impairment scores(13.85±1.18 points,9.71±1.08 points,6.81±0.96 points)in study group were lower than those of the reference group(16.01±1.43 points,14.34±2.79 points,9.67±1.09 points).The self-care ability score(74.09±9.44 points)was higher than that of the reference group(65.39±6.44 points);the length of hospital stay(12.12±4.27d)was shorter than that of the reference group(19.74±5.69d);the data comparison was statistically significant(P<0.05).Conclusions The application of the integrated model of pre-hospital and in-hospital first aid can not only shorten the rescue time of patients with acute cerebral infarction in the emergency department,but also improve the effect of first aid and positively affect the prognosis of the disease,which has the value of further application and promotion.