基于跨理论模型的分级干预在脑梗死溶栓治疗后患者中的应用

Application of Graded Intervention Based on Cross Theoretical Models in Patients with Cerebral Infarction after Thrombolytic Therapy

目的探讨基于跨理论模型的分级干预在脑梗死溶栓治疗后患者中的应用效果。方法前瞻性选取2021年1月—2022年12月巨野县人民医院收治的96例行溶栓治疗的脑梗死患者为研究对象,根据随机数表法分为干预组和对照组,每组48例。对照组采用常规护理联合分级干预护理,干预组采用基于跨理论模型分级护理干预,两组均干预4周,比较两组干预前后神经受损功能情况[神经功能缺损(NIHSS)评分]、肢体功能[Fugl-Meyer运动量表(FMA)评分]、自护能力[自护能力量表(ESCA)评分]、日常生活活动能力[Barthel指数(BI)评分]以及护理风险事件发生情况。结果干预3个月后,两组NIHSS评分明显降低,FMA评分明显升高,且干预组NIHSS评分低于对照组,FMA评分高于对照组,差异有统计学意义(P<0.05);干预3个月,两组自护能力各维度评分与BI评分均高于干预前,且干预组高于对照组,差异有统计学意义(P<0.05);护理后,干预组护理风险事件发生率明显低于对照组,差异有统计学意义(P<0.05)。结论基于跨理论模型的分级干预对脑梗死溶栓治疗后患者神经功能和肢体功能改善有明显成效,可提高患者自护能力及日常生活活动能力,并减少护理干预中风险事件的发生。

Objective To explore the application effect of graded intervention based on cross theoretical models in patients with cerebral infarction after thrombolytic therapy.Methods This study used a prospective randomized controlled analysis and included 96 patients with cerebral infarction who underwent thrombolytic therapy in the Department of Neurology,Juye County People's Hospital,Shandong from January 2021 to December 2022 as the study subjects.They were randomly divided into an intervention group and a control group based on a random number table,with 48 patients in each group.The control group received graded intervention nursing,while the intervention group received graded nursing intervention based on a cross theoretical model.Both groups received 4 weeks of intervention.The neurological impairment function[neurological deficit(NIHSS)score],limb function[Fugl-Meyer exercise scale(FMA)score],self-care ability[self-care ability scale(ESCA)score],activities of daily living ability[Barthel index(BI)score]and nursing risk events were compared between the two groups before and after intervention.Results After 3 months of intervention,the NIHSS score of the two groups significantly decreased,while the FMA score significantly increased.The NIHSS score of the intervention group was lower than that of the control group,while the FMA score was higher than that of the control group(P<0.05).After 3 months of intervention,the scores of self-care ability and BI in both groups increased,and the intervention group was higher than the control group(P<0.05).The incidence of nursing risk events in the intervention group after nursing intervention was significantly lower than that in the control group(P<0.05).Conclusion The graded intervention based on a cross theoretical model has significant effects on the improvement of neurological and limb functions in patients with cerebral infarction after thrombolytic therapy,improving their self-care ability and daily living activities,and reducing the occurrence of risk events in nursing interventions.