医护治一体化管理模式对脑梗死康复期患者康复效果及负性情绪的影响

Impact of integrated management of medical care and treatment on rehabilitation outcomes and negative emotions in patients during stroke recovery

目的探讨医护治一体化管理模式用于脑梗死康复期患者的干预效果,以期为脑梗死康复期患者护理干预方案的选择提供参考。方法选取2022年2月-2023年2月南京医科大学第一附属医院收治的130例脑梗死康复期患者为研究对象,采用随机数字表法分为对照组和观察组,每组65例。对照组患者采用传统护理管理模式进行干预,观察组患者采用医护治一体化管理模式进行干预。比较2组患者干预前后的神经功能、上下肢运动功能、日常生活能力、负性情绪状况、生活质量及住院时间等指标。结果干预前,2组患者美国国立卫生研究院卒中量表(NIHSS)各维度评分及总分比较,差异均无统计学意义(P>0.05);干预后,2组患者NIHSS各维度评分及总分均低于干预前,且观察组均低于对照组,差异均有统计学意义(P<0.05)。干预前,2组患者肢体运动功能评定量表(FMA)上肢运动功能、下肢运动功能评分及总分比较,差异均无统计学意义(P>0.05);干预后,2组患者FMA量表上肢运动功能、下肢运动功能评分及总分均高于干预前,且观察组均高于对照组,差异均有统计学意义(P<0.05)。干预前,2组患者焦虑自评量表(SAS)及抑郁自评量表(SDS)评分比较,差异均无统计学意义(P>0.05);干预后,2组患者SAS及SDS评分均低于干预前,且观察组均低于对照组,差异均有统计学意义(P<0.05)。干预前,2组患者Barthel指数及脑卒中专用量表(SS-QOL)评分比较,差异均无统计学意义(P>0.05);干预后,2组患者Barthel指数及SS-QOL评分均高于干预前,且观察组均高于对照组,差异均有统计学意义(P<0.05)。观察组与对照组患者平均住院时间分别为(7.53±1.52)d和(7.62±1.50)d,差异无统计学意义(t=0.340,P=0.735)。结论相较于传统护理管理模式,医护治一体化管理模式更能提升脑梗死康复期患者的神经功能、上下肢运动功能、日常生活能力和生活质量,有助于改善患者负性情绪,适合在脑梗死恢复期患者中应用。

Objective To explore the intervention effects of integrated management of medical care and treatment on rehabilitation outcomes and negative emotions in patients z,providing a reference for nursing intervention programs.Methods A total of 130 stroke recovery patients admitted between February 2022 and February 2023 from The First Affiliated Hospital of Nanjing Medical University,were randomly allocated to control and observation groups,with 65 patients each.The control group received traditional nursing management,while the observation group received integrated management of medical care and treatment.Outcomes such as neurological function,limb motor function,activities of daily living,negative emotions,quality of life,and length of hospital stay duration were compared.Results Before intervention,no statistically significant differences were found between the two groups in the subscale and total scores of the National Institutes of Health Stroke Scale(NIHSS)(P>0.05).After intervention,the subscale and total scores of NIHSS in both groups were significantly lower than before intervention(P<0.05),with the observation group scoring significantly lower than the control group(P<0.05).Before intervention,no significant differences were observed between the two groups in the Fugl-Meyer Assessment(FMA)scores for upper limb motor function,lower limb motor function,and total scores(P>0.05).After intervention,FMA scores for upper limb motor function,lower limb motor function,and total scores in both groups were significantly higher than before intervention(P<0.05),with the observation group scoring significantly higher than the control group(P<0.05).Before intervention,no significant differences were noted between the two groups in the Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS)scores(P>0.05).After intervention,SAS and SDS scores in both groups were significantly lower than before intervention(P<0.05),with the observation group scoring significantly lower than the control group(P<0.05).Before intervention,no significant differences were found between the two groups in the Barthel Index and Stroke-Specific Quality of Life Scale(SS-QOL)scores(P>0.05).After intervention,Barthel Index and SS-QOL scores in both groups were significantly higher than before intervention(P<0.05),with the observation group scoring significantly higher than the control group(P<0.05).The average hospital stay was(7.53±1.52)days for the observation group and(7.62±1.50)days for the control group,with no statistical significance(t=0.340,P=0.735).Conclusion Integrated management of medical care and treatment significantly promotes neurological function,limb motor function,activities of daily living,and quality of life in stroke recovery patients,while also alleviating negative emotions,making it suitable for clinical application.