中青年脑卒中伴运动功能障碍患者社会疏离干预方案的构建与应用

Construction and application of a social isolation intervention scheme for the young and middle-aged stroke patients with motor dysfunction

目的构建中青年脑卒中伴运动功能障碍患者社会疏离干预方案,并评价其应用效果。方法以能力,机会,动机-行为模型为指导,通过对中青年脑卒中患者半结构性访谈及横断面调查,分析影响其社会疏离的促进和阻碍因素及需求,构建中青年脑卒中伴运动功能障碍患者社会疏离干预方案。按住院病区将78例中青年脑卒中伴运动功能障碍患者分为对照组和试验组各39例,对照组给予常规护理干预和随访,试验组在对照组的基础上采用社会疏离干预方案至出院后4周。结果对照组39例、试验组36例患者完成研究。干预后,试验组社会疏离及焦虑抑郁评分显著低于对照组,试验组感知社会支持评分显著高于对照组(均P<0.05)。结论对中青年脑卒中伴运动功能障碍患者实施社会疏离干预方案有利于缓解患者焦虑抑郁情绪,提高其感知社会支持水平,降低社会疏离水平。

Objective To construct a social isolation intervention scheme for the young and middle-aged stroke patients with motor dysfunction,and to evaluate its application effects.Methods Guided by the Capability,Opportunity,Motivation-Behaviour(COM-B)model,a social isolation intervention scheme for the young and middle-aged stroke patients with motor dysfunction was constructed based on semi-structured interviews and cross-sectional study exploring the barriers and enablers of social isolation and patients′demands of improving the status of social isolation.Then a total of 78 young and middle-aged stroke patients with motor dysfunction were divided into a control group and an experimental group according to wards,with 39 patients in each group.The control group were given routine nursing and follow-up,while the experimental group additionally received the social isolation intervention scheme until 4 weeks after discharge.Results A total of 39 cases in the control group and 36 cases in the experimental group completed the study.After the intervention,the scores of the General Alienation Scale and the Hospital Anxiety and Depression Scale in the experimental group were significantly lower than those of the control group,while its score of the Perceived Social Support Scale was significantly higher than that of the control group(all P<0.05).Conclusion Implementation of the social isolation intervention scheme for the young and middle-aged stroke patients with motor dysfunction is conducive to alleviating anxiety and depression,improve their perceived social support,and reduce the level of social isolation.