对颅脑损伤病人康复期间伤残评估与护理工作相关性的分析

Relationships between disability measures and nursing work: an analysis of rehabilitation of traumatic brain injury patients

目的 :验证功能独立性评测 (FunctionalIndependenceMeasure,FIM)对颅脑损伤康复病人功能状态评测的有效性 ,同时探讨FIM对护理工作量的预测作用。方法 :根据FIM制定的考察项目在病人入院后 72h内和出院前 1周进行打分 ,根据FIM的项目将护理工作分为 6类 ,记录 2 4h内各种护理工作的时间。结果 :随着FIM对病人运动和认知功能评分的升高 ,病人 -护士接触时间减少 ;给药、提供治疗、宣教所用的时间与FIM评分显著相关。结论 :护理工作量和FIM评分之间的相关性表明了FIM的有效性 ,通过FIM评分可以预测护理工作需要量。

Objective: This study sought to evaluate the concurrent validity of the Functional Independence Measure (FIM) in rehabilitation patients after traumatic brain injury and the effects of FIM in predicting the nursing service quantity. Methods: The FIM was completed in 72 hours after admission and one week before discharge. The nursing work was divided into six aspects according to FIM. Patient-nurse contacting time was recorded for a 24 hour period during the 72 hours after admission and one week before discharge. Results: Contacting time declined from the admission to discharge, concurrent with improving scores on motor and cognitive measures derived from the FIM. Statistically significant correlations between contacting time and FIM scores were observed for medication management, treatment providing and teaching at admission and discharge. Conclusion: These results supported the construct validity of the FIM by demonstrating strong relationships between burden of care and FIM. FIM is useful in predicting the work load of nursing.