通过患者日记提高脑卒中后患者生活方式依从性的-第三军医大学学报.docVIP

脑卒中后延续护理对出院患者独立生活能力和出院护理满意度的影响 钱春荣1，朱京慈1, 陈颖峥2 (400038 重庆，第三军医大学，护理学院护理学教研1；400038重庆，第三军医大学西南医院神经内科2) ［提要］ 目的 建立脑卒中后延续护理方案，探讨其提升脑卒中出院患者独立生活能力和出院护理满意度的效果。方法 有效纳入42例脑卒中伴神经功能轻度损伤的患者，随机分成实验组（23例）和对照组（19例），对照组施行常规护理，实验组施行实行常规护理和延续护理干预。脑卒中后延续护理方案采用4C框架的延续护理模型为理论指导，“4C”是指护理服务具有全面性、协调性、延续性和协作性4个特点。具体干预措施由4护理活动构成，即出院前1周的脑卒中课程教育、出院前3天的出院护理评估、出院后1周的电话随访以及出院后4周的家庭随访。观察指标为独立生活能力和主观生活质量和出院护理满意度，于出院前及出院后12周采用自制结构性问卷收集患者数据。结果 出院后12周，实验组患者BI指数的提高较对照组有统计学差异（t=1.580，P＜0.05）；实验组患者自评生活质量的提高1.52±0.85分较对照组1.05±1.08分无统计学差异（P＞0.05）；实验组患者对出院护理满意度较对照组有显著统计学差异（t=8.830，P＜0.01）。结论 脑卒中后延续护理方案在患者基础性独立生活能力和患者出院护理服务满意度两个领域有促进效果。 ［关键词］ 脑卒中; 延续护理; 独立生活能力; 生活质量; 患者满意度 Evaluation of a Transitional Care Program for Stroke Patients on independent living ability and Satisfaction with Discharge Care QIAN chun-rong1, ZHU jing-ci1, Cheng ying-zheng2 (1Department of Fundamental Nursing, Nursing School, Third Military Medical University, Chongqing, 400038, China; 2Department of Neurology, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China) ［Abstract］ Objective To evaluate the effects of a transitional care program for stroke patients on independent living ability and satisfaction with discharge care. Methods Four-two stroke patients with mild neurologic deficit were effectively enrolled in this study and randomized to the control group(n = 19) and the interventional group(n = 23). The control group received routine discharge care, whereas the study group received routine care plus the transitional intervention program. The program adopted the 4-C transitional care model as the theoretical framework, and the 4 Cs referred to comprehensiveness, continuity, coordination and collaboration. The specific interventions contained 4 nursing events which are stroke courses 1 week pre-discharge, comprehensive assessment 3 days pre-discharge, telephone follow-up 1 week post-discharge, and family visit 4 weeks post-discharge. The outcomes are independent living ability, subjective perce