动机性访谈对脑卒中患者日常生活活动能力的影响

目的 ：探讨动机性访谈对脑卒中患者日常生活活动能力康复进程的影响。方法 ：选取天津市某三级甲等医院的脑卒中患者60例,按照时间先后顺序分为实验组及对照组,各组均30例。在科室常规护理的基础上,对实验组进行一对一的为时30-40min的动机性访谈干预,并发放《卒中后日常生活活动锻炼手册》以及为期3个月的电话随访。对照组接受针灸科常规护理及健康教育。采用Barthel指数量表对干预前、出院前2天、出院后1个月、出院后3个月的干预效果进行评价。结果 ：实验组干预后日常生活活动能力得分高于对照组,差异有统计学意义（P〈0.05）。其中,实验组日常生活活动能力得分随时间变化幅度不同,表现为出院前2天得分涨幅达到较高水平,而3个月时得分逐渐趋于平稳。结论 ：动机性访谈可以提高患者的日常生活活动能力,加快患者的康复进程。而3个月时干预的正向效果随着时间发展逐渐削弱,应警惕出现故态复萌现象。

The impact of Motivational Interviewing on the Activities of Daily Living of stroke patients

Objective： To investigate the impact of Motivational Interviewing on Activities of Daily Living（ADL） after stroke in rehabilitation process. Methods： We selected 60 stroke patients from a hospital in Tianjin, and divided them into experimental group and control group according to time, 30 cases in each group. The experimental group received 30-40 minute one-on-one Motivational Interview intervention on the basis of conventional care, and was given a ＂Handbook on Activities of Daily Living after stroke＂ as well as a three-month telephone follow-up. The control group received acupuncture and health education as usual care. The intervention effect on patients＇ ADL was evaluated by using the Barthel Index Scale before intervention, 2 days before being discharged, and 1 month and 3 months after being discharged. Results： The experimental group＇s ADL score was higher than those of the control group（P0.05）. Moreover, the experimental group＇s ADL scores changed over time. It reached the highest at 2 days prior to discharge, and declined to average level gradually 3 month after discharge. Conclusion： Motivational Interviewing could improve patients＇ ADL ability and speed up their recovery process. The positive intervention effects would be undermined 3 months after discharge, and we should be alert on the appearance of relapse.