北京城市卒中社区康复及危险因素自我管理效果分析

目的应用以引导式教育为内容的康复治疗和危险因素自我管理措施,评价其对促进卒中患者卒中知识知晓、行为改善及功能恢复的作用。方法在北京市东城区选择两个社区分别作为干预社区与对照社区,结合现代康复理念、引导式教育、危险因素自我管理,先后对干预社区109例患者开展3个月的卒中康复治疗及6个月危险因素自我管理干预。通过卒中患者自身治疗和干预前、后比较以及与对照社区110例患者比较,评价干预效果。结果经3个月康复治疗后,干预社区卒中患者简化的Fugl-Meyer运动功能量表评分从57.0(30.0,81.5)分提高到70.5(40.5,92.0)分(P0.001);Barthel指数评分从90(65,95)分提高到95(75,100)分(P0.001);社会功能活动问卷评分从(11.6±8.3)分降低到(10.1±8.4)分(P=0.001)。经过6个月自我管理,干预社区卒中患者对危险因素(P0.001)、预警知识(P0.001)和康复技能知晓(P0.001)以及血糖控制(P=0.033)和坚持康复治疗情况(P0.001)均显著高于对照社区卒中患者。结论社区卒中康复及危险因素自我管理干预,可以提高卒中相关知识知晓、改善行为习惯和功能恢复。

The Effect Analysis of Community-based Rehabilitation and Risk Factors Self-management for Stroke Patients in Urban of Beijing

Objective To evaluate the effectiveness of a community-based rehabilitation based on conductive education and self-management measures of risk factors in improving awareness, behavior and functional recovery of stroke survivors. Methods Two communities were selected as either the intervention or control community in Dongcheng District. A 3-month community-based rehabilitation treatment plan and 6-month risk factors self-management program, based on modern rehabilitation theory, conductive education and risk factor self-management for stroke survivors, was successively implemented among 109 patients in intervention community. The effects before and after the intervention were evaluated through comparing stroke survivors in intervention community with themselves and 110 stroke survivors in control community. Results After 3-month rehabilitation treatment, median Fugel-Meyer assessment (FMA) score for stroke survivors in intervention community was enhanced from 57.0 (30.0-81.5) to 70.5 (40.5-92.0) (P<0.001), median Barthel index (BI) score from 90 (65-95) to 95 (75-100) (P<0.001) and mean score of function activity questionnaire (FAQ) was decreased from (11.6±8.3) to (10.1±8.4) (P<0.001). After 6-month self-management, the stroke risk factors awareness (P<0.001), warning awareness (P<0.001), rehabilitation awareness (P<0.001), blood glucose control (P=0.033) and adherence to rehabilitation(P<0.001) in intervention community were significantly higher than that in control community. Conclusion Community-based rehabilitation treatment and risk factors self-management program may improve awareness, behavior and functional recovery of stroke survivors.