健康教育干预对武汉市社区居民脑卒中相关知识知晓率影响的调查

目的：探讨健康教育干预对武汉市社区居民脑卒中相关知识知晓率的影响。方法：对武汉市硚口区下 属多个社区年龄≥40 岁的全部常住居民关于脑卒中相关知识（脑卒中九大危险因素、早期症状、急性期治 疗、康复治疗、二级预防措施）的知晓情况进行调查,并针对这些人群开展多种形式的健康教育活动,1 年后 再次调查该人群对脑卒中相关知识的知晓情况。结果：第一次调查：武汉市社区居民对脑卒中九大危险因 素如高血压、糖尿病、高血脂、吸烟、肥胖的知晓率为22%~60%,对心脏病、缺乏锻炼、酒精摄入过多、高同型 半胱氨酸的知晓率为1.5%~12%;对脑卒中早期症状知晓率为14%~55%;对脑卒中急性期溶栓、取栓治疗知 晓率分别为1.9%、0.9%;对卒中后康复治疗知晓率为22.2%;对卒中后二级预防措施知晓率为25%~50%。 第二次调查：在开展健康教育后,被调查居民对脑卒中九大危险因素、早期症状、康复治疗、二级预防措施的 知晓情况与第一次调查相比,除危险因素酒精摄入过多、高同型半胱氨酸外（P＞0.05）,差异有统计学意义 （均P＜0.05）;另外,居民对脑卒中急性期救治措施的认知情况健康教育干预前后无明显统计学差异。结 论：目前武汉市社区居民对脑卒中相关知识的知晓率偏低,健康教育干预有助于提高社区居民知晓率。     

脑卒中患者亲属对脑卒中康复知识知晓情况的调查

目的了解脑卒中患者亲属对脑卒中康复知识的知晓情况。方法采用方便抽样法对2015年2月至2016年2月脑卒中住院患者亲属850例进行问卷调查。统计实际调查人数、康复知识获取途径、脑卒中康复知识的知晓情况。结果实际接受调查者共822例,587例亲属(71.41%)表示有康复知识的获取途径,且大多数信息是从医务人员宣教中获得(64.05%),其他渠道不足50.00%。脑卒中早期症状、脑卒中危险因素和脑卒中康复功能锻炼知晓率分别是27.35%~62.17%、25.91%~66.42%和23.84%~62.41%。脑卒中康复知识的知晓程度与患者亲属的年龄、学历、职业相关,但亲属性别以及与患者的关系对脑卒中康复知识的知晓程度影响不明显。结论脑卒中患者亲属对脑卒中康复知识的知晓程度总体偏低,缺乏对脑卒中危险因素、早期症状和康复功能锻炼知识的掌握,医务工作者要针对重点亲属人群进行宣传教育。     

初次脑卒中患者二级预防危险因素掌握程度的现状调查与探讨

目的了解初次脑卒中住院患者卒中二级预防中对危险因素知识、态度、行为掌握的情况,早期及时对可干预危险因素进行积极的预防和控制,以降低脑卒中的复发率。方法对80例在我院神经内科卒中单元住院的初次脑卒中患者,采用自行设计的卒中危险因素问卷进行调查。结果初次脑卒中患者卒中危险因素的相关知识得分属低等水平(10.200±3.140),预防脑卒中危险因素态度得分属中等水平(14.550±3.656),预防脑卒中危险因素健康行为得分属低等水平(8.813±4.282)。结论初次脑卒中住院患者的危险因素掌握状况应引起医务人员的高度重视,卒中病房应结合相关危险因素为患者提供具有针对性的健康宣教,建立脑卒中二级预防体系势在必行。     

脑卒中患者对卒中危险因素知晓情况调查①

目的了解脑卒中患者对卒中相关危险因素知识掌握的情况。方法抽取甘肃省10家不同级别医院1043例住院的脑卒中患者,采用自行设计的问卷进行调查。结果危险因素知晓率从高到低依次为高血压(61.55%)、高脂血症(40.27%)、饮酒(32.21%)、吸烟(30.11%)、糖尿病(28.67%)、心脏病(23.11%);对6种危险因素全部知晓者占6.42%,全不知晓者占20.13%。各年龄组间,糖尿病知晓率有非常显著性差异(P<0.01);对高血压、高脂血症、糖尿病的知晓率随文化程度的增高而增加。结论脑卒中患者对常见危险因素认知水平偏低,应加强健康教育。     

东莞外来务工人员缺血性脑卒中防治知识认知水平的调查分析

目的：了解东莞外来务工人员对缺血性脑卒中防治知识的认知水平及其知识来源途径。方法2012年7月至2013年12月按照多阶段随机抽样原则,在东莞市不同企业抽取外来务工人员发放问卷10000份,调查内容包括被调查者的一般情况、缺血性脑卒中的危险因素、预警信号、诊疗常识和知识来源途径,各项内容采用描述性分析及多因素 Logistic 回归分析。结果回收有效问卷8975份,有效应答率为89.75%。缺血性脑卒中危险因素中高血压知晓率最高（61.51%）,糖尿病、高脂血症不足50%,其他危险因素知晓率更低;预警信号中“突发肢体麻木或无力”的知晓率最高（53.24%）,其他为6.81%～48.96%;在就诊方式上52.03%的人选择立即呼“120”急救;最常见的卒中信息来源为亲属介绍,其次为电视;在人群分层分析上,教育程度与脑卒中知识成正相关关系（rs=0.076,P＜0.001）,而年龄则成负相关关系（rs=-0.163,P＜0.001）。结论东莞外来务工人员缺血性脑卒中防治知识认知水平较低,且低教育程度者、中年务工人员相对更低,应该通过多种途径加强宣教,提高该人群的卒中防治知识水平,从而降低该人群的卒中发病率。     

高血压合并脑梗死患者健康知识的调查研究

目的了解高血压合并脑梗死患者的健康知识情况,为对其进行健康教育提供参考依据。方法采用脑卒中健康知识问卷对300例高血压合并脑梗死患者进行问卷调查。结果高血压合并脑梗死患者的脑卒中健康知识总标准分为66.67(44.44,77.78),卒中先兆和卒中处理得分较低,分别为50.00(33.33,66.67)及50.00(0,100)分。小学及以下学历、卒中病程短、无脑卒中家族史的患者脑卒中健康知识得分较低(P<0.05)。生活起居维度、卒中先兆及危险因素知晓率最低。结论高血压合并脑梗死患者在卒中先兆和卒中处理部分的健康知识不容乐观,预防复发知识掌握度有待提高;卒中病程短、文化程度低、无脑卒中家族史的老年患者的健康知识尤应引起关注;建议对脑梗死识别、处理、控制危险因素、坚持服药等方面上加强延续护理、争取患者亲属的支持、进行个性化健康教育模式,以提高高血压合并脑梗死患者的健康知识水平。     

武汉市社区居民脑卒中危险因素分布及知晓情况的调查分析

目的:调查和分析武汉市社区居民脑卒中危险因素的分布及脑卒中相关知识的知晓情况。方法:选择武汉市硚口区下属M社区40岁以上常住居民3092人进行问卷调查,收集脑卒中危险因素分布情况,评估出高危人群440例,对高危人群进行健康教育干预半年后,观察干预前后对脑卒中危险因素及脑卒中相关知识的知晓情况。结果 :筛查总人群有3092例,其中男1490人,女1602人;高危440例(14.23%),中低危人群2652人(85.7%)。其中男性高危人群265人(17.8%),女性高危人群175人(10.9%),男性较女性多。总体人群脑卒中危险因素检出率从高到低排序为:少运动、吸烟、超重、高血压病、高脂血症、心脏病、糖尿病、家族史;男女性别不同,其危险因素分布有所不同,在男性中,前三位的为:少运动、吸烟、高血压病,而女性中前三位的为:少运动、超重、高血脂;其中吸烟、少动、高血压病、超重等危险因素,在男女中,差异有统计学意义。对脑卒中高危人群进行健康教育后,对脑卒中危险因素、早期症状及溶栓的知晓率进行比较:干预后较干预前都大幅提高,差异有统计学意义。结论:健康教育干预后,脑卒中高危人群对脑卒中危险因素、早期症状及溶栓情况知晓率均明显提高,对帮助脑卒中高危人群自觉采取健康行为方式、治疗原发病、卒中后及时识别并尽快就医均具有重要的作用,所以加强对社区居民的脑卒中健康教育有着深远的意义。     

社区人群对脑卒中危险因素及预警信号的现状调查

目的了解社区人群对脑卒中危险因素及症状的知晓现状。方法随机抽样调查1 208名居民及112名医务人员的人口学特征、对危险因素及预警信号的知晓现状及其影响因素、信息来源及需求情况。结果 90.1%、100.0%的居民及医务人员可辨识高血压是卒中的危险因素,而社区居民及医务人员对年龄、糖尿病、吸烟等危险因素的认识比例分别为65.0%和85.0%,且对危险因素的控制策略缺乏了解。87.4%、100.0%社区居民及医务人员将一侧肢体的活动障碍作为卒中的第一大预警信号,其次为头晕、步态不稳、头痛、言语困难、视物模糊。卒中知识得分的单因素及多因素分析示:大学文化、已婚且在职的居民及高学历的医务人员对卒中信息的了解程度高。卒中信息的获取途径依次为电视、社区医生/讲堂、报纸、杂志、网络。结论西部城市社区人群卒中知识知晓率低,开展针对低学历医务者的卒中培训及低学历、独居及退休人员的居民讲堂是改善现状的必要途径。同时也为政府建立有效的院前早期识别及快速转诊技术提供了依据。     

脑卒中早期识别与急救知识现状调查与影响因素分析

目的调查患者及家属脑卒中早期识别与急救相关知识的知晓情况,并分析其影响因素。方法采用方便抽样法,于2016年11—12月借助康复助手微信公众号,对上海市6家医院共1 904名患者及家属进行脑卒中早期识别与急救相关知识的调查。结果患者及家属对脑卒中识别与急救相关知识知晓率低,单因素分析显示,年龄越小、女性、教育程度越高、脑力劳动者和接触过脑卒中者,其脑卒中早期识别和急救相关知识水平越高(P0.05);多因素分析显示,其水平与性别、教育程度、职业、脑卒中接触史有关(R~2=0.143,F=78.984,P0.05)。患者及家属对脑卒中预警症状的知晓率为23.7%,部分知晓为74.5%;对脑卒中识别方法和溶栓时间窗的知晓率仅略高于10%;获取脑卒中知识的途径主要为电视(53.6%)和网络(54.7%)。结论在医院内对患者及家属开展脑卒中早期识别与急救相关知识的健康教育势在必行,且应重点加强对男性、低学历、体力劳动、未接触过脑卒中者的教育,进一步促进脑卒中院前急救的有效落实。     

脑卒中早期识别与急救知晓现状与影响因素分析

目的调查患者及家属脑卒中早期识别与急救相关知识的知晓情况,并分析其影响因素。方法采用方便抽样法,于2016年11—12月借助康复助手微信公众号,对上海市6家医院共1 904名患者及家属进行脑卒中早期识别与急救相关知识的调查。结果患者及家属对脑卒中识别与急救相关知识知晓率低,单因素分析显示,年龄越小、女性、教育程度越高、脑力劳动者和接触过脑卒中者,其脑卒中早期识别和急救相关知识水平越高(P0.05);多因素分析显示,其水平与性别、教育程度、职业、脑卒中接触史有关(R~2=0.143,F=78.984,P0.05)。患者及家属对脑卒中预警症状的知晓率为23.7%,部分知晓为74.5%;对脑卒中识别方法和溶栓时间窗的知晓率仅略高于10%;获取脑卒中知识的途径主要为电视(53.6%)和网络(54.7%)。结论在医院内对患者及家属开展脑卒中早期识别与急救相关知识的健康教育势在必行,且应重点加强对男性、低学历、体力劳动、未接触过脑卒中者的教育,进一步促进脑卒中院前急救的有效落实。     

Stroke intervention

As current stroke therapies are refined and newer promising methodologies brought on line, the rapid, accurate diagnosis of stroke syndromes will become more important. The emergency department is in a unique and vital position for providing early diagnosis, for organizing and activating an interdisciplinary team to rapidly assess the stroke patient, and for establishing protocols for therapy. The emergency physician has an important role in increasing general awareness and in helping to educate the public about risk factors and early symptoms of various stroke syndromes. Nursing and emergency personnel must also be made increasingly aware of the desirability of early recognition of stroke and of new therapeutic measures. Stroke patients should no longer be considered of moderate to low priority, as has often been the case in the past. With an aggressive approach in dealing with risk factors, education in early recognition of symptoms, and new and promising interventional therapies, morbidity and mortality from this often catastrophic disease may be dramatically reduced.     

健康教育路径表在脑卒中患者康复护理中的应用效果评价

目的 探讨健康教育路径表在脑卒中患者康复中的应用效果。方法 本研究对本院近一年内入住神经内科普通病房的所有脑卒中患者进行采样,选取150例（实验组78例,对照组72例）。对照组对脑卒中患者进行神经内科常规的健康宣教,实验组则采用经过研究制作的临床护理路径对脑卒中患者进行健康宣教。对两组患者康复效果进行比较。结果 实验组中所有人都能掌握脑卒中康复过程中需要掌握的基础知识,而参照组中仍然有18%的患者不清楚脑卒中康复必备知识,18%的患者只能基本掌握脑卒中康复基础知识。组间差异具有统计学意义（P<0.05）;实验组满意度为98.72%,基本满意度为1.28%,无不满意患者。对照组满意度为79.17%,基本满意度为18.5%,不满意度为8.33%,可见实验组满意度高于对照组。结论 健康教育路径表能有效提高脑卒中患者对康复知识的掌握程度,提高患者对护理工作的理解,增加患者住院满意度,可以在临床中推广应用。     

首发脑卒中患者卒中相关知识的调查

目的调查首次发病的脑卒中患者脑卒中相关知识。方法对259例首次发病住院的脑卒中患者问卷调查患者的脑卒中相关知识及其获取知识的途径。结果患者对高血压容易并发脑卒中、脑卒中早期治疗重要性、脑卒中早期常见的偏瘫症状有所了解,缺少脑卒中其他知识如危险因素、高血压病标准等方面的知识。结论需要大力加强脑脑卒中防治知识的教育。     

Stroke-related knowledge and health behaviors among poststroke patients in inpatient rehabilitation

OBJECTIVE: To measure stroke knowledge and prestroke personal health behaviors of stroke patients undergoing inpatient rehabilitation and their caregivers. DESIGN: Prospective cohort. SETTING: Academic rehabilitation hospital. PARTICIPANTS: A total of 130 stroke patients and 85 caregivers interviewed after ischemic stroke. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: The Stroke Education Assessment measured stroke knowledge and prestroke personal health behaviors. RESULTS: Large deficiencies in patient and caregiver stroke knowledge were found. Fifty-two percent of patients could not name any stroke risk factors, 52% were unable to name a stroke warning sign, and 35% were unable to identify appropriate actions to take in a stroke emergency. Older patients were less knowledgeable than younger patients. Caregivers were more knowledgeable than patients. Regarding prestroke personal health behaviors, 28% of patients reported medication nonadherence, 26% did not see their primary care physician in the preceding year, and less than 40% of patients with diabetes or hypertension reported diets consistent with these diagnoses. CONCLUSIONS: Stroke patients participating in inpatient rehabilitation and their caregivers have large gaps in stroke knowledge and have suboptimal personal health behaviors, thereby putting patients at high risk for recurrent stroke. Our finding highlights the need to develop stroke-education programs for rehabilitating patients that are effective in closing these gaps in knowledge and personal health behaviors.     

急性脑卒中患者早期康复治疗对比研究

目的:探讨早期康复对急性脑卒中患者临床神经功能缺损程度及日常生活活动能力的影响。方法:对200例首次急性发病的脑卒中患者随机分为康复治疗组和对照组各100例,均进行神经内科常规药物治疗,康复治疗组于病后3￣10d开始早期康复训练,每天2次,30￣50min/次,第1次主要由康复医生完成,家属协助;第2次以后主要由家属完成,康复医生督促和指导,共84d。以临床日常生活能力评分、肢体运动功能(Fugl-Meyer即FMI)、肌力、FIM、神经功能缺损程度评分、Barthel指数进行治疗前后的功能评定。结果:康复治疗组治疗后神经功能缺损程度评定及日常生活活动能力评价,与对照组相比有显著性差异(P<0.05或0.01)。结论:早期康复治疗对降低急性脑卒中患者的神经功能缺损程度及促进日常生活活动能力的提高是安生有效的。     

The Impact of a Stroke Screening Program

Stroke is a leading cause of serious disability and is the third leading cause of death in the United States. Prevention and early intervention are key to reducing death and disability from stroke. This study investigated the impact of a community-based stroke-screening program on the knowledge of participants regarding signs and symptoms of stroke, related emergency action, and personal risk factors for stroke. Self-reported behavioral changes were also recorded. Initial data were collected at the screening site as part of the program, and follow-up data were collected by telephone interview at 1, 3, and 6-month intervals after the screening. Of the 107 people who participated in the screening, 85 (79%) participated in all three follow-up interviews. Findings indicate that participants in this community-based stroke-screening program showed increases in their knowledge about stroke, including what a stroke is, signs and symptoms, related emergency action, personal risk factors, and ways to reduce risk. Furthermore, the findings demonstrate that the knowledge was retained throughout the study period. Approximately half of the participants also reported having made at least one behavioral change to reduce their stroke risk.     

Knowledge of stroke symptoms and risk factors among at-risk elderly patients in the UK

Assessing patient knowledge can help healthcare providers in planning measures directed at prevention, early identification and referral of patients. An incorrect understanding of stroke symptoms may delay patients seeking emergency help, thus missing the benefits of acute stroke treatments. Insufficient knowledge about stroke risk factors may affect risk factor control. We conducted a questionnaire-based interview among elderly patients at risk of stroke and assessed their baseline knowledge of stroke symptoms and risk factors. A large proportion were found to have an improper understanding of stroke symptoms and risk factors. Stress was considered the commonest risk factor for stroke. Most patients did not consider themselves to be at further risk of stroke. Further education is needed as part of stroke prevention strategies to remove misconceptions. Improved recognition of stroke symptoms when they occur will help when seeking emergency medical help.     

Rehabilitation After Stroke

The more severely involved the stroke patient is or the greater is the pre-existing physical disability, the greater is the need for special rehabilitation services to restore him to his optimal level of performance. The availability of resources in the family and community are important factors in determining whether or not the patient will need to be treated in a rehabilitation center. There is no contraindication to early initiation of rehabilitation and those patients for whom rehabilitation is initiated immediately after the stroke have the most rapid and optimal recovery. Ninety to 95 percent of hemiplegics can learn to walk. Forty percent of hemiplegics get good return of function in their upper extremity. Sixty-five percent of hemiplegics become independent in self-care and ambulation. For the stroke patient who does not have complicating disabilities independence in self-care and ambulation can be accomplished in 4 to 8 weeks. Intellectual or emotional problems indicate the need for a carefully planned rehabilitation program. The families of stroke patients need counseling and training regarding their responsibilities and duties to the patient.     

Stroke rehabilitation outcome: the Turkish experience

The objectives of this study were to examine the demographic and clinical characteristics of stroke patients admitted for inpatient rehabilitation, to study the occurrence of medical problems/complications, and to document functional outcome and possible factors influencing outcome. The mean age of this cohort (30 females, 53 males) was 58+/-12 years and the mean length of hospital stay was 45.7+/-23 days. The most common medical comorbidity was hypertension (65%), followed by heart disease (42%) and diabetes mellitus (22%). The length of hospital stay was related to the number of medical comorbidities (r=0.24, P<0.05). Almost all patients experienced several medical problems during rehabilitation stay (average 7.1 events/patient). Shoulder dysfunction (80.7%), symptomatic blood pressure fluctuations (72.3%) and psychosocial problems (57.8%) were among the most common problems. There was a statistically significant improvement in total Functional Independence Measure scores from admission to discharge (56.5 vs. 74.6), with a mean gain of 18.1. Functional Independence Measure gain was significantly correlated with onset to admission time (r=-0.21, P<0.05), length of hospital stay (r=0.50, P<0.001) and the number of previous strokes (r=-0.23, P<0.05), but not with age, onset to admission interval, comorbidities and the presence of medical problems. Discharge total Functional Independence Measure scores were significantly correlated only with the admission total Functional Independence Measure scores (r=0.72, P<0.001) and onset-admission interval (r=-0.23, P<0.05). Significant functional improvements were documented in this cohort of stroke patients after an interdisciplinary rehabilitation approach. Discharge functional status was best correlated with admission functional status. Medical problems/complications were common among patients undergoing stroke rehabilitation. In our patients, functional outcomes were not significantly influenced by the occurrence of medical problems.     

The protective effect of subhypothermiaon brain of patient with ischemic cerebrovascular disease on different time

The subhypothermia treatment presents the advantages of decreasing energy metabolism and consumption of lactic acid,reducing release of active amino acid and alleviating inflammatory brain injury by cerebrovascular disease protecting blood-cerebral barrier and stabilize permeability of vessel.OBJECTIVE:To observe the effect of Subhypothermia on brain of patient with acute and severe ischemic cerebrovascular disease in recovery period on different time.