脑卒中亲属康复相关知识知晓现状调查

目的了解脑卒中亲属对康复相关知识知晓现状。方法对甘肃省10家不同级别医院1082名脑卒中患者亲属进行问卷调查。结果共收回有效问卷1082份。甘肃省脑卒中亲属对脑卒中康复相关知识的知晓率普遍较低。不同年龄、文化程度、职业的患者亲属,知晓率不同(均P<0.05)。结论甘肃省脑卒中亲属对脑卒中康复相关知识知晓率低。应有针对性地对患者家属进行健康教育。     

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。     

神经内科护士对脑卒中早期康复知识的调查研究

目的了解神经内科护士对脑卒中康复护理知识的知晓情况。方法本研究为横断面调查法。采用自行设计问卷,对郑州市2所三级医院及4所二级医院202名神经内科护士进行调查。结果研究显示调查对象脑卒中康复护理知识知晓度整体偏低。其中不同医院等级(P0.001)、不同专业年限(P0.001)、科室是否开展康复护理(P=0.013)对年轻护士脑卒中康复护理知识的认知有显著性差异。而不同年龄(P=0.946)不同学历(P=0.898)由护士对脑卒中康复护理知识的认知无显著性差异。结论护理院校和医院均应重视对脑卒中康复护理的教育工作,采用多种途径提高护理人员的脑卒中康复护理知识水平,更好地为患者提供更优质的服务。     

急性脑卒中患者发生应激性溃疡并发症的危险因素分析

目的:探讨引起脑卒中患者发生应激性溃疡并发症的危险因素。方法:回顾性总结我科收治的脑卒中患者相关临床资料共计125例。结果:单因素分析结果显示,年龄(χ2=5.77)、脑卒中类型(χ2=18.90)、脑卒中严重程度(χ2=11.39)、神经功能缺损程度(χ2=9.45)和肠内营养情况(χ2=8.75)5个因素的应激性溃疡发生率具有统计学意义(P0.05),Logistic回归分析结果显示,年龄(β=0.36)、脑卒中类型(β=0.45)、脑卒中严重程度(β=0.61)和神经功能缺损程度(β=0.70)是引起脑卒中患者发生应激性溃疡并发症的独立危险因素。结论:对于高龄、出血性脑卒中、重度脑卒中和GCS评分为3~8分的脑卒中患者,因其出现应激性溃疡并发症的危险性较大,应进行针对性的重点预防。     

甘肃省脑卒中患者对卒中及康复认知现状调查

目的了解脑卒中患者对卒中危险因素、早期症状、康复知识的认知情况。方法分层随机抽取甘肃省10 家不同级别医院1043 例神经内外科住院的脑卒中患者,采用自行设计的问卷进行调查。结果脑卒中患者对卒中各种危险因素中,知晓率最高的为高血压(61.55%), 全部危险因素知晓率为6.42%; 防治方法中, 合理饮食知晓率最高(56.18%), 其次为戒烟戒酒(52.92%);早期症状中,偏侧肢体发麻知晓率最高(53.88%),其次为头痛头晕(50.14%),视物模糊、恶心呕吐、舌部发硬等症状的知晓率均低于30%;60%患者对康复相关知识完全不了解,22%不清楚是否需要康复治疗;无论家庭月收入高低,约80%脑卒中患者在治疗期间选择药物治疗,进行康复的比率不足30%。结论对脑卒中危险因素、早期症状、康复知识的普及应引起医务人员的高度重视,健康教育和康复知识的宣传需要进一步加强。     

信息护理IIFAR模式在骨科健康宣教中的应用

目的 探讨信息护理在骨科健康宣教中的应用.方法 选取2014年12月至2015年12月骨科手术患者200例,随机分为对照组和实验组各100例.对照组按临床宣教路径进行入院、术前、术后、出院程序化宣教,实验组在此基础上融入IIFAR模式进行宣教,比较两组功能锻炼的依从性、相关知识的掌握情况、患者对医护人员的满意度、自理能力和并发症发生情况.结果 实验组功能锻炼的依从性高于对照组(χ2=14.051,P<0.001);实验组的相关知识掌握率为89.00%,高于对照组的78.00%(χ2=4.391,P=0.036);出院时,实验组对医护人员的满意度为96.55%,高于对照组的90.39%(t=11.843,P<0.001);实验组的自理能力优于对照组(χ2=9.912,P=0.007);实验组相关并发症的发生率显著低于对照组(P<0.05).结论 信息护理IIFAR宣教模式能明显提高患者对相关知识的掌握度及依从性,降低并发症,提高满意度,提升康复效果,值得临床推广应用.     

三级甲等医院医务人员脑卒中认知情况调查

[目的]调查了解三级甲等医院医务人员对脑卒中相关知识的认知情况,并分析其相关影响因素,为进一步开展和加强医务人员对脑卒中病人筛查和预防提供科学依据。[方法]采用自行设计的调查表对某三级甲等医院1 142名临床医务人员进行脑卒中相关知识问卷调查。[结果]该院医务人员对脑卒中相关知识总分为86.00分±23.77分;370名(32.4%)被调查者参加过脑卒中筛查相关知识培训;33.7%的调查对象不清楚脑卒中筛查的绿色通道流程,31.9%的调查对象不清楚脑卒中的叶酸药物干预;知晓率最高的是与脑卒中有关的基础疾病(88.7%)。影响医务人员脑卒中认知水平的因素主要有专业、学历、工龄、职称以及是否参加脑卒中筛查相关知识培训(P0.05)。[结论]三级甲等医院医务人员脑卒中认知水平总体较高,医院应鼓励和组织临床医务人员学习和掌握国内外最新的研究动态,全面把握脑卒中各类危险因素,将先进的研究成果自觉应用到脑卒中的临床筛查与预防中去。     

医护人员对急性缺血性脑卒中患者早期活动的知识和态度现况调查

目的 调查专科医务人员对急性缺血性脑卒中患者早期活动知识和态度的现况与影响因素。方法 选择来自江苏省4个城市的6所三级医院、3所二级医院的253名医护人员进行调查。结果 医务人员对急性缺血性脑卒中患者早期活动知识、态度的平均得分分别为(68.51±9.16)分和(68.19±8.66)分,知识与态度呈正向直线相关。多元线性回归分析结果显示：医院级别、专科工作年限、早期活动知识培训是医务人员对急性缺血性脑卒中患者早期活动知识和态度的影响因素。结论 医务人员对急性缺血性脑卒中患者早期活动的知识水平需要进一步提升,早期活动态度不够积极,能够意识到早期活动的益处,但过分担忧早期活动的潜在风险,需要通过加强相关知识培训与资源下沉,提升知识与态度水平,促进早期活动的实施。     

关于医护人员对新型冠状病毒肺炎康复知信行的调查研究

目的 了解医护人员对新型冠状病毒肺炎(COVID-19)康复的知识、信念态度及行为（即知信行）情况,为针对性地向医护人员进行COVID-19康复培训提供参考依据。 方法 2020年3月1日至2日,对296名参与抗疫的医护人员进行COVID-19康复的知信行问卷调查,以知信行得分评价医护人员对COVID-19康复的认识。 结果 医护人员COVID-19康复知信行总分、知识、态度、行为得分分别为（69.41±15.06）、（21.23±6.52）、（30.84±4.45）和（17.32±5.63）分,得分占满分的百分比分别为57.8%、53.1%、77.1%和43.3%。不同年龄、工龄、科室、职称以及康复学习经历的医护人员知信行总分差异有统计学意义（P＜0.05）。 Pearson相关性分析显示,医护人员COVID-19康复知识与态度（r=0.693,P＜0.01）、知识与行为（r=0.790,P<0.01）、态度与行为（r=0.697,P<0.01）之间均存在正性相关。 结论 医护人员对COVID-19康复的态度较为积极,但相关的理论知识及实践欠缺,需加强培训。     

程序化干预与脑卒中患者的功能恢复

目的评价程序化干预对脑卒中偏瘫患者功能恢复的干预效果。方法选择2001-01/2003-10在山东省泰山慢性病医院神经内科住院的首次发病的脑卒中患者72例,均知情同意。随机分成两组,实验组和对照组各36例。实验组除常规药物治疗护理外,配合系统的心理疗法、健康教育、早期康复活动等程序化干预,出院后进行为期1年的随访。并与给予常规药物治疗和护理的对照组相比较。随访内容包括脑卒中的防治知识、执行医嘱情况、并发症及步行能力、步态质量、日常活动能力。①步行能力评定指标>45m。②步态质量由Fugl-Meyer下肢功能积分评估,总分34分。≥24分为优良步态,≤17分为严重偏瘫步态。③日常活动能力采用Barthel指数评定,总分100分。≤40分为日常活动能力重度损害,>61分为轻度损害。结果72例患者均按计划完成全程实验,全部进入结果分析。①掌握脑卒中相关知识、配合医嘱情况:实验组优于对照组(92.7%,94.4%;72.7%,63.5%,χ2=8.692,10.290,P<0.01)。②出现并发症:实验组少于对照组(44.4%,77.8%,(χ2=8.416,P<0.01)。③步行能力、步态质量及日常活动能力:实验组优于对照组(χ2=5.143,u=20484,2.727,P<0.05～0.01)。结论程序化干预可以在常规药物治疗护理基础上,早期有效的改善脑卒中偏瘫患者的抑郁情绪、下肢运动功能及日常活动能力,促进脑卒中患者的尽早康复。     

A cross-sectional assessment of stroke rehabilitation in nebraska hospitals

Jones KJ, Cochran TM, Jensen LE, Roehrs TG, Volkman KG, Goldman AJ. A cross-sectional assessment of stroke rehabilitation in Nebraska hospitals.ObjectiveTo assess the structure and process of stroke rehabilitation in Nebraska hospitals.DesignCross-sectional mail survey using the Dillman tailored-design method of administration.SettingHospitals in Nebraska.ParticipantsApproximately 77% of the 84 Nebraska hospitals that provide stroke rehabilitation are critical access hospitals (CAHs) that are limited to 25 beds. Our study sample of hospitals (N=53) included the 19 hospitals licensed for 47 to 689 beds (non-CAHs) and a stratified random sample of 34 of the 65 CAHs.InterventionsNot applicable.Main Outcome MeasuresSelf-reported stroke rehabilitation team structure and processes, purposes of and barriers to the use of evidence-based standardized assessments, specific assessments used, and access to specialized stroke rehabilitation services and community resources.ResultsThirty-six (68%) of the 53 hospitals responded to the survey. Approximately 61% of the hospitals used an organized team to provide stroke rehabilitation; 8% of the hospitals—all non-CAHs—had a team dedicated to stroke rehabilitation. After adjusting for hospital size, having an organized team was significantly associated with the use of standardized assessments to improve communication, measure progress and outcomes, evaluate effectiveness of practice, and compare patient outcomes across conditions. Access to specialized stroke rehabilitation professionals and services was significantly greater in non-CAHs.ConclusionsHospital size and the presence of a team are determinants of the structure and process of stroke rehabilitation in Nebraska hospitals. Further research is needed to determine (1) whether team structure is a determinant of stroke rehabilitation outcomes across the continuum of care settings, (2) the needs of rural stroke survivors, and (3) whether technology can facilitate the use of stroke rehabilitation standardized assessments by rural health care professionals.     

瘢痕子宫再次妊娠孕产妇选择分娩方式的影响因素

[目的]探讨瘢痕子宫再次妊娠孕产妇选择分娩方式的影响因素分析.[方法]制定问卷,选择2016年1月至2016年12月深圳市10个医院产科产检、住院待产、分娩的瘢痕子宫再次妊娠的孕产妇、家属及各级医院的妇产科医务人员为调查对象.分别发放问卷调查表,调查孕产妇及家属对瘢痕子宫再次妊娠顺产、剖宫产知识的知晓情况及妇产科医务人员的剖宫产后阴道分娩(VBAC)的知晓情况,采用Logistic回归分析影响孕产妇选择分娩方式的因素.[结果]993例孕产妇选择VBAC,其中648例试产成功(占65.26％),其比例明显高于选择再次剖宫产在待产期自然分娩的孕产妇(占11.01％)(χ2=31.22,P=0.000);孕妇居住地、对顺产及剖宫产知识的认知、对顺产的紧张度、既往有阴道分娩史、家属建议阴道分娩等对孕产妇分娩方式的选择均有影响(P<0.05);在回收的738份有效调查问卷中,医生认为可以阴道分娩的知晓率为61.65％(328/532),明显高于护士21.19％(50/236),其差异有统计学意义(χ2=93.37,P=0.000);三级医院医生对VBAC的知晓率为68.46％,明显高于二级(46.62％)和一级医院(20.69％),其差异有统计学意义(χ2=45.26,P=0.000),其中专科医院医生和护士的知晓率均高于综合医院(P<0.05);具有高级职称的医务人员对VBAC的认知率明显高于初、中级职称的医务人员(P=0.000).[结论]对瘢痕子宫再次妊娠阴道分娩知识及再次剖宫产史知识的认知对分娩方式的选择有影响,需加强此方面知识的宣传.     

Functioning in everyday life after stroke: a longitudinal study of elderly people receiving rehabilitation at home

OBJECTIVE: There is a need to identify different rehabilitation needs over time among individuals with stroke in order to implement client-centred rehabilitation interventions after stroke. The objective of this research was to describe changes in some aspects of functioning and to explore the patterns of change in functioning in everyday life during the first year after stroke for elderly patients participating in rehabilitation at home. DESIGN AND SUBJECTS: Patients who fulfilled the inclusion criteria for a regular rehabilitation-at-home programme after stroke were considered for participation in this study. Twenty-seven elderly patients participated on four data collection occasions during the year immediately subsequent to a stroke. The mean age of the 27 participants was 78.8 years (SD = 5.9) and 67% of the participants were women. METHODS: Data on certain aspects of functioning were collected and a person-oriented approach was used to describe the patterns in the change in functioning for individuals. RESULTS: Four different patterns were identified: (a) moderate change in functioning (n = 4), (b) minor change in functioning (n = 11), (c) minor change despite major life event (n = 7), (d) disrupted change in functioning (n = 5). The study group improved significantly in most aspects of functioning, but still, most participants (n = 20) showed dissatisfaction with life as a whole 12 months after their stroke. CONCLUSION: This study identified different patterns of change in functioning in everyday life. This knowledge should serve to help guide rehabilitation professionals in their assessment of clients' needs during different phases after stroke.     

急性脑卒中合并不同程度阻塞性睡眠呼吸暂停低通气综合征患者伴发脑心综合征的临床分析

目的探讨急性脑卒中合并不同程度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者发生脑心综合征(CCS)的差异性,为临床监测及干预治疗提供依据。方法收集急性脑卒中合并OSAHS患者471例,其中缺血性卒中伴轻度OSAHS组85例,缺血性卒中伴中度OSAHS组74例,缺血性卒中伴重度OSAHS组68例,出血性卒中伴轻度OSAHS组69例,出血性卒中伴中度OSAHS组83例,出血性卒中伴重度OSAHS组92例。观察各组心电图、心肌酶、肌钙蛋白的变化。结果缺血性脑卒中合并不同程度OSAHS患者发生CCS的比较,差异有统计学意义(χ~2=6.532,P=0.012),其中两两比较差异均有统计学意义(P0.01)。出血性脑卒中合并不同程度OSAHS患者发生CCS的比较,差异有统计学意义(χ~2=12.741,P=0.005),其中两两比较差异均有统计学意义(P0.01)。缺血性卒中合并轻度OSAHS与出血性卒中合并轻度OSAHS患者发生CCS的比较,差异有统计学意义(χ~2=6.972,P=0.010)。缺血性卒中合并中度OSAHS与出血性卒中合并中度OSAHS患者发生CCS的比较,差异有统计学意义(χ~2=9.248,P=0.005)。缺血性卒中合并重度OSAHS与出血性卒中合并重度OSAHS患者发生CCS的比较,差异有统计学意义(χ~2=10.831,P=0.005)。结论急性脑卒中合并OSAHS的患者,随着OSAHS程度的加重,CCS的发生率增加,且出血性卒中合并OSAHS的患者较缺血性卒中合并OSAHS的患者更易导致CCS的发生。     

非瓣膜性心房颤动患者抗凝治疗知识知晓率及治疗行为调查分析

目的 了解非瓣膜性心房颤动(房颤)患者抗凝治疗知识知晓率及抗凝治疗行为,提高房颤患者抗凝治疗行为及依从性.方法 从北京市城八区选择8所三级医院和7所二级医院(社区卫生服务中心).由内科医生对门诊或病房非瓣膜房颤患者采取统一问卷调查.结果 583例非瓣膜性房颤患者43.2%知晓房颤易导致脑卒中,39.1%知晓房颤患者需要抗凝治疗.未采取抗凝治疗的患者以上知识知晓率仅为25.2%和21.8%.抗凝治疗知识主要来源于医生,占91.8%,仅13.2%来源于健康教育手册.房颤患者华法林总体服用率为18.9%,脑卒中高危房颤患者华法林服用率为18.2%.不采取抗凝治疗的主要原因是患者不知道需要抗凝治疗,占78.6%.结论 我国房颤患者抗凝治疗率低,缺乏抗凝治疗相关知识是影响抗凝行为的重要原因.房颤患者健康教育是提高抗凝治疗知识,改善抗凝治疗行为的重要措施.     

脑卒中患者主要照顾者护理知识调查

目的了解脑卒中家庭主要照顾者护理知识掌握情况。方法采用自行设计的调查表对250例脑卒中家庭主要照顾者的护理知识和健康教育需求进行调查。结果77.6％照顾者了解疾病的临床症状,说明对疾病有一定的认识,但缺乏康复护理知识和基本护理技巧。92.4％照顾者希望通过提供护理示范指导,90.4％希望进行个别指导,84.0％希望开办疾病专题讲座等方式从医务人员处获得护理知识和护理技能。结论医护人员应重视脑卒中患者家属健康教育需求,有针对性地进行宣教和指导,帮助家属掌握护理要点,以利于患者康复,提高生活质量。     

Barriers associated with exercise and community access for individuals with stroke

Increasing participation in physical activity among people with stroke continues to be a major challenge for healthcare professionals. We administered a survey to a group of 83 adults with unilateral stroke (mean age = 54.2 yr) to determine their perceived barriers to exercise. The five most common barriers in rank order were (1) cost of the program (61%), (2) lack of awareness of a fitness center in the area (57%), (3) no means of transportation to a fitness center (57%), (4) no knowledge of how to exercise (46%), and (5) no knowledge of where to exercise (44%). The least common barriers were (1) lack of interest (16%), (2) lack of time (11%), and (3) concern that exercise would worsen their condition (1%). People with stroke reported several barriers that prevented or reduced their participation in exercise. Healthcare professionals must identify and remove these barriers to promote greater participation in exercise among people with stroke.     

Life satisfaction and self-efficacy in patients affected by a first stroke living in Kuwait: A two-phase study

Life satisfaction and self-efficacy are important aspects of stroke rehabilitation. Previous research focuses on Western stroke survivors, neglecting the stroke experience in the Middle East. This research was conducted in Kuwait and entailed both quantitative and qualitative phases to obtain a more comprehensive, clinically relevant understanding of self-efficacy and life satisfaction during stroke rehabilitation in this culture. The aims were to: 1) investigate the relationships between self-efficacy and life satisfaction in female patients affected by stroke (Phase 1); and 2) explore health professionals' views regarding the importance of self-efficacy and possible strategies for enhancing self-efficacy during rehabilitation, through semi-structured interviews (Phase 2). Significant correlations were found between patients' general self-efficacy, and psychosocial adaptation self-efficacy following stroke. Self-efficacy (both general and psychosocial adaptation) showed significant correlations with life satisfaction post-stroke. Health professionals (more than half of whom were physiotherapists) recognised the importance of self-efficacy within stroke rehabilitation and identified five main ways to increase self-efficacy during stroke rehabilitation. These were to: 1) motivate and encourage patients; 2) provide more education about stroke and rehabilitation; 3) identify change; 4) offer a high-quality environment and therapy; and 5) set goals. In conclusion, psychosocial self-efficacy was identified as having a stronger relationship to life satisfaction compared with general self-efficacy within this sample of Kuwaiti female patients. Health professionals suggested various strategies for enhancing self-efficacy and thereby life satisfaction post-stroke during the rehabilitation process in Kuwait. Despite the collectivist culture of Kuwait, the findings indicate that the patient's own confidence and sense of responsibility for progress may be relevant to rehabilitation.     

实习护生对血源性传播疾病职业暴露认知的调查与分析

目的了解不同实习阶段、教育程度和不同等级医院护生对血源性疾病职业防护知识的认知状况,为今后有针对性在护生中开展职业防护教育提供依据。方法采用问卷调查的方法,对盐城地区8所二级甲等以上综合医院的344名实习护生进行实习前、初、中、末期职业防护认知现状调查。结果不同实习阶段护生对血源性疾病职业防护知识的掌握情况存在差异;本科实习护生在职业认知与防护方面优于专科、中专实习护生,差异有统计学意义（,分别为6．74、54．37,P〈0．01）;三级医院与二级医院的实习护生职业认知与防护知晓程度差异有统计学意义（t分别为2．46、8．85,P〈0．05或P〈0．01）。结论学历及实习医院级别越高,实习时间越长,护生职业防护意识越强。但护生职业防护执行力普遍较差,需加强学校和实习医院职业防护教育和培训,加强对护生职业防护执行力的督查。