医院－社区－家庭康复护理模式在脑卒中患者康复中的效果评估

目的：探讨医院-社区-家庭康复护理模式对脑卒中患者实施康复护理的合理性、科学性及效用性，为今后康复护理干预提供指导和依据。方法：选择2010年5月－2013年5月县人民医院内科收治的符合选择标准的脑卒中患者144例，按随机数字表法分为干预组和对照组，每组各72例。对照组给予常规神经内科治疗和护理，干预组在对照组基础上实施医院－社区－家庭康复护理干预，包括心理康复护理、良姿位及肢体功能训练、日常生活能力训练、吞咽训练及语言训练、社区卫生康复护理、家庭康复等。分别于干预前及干预后3个月后评估运动功能、日常生活活动能力评定及并发症发生率。结果：两组组内干预前后的运动功能评分、日常生活活动能力评分比较差异均有统计学意义（P＜0.05），但干预组改善幅度更为明显（t=6.84，P=0.000；t=5.99，P=0.000）；干预组褥疮、肺部感染、泌尿系感染、肩关节半脱位、肩手综合征、肌肉萎缩、异常运动等并发症的发病率明显低于对照组，差异均有统计学意义（P＜0.05）。结论：医院-社区-家庭康复护理模式康复护理干预能够有效地减轻脑卒中患者功能障碍，提高生存质量。

Effect Evaluation of Rehabilitation Nursing Model of Hospital-Community-Family in Rehabilitation of Patients with Stroke

Objective：To explore the effect of rehabilitation nursing model of Hospital-Community-Family in rehabilitation of patients with stroke and to provide evidence for nursing intervention for these patients. Method：144 stroke patients were divided into intervention group and control group according to random number table method,each group with 72 patients. All patients in both groups were received routine neurological medical therapy and the routine care. The intervention group was received rehabilitation nursing model of Hospital-Community-Family besides in above treatment, included health assessment,rehabilitation consultation,health education,psychological rehabilitation nursing,good posture and body function training,daily living skills training,swallowing training and language training,community nursing and home rehabilitation. After 3 months,the scores of motor function and living skills training and the incidence of complications were studied. Result：Before and after the intervention,the scores of motor function and living skills training of inner the two groups were compared,and the differences were statistically significant（P〈0.05）,but the intervention group improved more obviously（t=6.84,P=0.000;t=5.99,P=0.000）;the incidence of complications in the intervention group such as bedsore,pulmonary infection,urinary tract infection,shoulder joint subluxation,shoulder hand syndrome,muscle atrophy, abnormal movement were significantly lower than the control group,the differences had statistical significance（P〈0.05）. Conclusion：Rehabilitation nursing intervention of Hospital-Community-Family can effectively,lighten dysfunction in patients with stroke and improve the quality of life.