脑卒中患者家庭康复综合状况调查研究

目的 通过横断面调查研究，了解脑卒中患者家庭康复状况，比较不同特征下卒中患者的康复效果。方法 采用便利抽样，选取某三甲医院康复医学中心已出院的卒中患者共计234例为研究对象，采用自制的《患者一般资料调查表》及Barthel指数评定（BI）量表、工具性日常生活活动能力(IADL)量表、移动能力评定(MRMI)量表、患者自我感受负担(SPBS)量表、照顾者负担(ZBI)量表对患者进行问卷调查。结果 患者BI得分（61.77±22.83）分，61.11%的患者日常生活轻度依赖；IADL得分（7.25±6.26）分，处于低水平；MRMI得分（28.90±10.22）分；SPBS得分（29.26±7.07）分，超过90%的患者有疾病自我负担感；ZBI得分（43.97±12.28）分。脑梗塞、男性患者各量表得分均优于脑出血、女性患者；年龄<60岁、家庭康复时间超过1年、由亲属照顾、女性照顾的脑卒中患者其家庭康复躯体功能总体优于老年、家庭康复时间少于1年、由非亲属、男性照顾的患者，但患者自我感受负担、照顾者负担无明显差异。结论 我国脑卒中患者家庭康复效果差。卒中类型、性别、年龄和家庭康复时间等对脑卒中患者家庭康复效果产生影响。

Home-based Rehabilitation of Stroke Patients

Objective To assess the physical, psychological and social functioning of stroke patients with home-based rehabilitation. Methods Convenient sampling strategy was adopted to select 234 stroke patients discharged from a tertiary hospital rehabilitation center. The patients were assessed using Barthel index (BI), instrumental activities of daily living (IADL) scale, modified rivermead mobility index (mRMI), self-perceived burden scale (SPBS), self-rating depression scale, and Zarit caregiver burden interview (ZBI) during their outpatient visits, household visits, or telephone interviews. Results The patients had an average BI score of 61.77±22.83, 61.11% had mild dependence on daily life. Their IADL score was low at an average of 7.25±6.26. They had 28.90±10.22 in MRMI score and 29.26±7.07 in SPB score. More than 90% had a feeling of self-burden. The caregiver burden score reached 43.97±12.28. Male patients and those with cerebral infarction had better functioning than female patients and those with cerebral hemorrhage. Better physical functioning was demonstrated in those who were younger than 60 yr., experienced more than one year home-based rehabilitation, were cared by relatives, and had a female caregiver. But such differences were not significant in SPBS and ZBI scores. Conclusion Home-based rehabilitation of stroke has failed to achieve anticipated results. The outcomes vary across those with different age, gender, and type of stroke.