脑卒中吞咽障碍患者居家护理模式及效果评价

目的:构建脑卒中吞咽障碍患者居家护理模式并评价其效果。方法:选取脑卒中吞咽障碍患者78例为研究对象。采用计算机产生随机序列法将患者随机分为观察组和对照组,每组各39例。对照组给予常规健康教育,观察组在常规健康教育基础上给予居家护理服务计划和干预措施,干预12周后,评价并比较2组患者干预前后的吞咽障碍情况、神经功能缺损程度、营养风险、自理能力、日常活动能力、心理状态及康复依从性。结果:干预12周后,2组吞咽障碍功能较治疗前明显提高(P<0.05),且观察组更优于对照组(P<0.05)。干预后,观察组患者神经功能缺损、营养风险、抑郁评分明显低于干预前及对照组(均P<0.05),观察组患者自理能力、日常活动能力、依从性得分均高于干预前及对照组(均P<0.05);对照组各项指标干预前后比较除营养风险和抑郁评分外,其余各项指标差异有统计学意义(均P<0.05)。结论:脑卒中吞咽障碍患者居家护理模式有较高的实用价值,对改善脑卒中吞咽障碍患者吞咽情况,提高患者生活质量,促进患者康复,实现医院-社区-家庭的无中断长期护理服务有重要作用。

Home care mode and effect evaluation of stroke patients with dysphagia

Objective:To construct and evaluate the home care mode of stroke patients with dysphagia.Methods:Seventy-eight stroke patients with dysphagia who visited our hospital from July 2017 to May 2018 were selected as subjects.Using computer generated random sequence method,the patients were randomly divide into experimental group and control group,39 cases in each group,General health education would be taken to the control group and a door-to-door home care,which is on the basis of general health education,would be taken to the experimental group at the same time.At the week 12 of the intervention,the swallowing disorder,neurological deficit,nutrition risk,self-care ability,daily activities,psychological status and rehabilitation compliance were evaluated and compared between the two groups before and after intervention.Results:After treatment,swallowing dysfunction of the two groups was significantly improved as compared with that before treatment(P<0.05),more significant in the observation group than in the control group(P<0.05).After 12 weeks of intervention,the scores of neurological deficit,nutrition risk and depression in the experimental group were significantly lower than those before intervention and in the control group(P<0.05).The scores of self-care ability,daily activity ability and compliance in the experimental group were significantly higher than those before intervention and in the control group(P<0.05).Before and after the intervention,all the indicators in the control group had statistically significant differences except for nutritional risk and depression score(P<0.05).Conclusion:Home care for stroke patients with dysphagia has higher practica value,and it plays an important role in improving the swallowing condition of stroke patients with dysphagia,improving the quality of life of patients,promoting the rehabilitation of patients,and realizing the uninterrupted long-term care service of hospital-community-family.