社区专业人员介入对脑卒中患者辅助器具适配的影响

目的:探讨社区康复专业人员介入对上海市适配辅助器具家庭组合的影响。方法:将上海市杨浦区12个街道筛选持有上海市残疾证明的脑卒中患者120例随机分为2组各60例,对照组进行常规辅助器具家庭组合适配。观察组在此服务的基础上,对社区康复专业人员、脑卒中患者和家属进行相关培训,然后由经过培训的社区康复医生参与整个适配过程。在辅具适配开始前及适配后3个月,采用巴氏指数(BI)及健康状况调查问卷(SF-36)分别对2组患者进行相关功能评定,同时评定辅助器具使用的满意度(魁北克辅助科技使用者满意度评估量表(QUEST)和辅具使用率。结果:干预3个月后,2组BI评分及SF-36各维度得分均较干预前明显提高(P0.05);且观察组更高于对照组(P0.05)。干预后,观察组QUEST评分明显高于对照组(P0.05)。结论:整合社区康复资源,增加对社区康复人员、脑卒中患者及家属进行相关的培训,可以明显提高脑卒中患者对辅助器具家庭组合适配后的独立生活能力及生存质量,提高辅具的使用率及对辅具适配服务的满意度。

Effects of community rehabilitation on assistive devices in stroke patients

Objective: To investigate the effect of community rehabilitation staffs'' involvement on home assistive devices for stroke patients in Shanghai. Methods: 120 stroke patients from 12 communities in Yangpu district, who had certificates of disability, were randomly divided into intervention group and control group. Both groups were given assistive devices in their family. In the intervention group, relative education was additionally given to the community rehabilitation clerks, stroke patients and their family members, and the well-trained community rehabilitation doctors followed up the whole process. Barthel index (BI) and 36-item Short-Form Health Survey (SF-36) were assessed for both groups at the baseline and 3 months after the assistive devices were equipped. The Quebec Use Evaluation of Satisfaction with Assistive Technology (QUEST ) and utilization rate were also assessed after 3 months to see whether the patients were satisfied with the devices. Results: The independent activity of daily life in both two groups was significantly improved (P<0.05). And the intervention group showed better result. BI of intra group comparison and between group comparison showed significant change (P<0.05). Besides, SF-36 index was also improved in both two groups after the assistive devices were equipped (P<0.05), of which intervention group''s improvement was more significant (P<0.05). Further, Quest results and utilization rate of the intervention group were better than those of the control group (P<0.05). Conclusion: Integrating community rehabilitation resources and educating the community rehabilitation staffs, stroke patients and their family members can significantly help the stroke patients improve their independent activity of daily life and quality of life after equipped with assistive devices, but also improve the utilization rate and satisfaction of assistive devices.