延续性护理对脑卒中患者健康行为的影响

发布时间：2018-01-12 20:30

本文关键词：延续性护理对脑卒中患者健康行为的影响　出处：《郑州大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的描述两组患者从出院前到出院后3个月、6个月健康行为的变化;探讨对脑卒中患者实施网络结合电话随访式的延续性护理干预,以改进其行为生活方式的可行性和有效性,为以后建立本土化的脑卒中延续性护理模式提供参考。方法1.2013年11月-2014年11月期间,便利选取郑州大学第一附属医院首次发病住院的脑卒中患者120例,采用随机数字表法,按照住院号的先后顺序分为对照组(60例)和干预组(60例),对照组患者按照神经内科常规护理于出院前2天开展出院指导,干预组患者除接受常规护理外,还由研究者在脑卒中患者出院前1天对其进行脑卒中健康相关行为宣教,宣教结束后发放《脑卒中患者健康相关行为手册》,在患者出院后每两周通过QQ群、微信群群发中国卒中协会颁布的有关行为生活方式的指导内容。出院后3个月内每2周根据《干预组健康教育指导手册》进行电话随访,3-6个月内每1个月进行电话随访。2.两组分别于出院时、出院后3个月、6个月收集基线资料及生化指标,采用健康促进生活方式量表II(Health Promoting Lifestyle,HPLPII)对脑卒中患者的知识、态度及行为改变进行评价;采用甘油三酯、胆固醇、高密度脂蛋白、低密度脂蛋白对患者的生化指标改变进行评价。3.首先收集数据资料,然后采用SPSS17.0软件对数据进行处理,采用的统计方法主要有描述性统计分析、两样本独立t检验、卡方检验、重复测量方差分析等。结果1.两组脑卒中患者临床基线资料间比较差异无统计学意义(P=0.789)。2.在患者出院时、出院后3个月和出院后6个月时,统计干预组患者和对照组患者的总体健康行为得分,对数据的重复测量方差分析结果表明,对照组的总体健康行为得分提高趋势劣于干预组,且差异具有统计学意义(P0.05)。3.在患者出院时、出院后3个月和出院后6个月时,统计干预组患者和对照组患者自我实现、健康责任、压力应对的得分,对得分数据进行重复测量方差分析显示,对照组患者的自我实现、健康责任、压力应对三个维度的上升趋势劣于干预组患者,且差异具有统计学意义(P0.05)。4.在患者出院时、出院后3个月和出院后6个月时,统计干预组患者和对照组患者营养、运动、人际关系得分,对得分数据进行重复测量方差分析显示,对照组患者的营养、运动、人际关系三个维度的上升趋势劣于干预组患者,且差异具有统计学意义(P0.05)。5.重复测量方差分析显示,干预组与对照组的总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白水平差异均无统计学意义(P0.05);总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白水平差异不存在时间效应及交互作用,差异无统计学意义(P0.05)。结论延续性护理模式可以有效地改善脑卒中患者的运动、营养、健康责任、人际关系、自我实现、压力应对能力,临床护理工作中应推广此模式。
[Abstract]:Objective to describe the changes of health behavior in the two groups from the time before discharge to 3 months after discharge and 6 months after discharge. To explore the feasibility and effectiveness of continuous nursing intervention for stroke patients by network and telephone follow-up in order to improve their behavioral lifestyle. Methods 1. From November to November 2014. 120 stroke patients in the first affiliated Hospital of Zhengzhou University were selected and randomly divided into control group (n = 60) and intervention group (n = 60). The patients in the control group were discharged two days before discharge according to the routine nursing care in neurology department, and the patients in the intervention group received the routine nursing. The health related behaviors of stroke patients were also taught one day before discharge from the hospital. After the education was finished, the Health related behavior Manual of Stroke patients was issued, and the QQ group was passed every two weeks after discharge from the hospital. WeChat group issued by China Stroke Association issued guidelines on behavior lifestyle. 3 weeks after discharge from the hospital according to the intervention group health education guide manual telephone follow-up. Telephone follow-up was conducted every 1 month in 3-6 months. The baseline data and biochemical indexes were collected at the time of discharge, 3 months after discharge and 6 months after discharge. II(Health Promoting lifestyle scale (HPLPII) was used to evaluate the knowledge of stroke patients. Attitude and behavior changes were evaluated; Triglyceride, cholesterol, high density lipoprotein and low density lipoprotein were used to evaluate the changes of biochemical indexes in patients. Then the SPSS17.0 software is used to process the data. The statistical methods are mainly descriptive statistical analysis, independent t-test of two samples, chi-square test. Results 1. There was no significant difference between the two groups in the clinical baseline data of stroke patients. There was no significant difference between the two groups. 2. At the time of discharge, there was no significant difference between the two groups. 3 months after discharge and 6 months after discharge, the overall health behavior scores of the patients in the intervention group and the control group were statistically analyzed. The overall health behavior score of the control group was worse than that of the intervention group, and the difference was statistically significant (P0.05. 3) at the time of discharge, 3 months after discharge and 6 months after discharge. Statistical intervention group and control group patients self-realization, health responsibility, stress coping score, score data repeated measurement variance analysis showed that the control group self-realization, health responsibility. The rising trend of the three dimensions of stress coping was worse than that of the intervention group, and the difference was statistically significant (P 0.05. 4) at the time of discharge, 3 months after discharge and 6 months after discharge. Statistical intervention group and control group patients with nutrition, exercise, interpersonal relations score, score data repeated measurement of variance analysis, control group patients nutrition, exercise. The rising trend of the three dimensions of interpersonal relationship was worse than that of the patients in the intervention group, and the difference was statistically significant (P 0.05). The repeated measurement of variance showed that the total cholesterol and triglyceride of the intervention group and the control group were higher than those of the control group. There was no significant difference in high density lipoprotein (HDL) and low density lipoprotein (LDL) levels (P 0.05). There was no time effect or interaction between the levels of total cholesterol, triglyceride, high density lipoprotein and low density lipoprotein. Conclusion continuous nursing model can effectively improve stroke patients' exercise, nutrition, health responsibility, interpersonal relationship, self-realization, stress coping ability. This model should be popularized in clinical nursing work.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R473.74

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