脑卒中患者与家属居家护理需求调查及干预研究

发布时间：2018-03-26 17:24

本文选题：脑卒中　切入点：居家护理　出处：《山西医科大学》2017年硕士论文

【摘要】：目的:1.通过对出院脑卒中患者与家属进行居家护理需求调查,了解脑卒中患者与家属的居家护理需求现状并分析其影响因素。2.在前期现状调查的基础上结合时机理论制定一套符合脑卒中患者与家属需求的居家护理干预方案。3.探讨方案在中青年脑卒中患者与家属中的应用效果。方法:1.调查研究:采用便利抽样法于2016年3-5月对山西省某3所三甲医院神经内科的待出院脑卒中患者与家属各205名进行现状调查,以自制脑卒中患者与家属居家护理需求调查问卷为调查工具,了解脑卒中患者与家属的居家护理需求现状及其影响因素。2.干预研究:采用便利抽样法于2016年6月选取山西省某三甲医院的中青年脑卒中患者与家属各110名作为研究对象进行为期6个月的居家护理干预研究,根据随机数字表将其分为干预组和对照组各55名,干预组在常规护理与随访的基础上采取以时机理论为基础的居家护理;对照组接受神经内科常规护理与随访,分别于出院时、出院3个月及6个月,对干预效果进行评价。结果:1.调查结果(1)脑卒中患者的居家护理需求总得分为3.25±2.89。单因素方差分析结果显示:年龄、性别、婚姻状况、文化程度、工作状况、脑卒中类型、卒中次数、有无后遗症、出院后治疗及日常生活活动能力是其影响因素,将单因素方差分析有意义的变量引入多元线性回归,结果显示:日常生活活动能力、后遗症、文化程度是其主要影响因素(F=67.02,P0.001)。(2)脑卒中家属的居家护理需求总得分为3.24±0.35。单因素方差分析结果显示:性别、婚姻状况、与患者关系、是否与患者同住是其影响因素,将单因素方差分析有意义的变量引入多元线性回归,结果显示:性别、婚姻状况、与患者关系是其主要影响因素(F=17.59,P0.001)。2.干预结果(1)干预前两组患者的自我护理能力和自我效能水平经两独立样本t检验,结果显示:差别无统计学意义(P0.05)。干预后,干预组患者自护能力在各测量点上均高于对照组(P0.05),重复测量方差分析结果显示:差别有统计学意义(P0.001)。干预6个月后,干预组患者自我效能水平高于对照组,差别有统计学意义(P0.05)。(2)干预前两组家属的照顾能力和自我效能水平经两独立样本t检验,结果显示:差别无统计学意义(P0.05)。干预后,干预组家属照顾能力在各测量点上均高于对照组(P0.05),重复测量方差分析结果显示:差别有统计学意义(P0.001)。干预6个月后,干预组家属自我效能水平高于对照组,差别有统计学意义(P0.05)。结论:1.脑卒中患者居家护理需求主要受日常生活活动能力、后遗症和文化程度的影响,脑卒中家属居家护理需求主要受性别、婚姻状况和与患者关系的影响,因此,对此人群进行居家护理干预时应注意这些因素的影响。2.以时机理论为基础的居家护理能更有效地提高中青年脑卒中患者的自护能力和其家属的照顾能力,并改善两者的自我效能。
[Abstract]:Objective to investigate the home nursing needs of discharged stroke patients and their family members. To understand the status quo of the home nursing needs of stroke patients and their families and analyze the influencing factors. 2. Based on the investigation of the previous situation and the opportunity theory, to formulate a set of home nursing intervention scheme that meets the needs of stroke patients and their families. To explore the effect of the program on stroke patients and their families in young and middle-aged people. Methods: a survey was conducted on stroke patients and their families in three third-class hospitals in Shanxi Province from May to May 2016 by using convenience sampling method. A survey was conducted by 205 individuals each, Self-made questionnaire on nursing needs of stroke patients and their families was used as a tool. To understand the status quo of home nursing needs of stroke patients and their family members and its influencing factors. 2. Intervention study: in June 2016, 110 young and middle-aged stroke patients and their families in a third Class A Hospital in Shanxi Province were selected by the convenient sampling method. The subjects conducted a 6-month home nursing intervention study. According to the random number table, the intervention group was divided into two groups: the intervention group (55 cases) and the control group (55 cases). On the basis of routine nursing and follow-up, the intervention group adopted home-based nursing based on the theory of opportunity, while the control group received routine nursing and follow-up of neurology, respectively, when they were discharged from hospital. After 3 and 6 months of discharge, the intervention effect was evaluated. Results: 1.Results: 1) the total score of home nursing needs of stroke patients was 3.25 卤2.89.The results of univariate ANOVA showed: age, sex, marital status, education level. Work status, stroke type, stroke frequency, sequelae, post-discharge treatment and activities of daily living were the influencing factors. The significant variables of univariate ANOVA were introduced into multivariate linear regression. The results showed that daily living ability, sequelae and education level were the main influencing factors. The total score of home nursing needs of stroke family was 3.24 卤0.35.The results of univariate ANOVA showed: sex, marital status, and relationship with patients. Whether living with the patient is the influencing factor, the significant variable of univariate ANOVA is introduced into the multivariate linear regression, the results show that: sex, marital status, The relationship with patients was the main influencing factor. The results showed that there was no significant difference in self-nursing ability and self-efficacy between the two groups after intervention. The self-care ability of the patients in the intervention group was higher than that in the control group at each measuring point, and the results of repeated measurement of variance analysis showed that the difference was statistically significant (P 0.001). After 6 months of intervention, the self-efficacy level of the patients in the intervention group was higher than that in the control group. Before intervention, the care ability and self-efficacy level of the two groups were tested by two independent samples. The results showed that the difference was not statistically significant (P 0.05). After intervention, there was no significant difference between the two groups. The care ability of the family members in the intervention group was higher than that in the control group at each measuring point. The results of repeated measurement variance analysis showed that the difference was statistically significant (P 0.001). After 6 months of intervention, the self-efficacy level of the family members in the intervention group was higher than that in the control group. The difference was statistically significant (P 0.05). Conclusion 1. The home nursing needs of stroke patients are mainly influenced by the ability of daily life, sequelae and education level, and the home nursing needs of stroke family are mainly affected by sex. The effects of marital status and relationships with patients, therefore, The influence of these factors should be paid attention to when carrying on the home nursing intervention to this crowd. The home-based nursing based on the opportunity theory can improve the self-care ability of the young and middle-aged stroke patients and the care ability of their families more effectively. And improve their self-efficacy.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.2

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