背景:患有中风的残疾老人通常在出院后难以获得专业的康复干预,自我健康管理能力低,所以他们的病容易复发。医院社区综合服务模式(HCISM)是为满足出院后居家护理需求而设计的科学模式,改善患者出院后的生活质量,减轻家庭负担,提高社区医务人员的服务能力。目的探讨HCISM在脑卒中失能老人家庭康复中的应用效果。
方法:选取2019年9月至2020年9月江南大学附属医院收治的120例老年脑卒中失能患者,采用随机数字表法分为两组。每组60例。两组均在出院后接受家庭康复治疗,对照组给予常规干预,观察组给予HCISM干预。生活自理能力的变化,合规行为,自我效能感,比较两组干预前后的不良情绪。
结果:干预3个月后观察组改良Barthel指数(MBI)评分高于对照组(P<0.05)。在观察组中,药物比例的变化,合理的饮食,适度运动,且3个月后定期回访均高于对照组(P<0.05)。干预3个月后,观察组一般自我效能量表(GSES)评分高于对照组(P<0.05)。干预3个月后,观察组Zung’s焦虑自评量表(SAS)和抑郁自评量表(SDS)评分均低于对照组(P<0.05)。
结论:HCISM应用于老年脑卒中失能患者的家庭康复中,能提高生活自理能力和自我效能感。改善医疗合规行为,减少负面情绪,因此值得进一步推广。
BACKGROUND: Disabled elderly with stroke usually have difficulty in obtaining professional rehabilitation intervention after being discharged from the hospital, and their self-health management ability is low, so their illness is prone to relapse. The hospital community-integrated service model (HCISM) is a scientific model designed to meet the needs of home care after discharge from the hospital, improve the quality of life of patients after discharge from the hospital, ease the burden on the family, and improve the service capabilities of community medical staff. The purpose of this study is to explore the effect of HCISM in home rehabilitation of stroke disabled elderly.
METHODS: From September 2019 to September 2020, 120 the disabled elderly patients with stroke admitted to Affiliated hospital of Jiangnan University were selected and divided into two groups with a random number table method, with 60 cases in each group. Both groups underwent home rehabilitation after discharge, the control group was given routine intervention, and the observation group was given HCISM intervention. The changes of self-care ability, compliance behavior, self-efficacy, and adverse mood before and after intervention were compared between the two groups.
RESULTS: The modified Barthel Index (MBI) score of the observation group after 3 months of intervention was higher than that of the control group (P<0.05). In the observation group, the changes in the proportion of medication, reasonable diet, moderate exercise, and regular return visits after 3 months were higher than those in the control group (P<0.05). The General Self-efficacy Scale (GSES) score of the observation group was higher than that of the control group after 3 months of intervention (P<0.05). Zung\'s Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) scores in the observation group were low after 3 months of intervention than those in the control group (P<0.05).
CONCLUSIONS: HCISM applied to the home rehabilitation of the disabled elderly patients with stroke can improve life self-care ability and self-efficacy, improve medical compliance behavior, and reduce negative emotions, thus making it worthy of further promotion.