本文關(guān)鍵詞：延續(xù)性護(hù)理對腦卒中患者健康行為的影響　出處：《鄭州大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

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【摘要】：目的描述兩組患者從出院前到出院后3個月、6個月健康行為的變化;探討對腦卒中患者實施網(wǎng)絡(luò)結(jié)合電話隨訪式的延續(xù)性護(hù)理干預(yù),以改進(jìn)其行為生活方式的可行性和有效性,為以后建立本土化的腦卒中延續(xù)性護(hù)理模式提供參考。方法1.2013年11月-2014年11月期間,便利選取鄭州大學(xué)第一附屬醫(yī)院首次發(fā)病住院的腦卒中患者120例,采用隨機數(shù)字表法,按照住院號的先后順序分為對照組(60例)和干預(yù)組(60例),對照組患者按照神經(jīng)內(nèi)科常規(guī)護(hù)理于出院前2天開展出院指導(dǎo),干預(yù)組患者除接受常規(guī)護(hù)理外,還由研究者在腦卒中患者出院前1天對其進(jìn)行腦卒中健康相關(guān)行為宣教,宣教結(jié)束后發(fā)放《腦卒中患者健康相關(guān)行為手冊》,在患者出院后每兩周通過QQ群、微信群群發(fā)中國卒中協(xié)會頒布的有關(guān)行為生活方式的指導(dǎo)內(nèi)容。出院后3個月內(nèi)每2周根據(jù)《干預(yù)組健康教育指導(dǎo)手冊》進(jìn)行電話隨訪,3-6個月內(nèi)每1個月進(jìn)行電話隨訪。2.兩組分別于出院時、出院后3個月、6個月收集基線資料及生化指標(biāo),采用健康促進(jìn)生活方式量表II(Health Promoting Lifestyle,HPLPII)對腦卒中患者的知識、態(tài)度及行為改變進(jìn)行評價;采用甘油三酯、膽固醇、高密度脂蛋白、低密度脂蛋白對患者的生化指標(biāo)改變進(jìn)行評價。3.首先收集數(shù)據(jù)資料,然后采用SPSS17.0軟件對數(shù)據(jù)進(jìn)行處理,采用的統(tǒng)計方法主要有描述性統(tǒng)計分析、兩樣本獨立t檢驗、卡方檢驗、重復(fù)測量方差分析等。結(jié)果1.兩組腦卒中患者臨床基線資料間比較差異無統(tǒng)計學(xué)意義(P=0.789)。2.在患者出院時、出院后3個月和出院后6個月時,統(tǒng)計干預(yù)組患者和對照組患者的總體健康行為得分,對數(shù)據(jù)的重復(fù)測量方差分析結(jié)果表明,對照組的總體健康行為得分提高趨勢劣于干預(yù)組,且差異具有統(tǒng)計學(xué)意義(P0.05)。3.在患者出院時、出院后3個月和出院后6個月時,統(tǒng)計干預(yù)組患者和對照組患者自我實現(xiàn)、健康責(zé)任、壓力應(yīng)對的得分,對得分?jǐn)?shù)據(jù)進(jìn)行重復(fù)測量方差分析顯示,對照組患者的自我實現(xiàn)、健康責(zé)任、壓力應(yīng)對三個維度的上升趨勢劣于干預(yù)組患者,且差異具有統(tǒng)計學(xué)意義(P0.05)。4.在患者出院時、出院后3個月和出院后6個月時,統(tǒng)計干預(yù)組患者和對照組患者營養(yǎng)、運動、人際關(guān)系得分,對得分?jǐn)?shù)據(jù)進(jìn)行重復(fù)測量方差分析顯示,對照組患者的營養(yǎng)、運動、人際關(guān)系三個維度的上升趨勢劣于干預(yù)組患者,且差異具有統(tǒng)計學(xué)意義(P0.05)。5.重復(fù)測量方差分析顯示,干預(yù)組與對照組的總膽固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白水平差異均無統(tǒng)計學(xué)意義(P0.05);總膽固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白水平差異不存在時間效應(yīng)及交互作用,差異無統(tǒng)計學(xué)意義(P0.05)。結(jié)論延續(xù)性護(hù)理模式可以有效地改善腦卒中患者的運動、營養(yǎng)、健康責(zé)任、人際關(guān)系、自我實現(xiàn)、壓力應(yīng)對能力,臨床護(hù)理工作中應(yīng)推廣此模式。
[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.
【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R473.74

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