本文關(guān)鍵詞： 居家 腦卒中 專業(yè)化照護需求 評估工具 日常生活活動能力　出處：《鄭州大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的1.研制并評測《居家腦卒中患者專業(yè)化照護需求問卷》;2.了解居家腦卒中患者的專業(yè)化照護需求現(xiàn)狀及影響因素,并探討不同ADL的居家腦卒中患者對專業(yè)化照護的需求差異。方法研究分為兩個部分:第一部分為居家腦卒中患者專業(yè)化照護需求問卷的研制及信效度檢驗:首先是居家腦卒中患者專業(yè)化照護需求的質(zhì)性研究,采用目的抽樣法選取居家腦卒中患者11位和/或其照顧者7位,采用半結(jié)構(gòu)訪談及Colaizzi 7步分析法收集和分析資料。之后形成《居家腦卒中患者專業(yè)化照護需求問卷》條目池,以馬斯洛需要層次理論和奧瑞姆自護理論為指導形成《居家腦卒中患者專業(yè)化照護需求問卷》初稿,經(jīng)Delphi專家函詢對問卷初稿進行修改后形成問卷函詢稿。預(yù)調(diào)查后形成問卷施測稿。選取318位居家腦卒中患者及6位專家測評問卷信效度。第二部分為居家腦卒中患者專業(yè)化照護需求的量性研究:以《居家腦卒中患者專業(yè)化照護需求問卷》和巴氏指數(shù)為工具,便利選取428位居家腦卒中患者進行調(diào)查。采用IBM SPSS Statistics 21.0軟件包進行數(shù)據(jù)錄入與分析,采用描述性統(tǒng)計、單因素分析、逐步多重線性回歸的方法分析居家腦卒中患者專業(yè)化照護需求現(xiàn)狀及影響因素;采用隨機區(qū)組設(shè)計的方差分析和多重比較分析不同日常生活活動能力的居家腦卒中患者群體對各維度專業(yè)化照護需求的差異。結(jié)果第一部分:針對居家腦卒中患者專業(yè)化照護需求得出3個主題,9個亞主題。(1)生理的需要:飲食指導,睡眠指導;(2)安全的需要:疾病知識,康復指導,用藥指導,資源信息,指標監(jiān)測;(3)歸屬的需求:回歸社會,心理援助。形成的《居家腦卒中患者專業(yè)化照護需求問卷》,包括指導生活護理(11個條目),專業(yè)知識技能(11個條目),后遺癥、并發(fā)癥護理(12個條目),社會支持(10個條目)4個維度。問卷信效度檢驗時,各條目決斷值各條目均t3.00(P≤0.05),條目與總分的相關(guān)性為0.672~0.872(P≤0.01);整體水平全體一致性內(nèi)容效度為0.82,平均內(nèi)容效度為0.97,各條目水平內(nèi)容效度為0.83~1.00;探索性因子分析提取4個因子,累計方差貢獻率83.894%;總Cronbach'sα系數(shù)、Guttman Spilt折半系數(shù)、重測信度分別為0.987、0.919、0.988。第二部分:居家腦卒中患者專業(yè)化照護需求總分為(126.73±46.58)分,其中,指導生活護理維度(31.37±15.62)分,專業(yè)知識技能維度(35.61±11.73)分,后遺癥、并發(fā)癥護理維度(29.30±15.26)分,社會支持維度(30.46±10.54)分。其中,日常生活活動能力、主要照顧者可影響居家腦卒中患者專業(yè)化照護需求總分及各維度需求得分。隨機區(qū)組設(shè)計的分析結(jié)果顯示,指導生活護理是重度依賴的居家腦卒中患者最需要的專業(yè)化照護,專業(yè)知識技能是中度依賴、輕度依賴和無需依賴的居家腦卒中患者最需要的專業(yè)化照護。結(jié)論1.《居家腦卒中患者專業(yè)化照護需求問卷》信效度良好,可用于居家腦卒中患者專業(yè)化照護需求的評估。2.居家腦卒中患者專業(yè)化照護需求較高,日常生活活動能力、婚姻狀況、腦卒中類型及主要照顧者是其主要影響因素。另外,指導生活護理是重度依賴的居家腦卒中患者最需要的專業(yè)化照護,而專業(yè)知識技能是中度依賴、輕度依賴、無需依賴的居家腦卒中患者最需要的專業(yè)化照護,提示不同日常生活活動能力的腦卒中患者關(guān)注點不一樣,在滿足需求的同時應(yīng)針對不同日常生活活動能力的患者有不同的側(cè)重,以滿足其最需要的照護。
[Abstract]:Objective to develop and evaluate < 1. stroke patients at home professional care needs questionnaire > 2.; understand the home patients with stroke care professional status and demand factors, and to explore the different needs of different ADL of stroke patients at home for professional care. Methods the study was divided into two parts: the first part is the development of reliability and validity test for stroke patients at home professional care needs questionnaire: the first is a qualitative study of stroke patients at home professional care needs, select stroke patients at home to take care of the 11 and / or by purpose sampling method 7, using semi-structured interviews and Colaizzi 7 step method to collect and analyze the data. After the formation of "stroke patients at home professional care needs questionnaire > item pool, with Maslow's hierarchy of needs theory and theory of the formation of" Orem self-care of stroke patients at home professional care needs questionnaire "Draft by Delphi expert consultation on the draft questionnaire was revised form of questionnaire inquiry draft. After the formation of the pre survey questionnaire draft. Selected 318 stroke patients at home and 6 experts evaluating the reliability and validity of the questionnaire. The second part is the amount of stroke patients at home care needs professional research: in" home of brain stroke patients with professional care needs questionnaire > and Barthel index as a tool, a convenient sample of 428 home stroke patients were investigated. The package for data entry and analysis using IBM SPSS Statistics 21 software, using descriptive statistics, single factor analysis, stepwise multiple linear regression analysis of stroke patients at home care professional status and influence of demand the factors of stroke patients at home; the population variance analysis and multiple comparison of randomized block design analysis of different daily activities on each dimension of professional care needs The first part: according to the results. The difference of stroke patients at home professional care needs that 3 themes and 9 sub themes. (1) physiological needs: diet guidance, sleep guidance; (2) security needs: disease knowledge, rehabilitation guidance, medication guide, resource information, monitoring index (3;) belonging needs: return to society, professional psychological assistance. The formation of cerebral apoplexy patients in home care needs questionnaire of < >, including the direction of life care (11 items), professional knowledge and skills (11 items), sequelae, complications (12 items), social support (10 items) 4 dimensions. The reliability and validity of the questionnaire survey, the entry decision value of each entry is t3.00 (P = 0.05), the correlation between item score and total score for 0.672~0.872 (P = 0.01); the overall level of the consistency of content validity was 0.82, the average content validity was 0.97, the entry level of content validity was 0.83~1.00; exploratory factor analysis Take the 4 factors, the cumulative variance contribution rate of 83.894%; the total Cronbach's alpha coefficient, split half coefficient Guttman Spilt, the test-retest reliability was 0.987,0.919,0.988. second parts: professional home care needs of patients with Nao Zuzhong score was (126.73 + 46.58), among them, the guidance of life care dimensions (31.37 + 15.62) points, professional knowledge and skills dimensions (35.61 + 11.73) points, sequelae and complications nursing dimensions (29.30 + 15.26), social support dimensions (30.46 + 10.54). Among them, the activities of daily living, caregivers can affect the professional home care needs of patients with Nao Zuzhong score and each dimension score. Demand analysis results of randomized block design display. The guidance of life nursing professional care on severe stroke patients at home most in need of professional knowledge and skills are moderately dependent, mild dependence and without relying on the stroke patients at home are most in need of professional Conclusion 1.< care of stroke patients at home professional care needs questionnaire > good reliability and validity can be used at home with Nao Zuzhong professional care needs assessment.2. stroke patients at home professional care needs higher, marital status, activities of daily living, stroke types and caregivers are the main influencing factors. In addition, guidance life is a specialized nursing care on severe stroke patients at home need most, and professional knowledge and skills are moderately dependent, mild dependence, without relying on the home of Nao Zuzhong patients most in need of professional care, focus on stroke patients suggested that different activities of daily life are not the same, according to the different activities of daily living the patient has a different focus should be at the same time to meet the demand, to meet the need of care.

【學位授予單位】：鄭州大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R473.2

【參考文獻】

相關(guān)期刊論文 前10條

1 汪暉;官小莉;孟玲;黃海珊;;腦卒中吞咽障礙患者護理需求及影響因素調(diào)查[J];護理學雜志;2016年21期

2 羅莉;羅盛;李偉;;城市社區(qū)慢性病老年人護理服務(wù)需求及影響因素[J];中國老年學雜志;2016年19期

3 趙藝璞;胡秀英;;居家老年人護理需求的文獻回顧與分析[J];中國社會醫(yī)學雜志;2016年02期

4 劉涓;謝瑞娟;鄧峗;陳璐;周金英;蔡倩倩;;60例腦卒中偏癱患者心理需求的調(diào)查分析[J];承德醫(yī)學院學報;2016年02期

5 肖紅;王芳;張丹;姜穎;宋靜;羅云婷;胡義婷;張海燕;;腦卒中患者及照護者腦卒中知識認知狀況與護理康復需求分析[J];齊魯護理雜志;2016年07期

6 謝薇;李永紅;黃艷;;社區(qū)缺血性腦卒中患者中醫(yī)康復護理需求調(diào)查報告[J];貴陽中醫(yī)學院學報;2015年06期

7 楊榮芳;馬京華;陳海英;李冬莉;;城市社區(qū)衛(wèi)生服務(wù)機構(gòu)護理人力資源的研究現(xiàn)狀[J];社區(qū)醫(yī)學雜志;2015年12期

8 陳谷蘭;李壯苗;何瓊霞;;腦卒中患者院外延續(xù)性護理需求的質(zhì)性研究[J];齊魯護理雜志;2015年07期

9 蘭火連;;腦卒中患者社區(qū)護理需求及影響因素分析[J];中國醫(yī)藥導報;2015年02期

10 李星丹;張振香;張偉宏;;鄭州市腦卒中連續(xù)康復護理服務(wù)開展現(xiàn)狀及影響因素分析[J];中國實用護理雜志;2014年17期

相關(guān)碩士學位論文 前2條

1 李星丹;腦卒中患者連續(xù)康復護理模式的構(gòu)建[D];鄭州大學;2014年

2 付凌敏;南昌市腦卒中患者社區(qū)護理需求調(diào)查及其影響因素分析[D];南昌大學;2011年

，

本文編號：1495201