發(fā)布時(shí)間：2018-03-26 17:24

  本文選題：腦卒中　切入點(diǎn)：居家護(hù)理　出處：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:1.通過對(duì)出院腦卒中患者與家屬進(jìn)行居家護(hù)理需求調(diào)查,了解腦卒中患者與家屬的居家護(hù)理需求現(xiàn)狀并分析其影響因素。2.在前期現(xiàn)狀調(diào)查的基礎(chǔ)上結(jié)合時(shí)機(jī)理論制定一套符合腦卒中患者與家屬需求的居家護(hù)理干預(yù)方案。3.探討方案在中青年腦卒中患者與家屬中的應(yīng)用效果。方法:1.調(diào)查研究:采用便利抽樣法于2016年3-5月對(duì)山西省某3所三甲醫(yī)院神經(jīng)內(nèi)科的待出院腦卒中患者與家屬各205名進(jìn)行現(xiàn)狀調(diào)查,以自制腦卒中患者與家屬居家護(hù)理需求調(diào)查問卷為調(diào)查工具,了解腦卒中患者與家屬的居家護(hù)理需求現(xiàn)狀及其影響因素。2.干預(yù)研究:采用便利抽樣法于2016年6月選取山西省某三甲醫(yī)院的中青年腦卒中患者與家屬各110名作為研究對(duì)象進(jìn)行為期6個(gè)月的居家護(hù)理干預(yù)研究,根據(jù)隨機(jī)數(shù)字表將其分為干預(yù)組和對(duì)照組各55名,干預(yù)組在常規(guī)護(hù)理與隨訪的基礎(chǔ)上采取以時(shí)機(jī)理論為基礎(chǔ)的居家護(hù)理;對(duì)照組接受神經(jīng)內(nèi)科常規(guī)護(hù)理與隨訪,分別于出院時(shí)、出院3個(gè)月及6個(gè)月,對(duì)干預(yù)效果進(jìn)行評(píng)價(jià)。結(jié)果:1.調(diào)查結(jié)果(1)腦卒中患者的居家護(hù)理需求總得分為3.25±2.89。單因素方差分析結(jié)果顯示:年齡、性別、婚姻狀況、文化程度、工作狀況、腦卒中類型、卒中次數(shù)、有無后遺癥、出院后治療及日常生活活動(dòng)能力是其影響因素,將單因素方差分析有意義的變量引入多元線性回歸,結(jié)果顯示:日常生活活動(dòng)能力、后遺癥、文化程度是其主要影響因素(F=67.02,P0.001)。(2)腦卒中家屬的居家護(hù)理需求總得分為3.24±0.35。單因素方差分析結(jié)果顯示:性別、婚姻狀況、與患者關(guān)系、是否與患者同住是其影響因素,將單因素方差分析有意義的變量引入多元線性回歸,結(jié)果顯示:性別、婚姻狀況、與患者關(guān)系是其主要影響因素(F=17.59,P0.001)。2.干預(yù)結(jié)果(1)干預(yù)前兩組患者的自我護(hù)理能力和自我效能水平經(jīng)兩獨(dú)立樣本t檢驗(yàn),結(jié)果顯示:差別無統(tǒng)計(jì)學(xué)意義(P0.05)。干預(yù)后,干預(yù)組患者自護(hù)能力在各測量點(diǎn)上均高于對(duì)照組(P0.05),重復(fù)測量方差分析結(jié)果顯示:差別有統(tǒng)計(jì)學(xué)意義(P0.001)。干預(yù)6個(gè)月后,干預(yù)組患者自我效能水平高于對(duì)照組,差別有統(tǒng)計(jì)學(xué)意義(P0.05)。(2)干預(yù)前兩組家屬的照顧能力和自我效能水平經(jīng)兩獨(dú)立樣本t檢驗(yàn),結(jié)果顯示:差別無統(tǒng)計(jì)學(xué)意義(P0.05)。干預(yù)后,干預(yù)組家屬照顧能力在各測量點(diǎn)上均高于對(duì)照組(P0.05),重復(fù)測量方差分析結(jié)果顯示:差別有統(tǒng)計(jì)學(xué)意義(P0.001)。干預(yù)6個(gè)月后,干預(yù)組家屬自我效能水平高于對(duì)照組,差別有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:1.腦卒中患者居家護(hù)理需求主要受日常生活活動(dòng)能力、后遺癥和文化程度的影響,腦卒中家屬居家護(hù)理需求主要受性別、婚姻狀況和與患者關(guān)系的影響,因此,對(duì)此人群進(jìn)行居家護(hù)理干預(yù)時(shí)應(yīng)注意這些因素的影響。2.以時(shí)機(jī)理論為基礎(chǔ)的居家護(hù)理能更有效地提高中青年腦卒中患者的自護(hù)能力和其家屬的照顧能力,并改善兩者的自我效能。
[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 鹵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 鹵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.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R473.2

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