本文選題：社區(qū)康復(fù) + 腦出血�。� 參考：《南華大學(xué)》2014年碩士論文

【摘要】：目的腦出血是一種具備高死亡率、高復(fù)發(fā)率、高致殘率特征并嚴(yán)重影響人類生存質(zhì)量的疾病。社區(qū)康復(fù)是在社區(qū)與家庭兩個(gè)層面上，為殘疾人提供的康復(fù)服務(wù)。本研究旨在觀察社區(qū)康復(fù)治療對(duì)腦出血偏癱患者服藥依從性、整體功能及生活質(zhì)量的影響，探索一種對(duì)腦出血偏癱患者行之有效的社區(qū)康復(fù)模式。 方法收集120例已出院的腦出血偏癱患者，按照隨機(jī)數(shù)字表法分為對(duì)照組（n=60）和康復(fù)組（n=60），對(duì)照組采取常規(guī)內(nèi)科治療與健康教育的方法，在此基礎(chǔ)上，干預(yù)組實(shí)施社區(qū)康復(fù)治療，干預(yù)時(shí)間均為6個(gè)月。在干預(yù)后6個(gè)月末，比較兩組患者服藥依從性。在入組時(shí)（干預(yù)前）以及干預(yù)后3個(gè)月末、6個(gè)月末采用臨床神經(jīng)功能缺損程度評(píng)分量表（NIM）、功能綜合評(píng)定量表（FCA）、改良Barthel指數(shù)評(píng)定量表（MBI）及生活質(zhì)量綜合評(píng)定問(wèn)卷（GQOL-74）對(duì)兩組患者進(jìn)行評(píng)價(jià)。 結(jié)果 1.在干預(yù)過(guò)程中，對(duì)照組失訪5例，失訪率為8.33%，康復(fù)組失訪3例，失訪率為5.00%，兩組失訪率比較，差異無(wú)顯著性（χ2=1.69, P0.05） 2.康復(fù)組干預(yù)后6個(gè)月末服藥依從率明顯高于對(duì)照組，差異有顯著性（χ2=9.57, P 0.05）。 3.對(duì)照組干預(yù)后6個(gè)月末NIM評(píng)分低于干預(yù)前（P0.05），但干預(yù)后3個(gè)月末無(wú)影響（P0.05）；康復(fù)組干預(yù)后3個(gè)月末、6個(gè)月末NIM評(píng)分均較干預(yù)前減少（P0.01），且干預(yù)后6個(gè)月末NIM評(píng)分低于3個(gè)月末（P0.01）；兩組干預(yù)前NIM評(píng)分比較，差異無(wú)顯著性（P0.05），但康復(fù)組干預(yù)后3個(gè)月末、6個(gè)月末NIM評(píng)分明顯低于同期對(duì)照組（P0.05,0.01）。 4.對(duì)照組干預(yù)后6個(gè)月末運(yùn)動(dòng)功能評(píng)分高于干預(yù)前（P0.05），但干預(yù)后3個(gè)月末無(wú)影響（P0.05）；康復(fù)組干預(yù)前后運(yùn)動(dòng)功能評(píng)分逐漸升高，各時(shí)間點(diǎn)之間的差異均有顯著性（P0.05或0.01）；兩組干預(yù)前運(yùn)動(dòng)功能評(píng)分的差異無(wú)顯著性（P0.05），但康復(fù)組干預(yù)后3個(gè)月末、6個(gè)月末運(yùn)動(dòng)功能評(píng)分較同期對(duì)照組增加（P0.05）。 5.對(duì)照組干預(yù)后6個(gè)月末FCA評(píng)分較干預(yù)前增加（P0.05），但干預(yù)后3個(gè)月末無(wú)影響（P0.05）；康復(fù)組干預(yù)前后FCA評(píng)分呈逐漸升高趨勢(shì)，且相互之間比較，差異均有顯著性（P0.05或0.01）；兩組干預(yù)前FCA評(píng)分相比，差異無(wú)統(tǒng)計(jì)學(xué)意義（P0.05），然而，，康復(fù)組干預(yù)后3個(gè)月末、6個(gè)月末FCA評(píng)分顯著高于同期對(duì)照組（P0.05）。 6.對(duì)照組干預(yù)后6個(gè)月末MBI評(píng)分明顯高于干預(yù)前（P0.05），但干預(yù)后3個(gè)月末無(wú)影響（P0.05）；康復(fù)組干預(yù)前后MBI評(píng)分逐漸升高，且各時(shí)間點(diǎn)之間比較，差異均有顯著性（P0.05或0.01）；兩組患者干預(yù)前MBI評(píng)分比較，差異無(wú)顯著性（P0.05），但康復(fù)組干預(yù)后3個(gè)月末、6個(gè)月末MBI評(píng)分明顯高于對(duì)照組同期（P0.05）。 7.兩組患者干預(yù)前軀體功能、心理功能、社會(huì)功能、物質(zhì)生活以及總體生活質(zhì)量GQOL-74評(píng)分比較，差異均無(wú)顯著性（P0.05）；康復(fù)組干預(yù)后3個(gè)月末、6個(gè)月末GQOL-74各維度得分顯著高于同期對(duì)照組（P0.05）。 結(jié)論社區(qū)康復(fù)有助于提高腦出血偏癱患者的服藥依從性，促進(jìn)神經(jīng)功能恢復(fù)，并改善生活質(zhì)量。
[Abstract]:Objective intracerebral hemorrhage is a disease with high mortality, high recurrence rate, high disability rate and serious impact on human quality of life. Community rehabilitation is a rehabilitation service for the disabled at both community and family level. The purpose of this study was to observe the effects of community rehabilitation on drug compliance, overall function and quality of life of hemiplegic patients with cerebral hemorrhage, and to explore an effective community rehabilitation model for hemiplegic patients with cerebral hemorrhage. Methods 120 patients with cerebral hemorrhage hemiplegia who had been discharged from the hospital were randomly divided into two groups: control group (n = 60) and rehabilitation group (n = 60). The control group received routine medical treatment and health education. On the basis of this, the intervention group was treated with community rehabilitation. The intervention time was 6 months. At the end of 6 months after intervention, the compliance of the two groups was compared. Clinical Neurologic impairment scale (NIM), functional Comprehensive Assessment scale (FCA), modified Barthel Index scale (MBI) and quality of Life questionnaire (GQOL-74) were used at the time of entry (before intervention) and at the end of 3 months and 6 months after intervention. Two groups of patients were evaluated. Result 1. In the course of intervention, there were 5 cases in the control group and 8.33% in the control group, and 3 cases in the rehabilitation group and 5.00% in the rehabilitation group. There was no significant difference between the two groups (蠂 2, 1.69, P0.05). The compliance rate of rehabilitation group at the end of 6 months after intervention was significantly higher than that of control group (蠂 2 9.57, P 0.05). In the control group, the NIM score at the end of 6 months after intervention was lower than that before intervention (P0.05), but there was no effect at the end of 3 months after intervention (P0.05), and the NIM score of rehabilitation group at the end of 3 months and 6 months after intervention was lower than that before intervention (P0.01), and the score of NIM at the end of 6 months after intervention was lower than that before intervention (P0.01). There was no significant difference in NIM score between the two groups before intervention (P0.05), but the NIM score of rehabilitation group was significantly lower than that of control group at the end of 3 months and 6 months after intervention (P0.05 鹵0.01). The motor function score of the control group was higher at the end of 6 months than that of before intervention (P0.05), but had no effect at the end of 3 months after intervention (P0.05), and the score of motor function in rehabilitation group increased gradually before and after intervention, and the difference between each time point was significant (P0.05 or 0.01). There was no significant difference in motor function score between the two groups before intervention (P0.05), but the motor function score of rehabilitation group increased at the end of 3 months and 6 months after intervention compared with that of control group (P0.05). In the control group, the FCA scores increased at the end of 6 months after intervention (P0.05), but had no effect at the end of 3 months after intervention (P0.05), and the scores of FCA in rehabilitation group increased gradually before and after intervention, and there were significant differences between the two groups (P0.05 or 0.01). There was no significant difference in FCA score between the two groups before intervention (P0.05), however, the FCA score of rehabilitation group was significantly higher than that of control group at the end of 3 months and 6 months after intervention (P0.05). The MBI scores in the control group were significantly higher at the end of 6 months than before (P0.05), but had no effect at the end of 3 months after intervention (P0.05), and the scores of MBI in the rehabilitation group increased gradually before and after intervention, and there were significant differences between the two groups (P0.05 or 0.01). There was no significant difference in MBI score between the two groups before intervention (P0.05), but the MBI score of rehabilitation group was significantly higher than that of control group at the end of 3 months and 6 months after intervention (P0.05). There was no significant difference in the scores of physical function, psychological function, social function, material life and overall quality of life between the two groups before intervention (P0.05). The scores of each dimension of GQOL-74 in rehabilitation group were significantly higher than those in control group at the end of 3 and 6 months after intervention (P0.05). Conclusion Community rehabilitation can improve the compliance of patients with cerebral hemorrhage and hemiplegia, promote the recovery of nerve function and improve the quality of life.
【學(xué)位授予單位】：南華大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R743.34

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