中国现代神经疾病杂志 ›› 2020, Vol. 20 ›› Issue (7): 648-654. doi: 10.3969/j.issn.1672-6731.2020.07.016

• 临床研究 • 上一篇    下一篇

2 配偶同步回授法对缺血性卒中偏瘫患者康复锻炼依从性和健康素养的影响分析

蔡, 高敏茹, 刘琼   

  1. 200025 上海交通大学医学院附属瑞金医院神经内科
  • 收稿日期:2020-07-13 出版日期:2020-07-25 发布日期:2020-07-24
  • 通讯作者: 刘琼,Email:lq21391@rjh.com.cn

Effect of spouse synchronous feedback on rehabilitation compliance and health literacy of ischemic stroke hemiplegia patients

CAI Ying, GAO Min-ru, LIU Qiong   

  1. Department of Neurology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
  • Received:2020-07-13 Online:2020-07-25 Published:2020-07-24

摘要:

目的 探讨配偶同步回授法对缺血性卒中偏瘫患者康复锻炼依从性和健康素养的影响。方法 2018年6月至2019年10月诊治的缺血性卒中偏瘫患者随机接受常规健康教育(对照组,40例)和在常规健康教育基础上实施配偶同步回授法健康教育(试验组,40例),分别采用自行设计的康复锻炼依从性问卷、中国公民健康素养调查问卷、美国国立卫生研究院卒中量表(NIHSS)、徒手肌力测定(MMT)、Fugl-Meyer评价量表(FMA)、改良Barthel指数(mBI)和世界卫生组织生活质量评估简表(WHOQoL-BREF)对康复锻炼依从性、健康素养,以及神经功能、肌力、肢体功能、日常生活活动能力和生活质量进行评价。结果 无论是常规健康教育还是在常规健康教育基础上实施配偶同步回授法健康教育,经健康教育干预后两组患者康复锻炼依从性(P=0.006)、康复锻炼效果监测依从性(P=0.000)和主动寻求建议依从性(P=0.000)评分,健康知识(P=0.011)、健康信念(P=0.000)、健康行为(P=0.000)和健康技能(P=0.000)评分,MMT(P=0.000)、FMA(P=0.000)和ADL(P=0.000)评分,以及生理维度(P=0.000)、心理维度(P=0.000)、环境维度(P=0.000)和社会关系维度(P=0.000)等项参数均高于干预前,而NIHSS评分低于干预前(P=0.000);试验组除NIHSS评分降低(P=0.000),其余各项参数均高于对照组(P=0.000)。结论 缺血性卒中偏瘫患者在常规健康教育基础上实施配偶同步回授法健康教育,可促进患者康复锻炼依从性和健康素养,减轻神经功能缺损程度,改善肌力、肢体功能和日常生活活动能力,提高生活质量。

关键词: 卒中, 脑缺血, 偏瘫, 康复, 健康教育

Abstract:

Objective To explore the effect of spouse synchronous feedback on compliance of rehabilitation exercise and health literacy of ischemic stroke hemiplegic patients. Methods From June 2018 to October 2019, 80 ischemic stroke hemiplegic patients admitted in the ward were recruited in this study. They were divided into 2 groups, i.e. 40 cases in experimental group and 40 cases in control group randomly. The control group received routine health education, while the experimental group received spouse synchronous feedback health education based on routine health education. The rehabilitation compliance score, health literacy score, neurological deficit score, muscle strength score, limb function score, ability of daily living score and quality of life score of 2 groups were recorded for comparison. Results After health education intervention, the compliance of rehabilitation exercise (P=0.006), the compliance of monitoring the effect of rehabilitation exercise (P=0.000) and the compliance of actively seeking advice (P=0.000) scores, health knowledge (P=0.011), health belief (P=0.000), health behavior (P=0.000) and health skills (P=0.000) scores, MMT (P=0.000), FMA (P=0.000) and ADL (P=0.000) scores, as well as physiological dimension (P=0.000), psychological dimension (P=0.000), environmental dimension (P=0.000) and social relationship dimension (P=0.000) were higher than before intervention, while NIHSS score was lower than before intervention (P=0.000). Except NIHSS score was decreased in the experimental group (P=0.000), the other parameters were higher than those in the control group (P=0.000, for all). Conclusions In the health education of ischemic stroke patients with hemiplegia, the method of spouse synchronous feedback can enhance the compliance of rehabilitation exercise and health literacy of the patients, help to reduce nerve function damage, improve muscle strength, limb function and daily living ability, and improve the quality of living.

Key words: Stroke, Brain ischemia, Hemiplegia, Rehabilitation, Health education