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樊 巍,夏 楠,肖少华,陆 敏.脑卒中患者出院计划探索:5年横断面生存质量调查与影响因素分析[J].中国康复医学杂志,2020,(7):837~842
脑卒中患者出院计划探索:5年横断面生存质量调查与影响因素分析    点此下载全文
樊 巍  夏 楠  肖少华  陆 敏
华中科技大学同济医学院附属同济医院康复医学科,湖北省武汉市,430022
基金项目:
DOI:10.3969/j.issn.1001-1242.2020.07.013
摘要点击次数: 104
全文下载次数: 52
摘要:
      摘要 目的:探索影响脑卒中患者出院后生存质量的因素,并以此调整出院计划对这些因素进行干预,从而提高患者出院生存质量。 方法:电话随访2013年出院脑卒中病例29例,采集患者出院时的Barthel指数(BI),并使用BI和世界卫生组织残疾评定量表(WHODAS2.0)对该29例患者进行电话随访调查,分别评估其日常活动能力和居家生活质量,并进行数据对比分析。初步结果分析后,对BI评分变化较大的11例患者进行二次电话随访,对BI分数明显升高和显著下降的两组人群进行影响因素分析。 结果:5年后随访BI较出院时有显著提高(P<0.001),其中4例减少(10±7.1),1例持平,24例提高。WHO DAS2.0各领域得分中“与生活相关的各项活动”分值明显高于其他领域。二次随访结果显示家庭照顾情况、患者的心态、是否主动康复训练,以及娱乐活动的内容是主要的影响因素。 结论:为提高脑卒中患者回归后的生存质量,出院计划应对下述因素进行调整:①关注患者日常生活活动(ADL)能力,通过团队合作,定义各专业组医疗职责,将ADL训练落到实处;②加强宣教,包括疾病、心理健康,以及康复知识的宣教;③开展娱乐活动,避免久卧、久坐、久站。
关键词:出院计划  脑卒中  生存质量  日常生活活动
The discharge planning for patients with stroke: A cross-sectional study to analysis the factors that influenced the quality of life    Download Fulltext
Department of Rehabilitation Medicine, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan,430030
Fund Project:
Abstract:
      Abstract Objective:To define the factors that may influence the quality of life of patients with stroke after discharge, and to revise discharge planning based on these factors, which may improve their quality of life after discharge. Method:Telephone-interviewed 29 cases who were assessed Barthel Index (BI) and discharged in 2013. We assessed BI (which represent the ability of daily living) and WHO Disability Assessment Schedule 2.0 (WHODAS 2.0, which represent the quality of life), and went a comparison. After the initial analyses, we picked up the cases which have a massive change of BI from discharge to now, and made second telephone-interview to investigate what caused the change. Result:Present BI values of 29 cases that assessed in 2018 were significantly higher than those in 2013 (P<0.01), in which 4 cases decreased (10±7.1), one retained and 24 increased. Life activities, which is one of the six domains in WHODAS2.0, was much higher than other domains. The results of the second telephone-interview revealed that the home care status, leisure activities, patients’ mental state and attitude towards rehabilitation were the main factors that influenced the outcome. Conclusion:In order to improve the living status of patients with stroke after they went back to the community, discharge planning should involve the content as followed: ①Focus on their ability to activities of daily living,define the role of each medical team member specifically and improve ADL through teamwork;②Emphasize education of patients and caregivers, including patients’ medical condition, mental health, and knowledge of rehabilitation;③Advice to leisure activities and avoid keeping a position for long time should be given.
Keywords:discharge planning  stroke  quality of life  activities of daily
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