家庭跟进照料模式对老年卧床患者家庭康复效果的评价  

Evaluation of the Effect of Family Follow-up Care Model on the Family Rehabilitation of Bedridden Elderly Patients

作　　者：卢少萍[1] 任晓晓[1] 徐永能[1] 李绣球[1] 林建华[1] 黄巧[1] 肖凤霞[1] 

机构地区：[1]广东省人民医院广东省医学科学院广东省老年医学研究所,广东省广州市510080

出　　处：《中国全科医学》2015年第35期4354-4357,共4页Chinese General Practice

基　　金：广东省科技计划基金资助项目(2012B040301039);广东省医学科学技术研究基金资助项目(A2012004)

摘　　要：目的探讨家庭跟进照料模式对老年卧床患者家庭康复效果的影响。方法选择2012年10月—2013年7月在广东省人民医院出院的老年卧床患者120例,按照患者的出院时间顺序编号,奇数号为试验组,偶数号为对照组,每组各60例。试验组在出院时由医生、营养师、康复治疗师和康复专科护士根据患者的病情制定家庭康复计划,并通过家庭跟进照料来保证家庭康复计划的实施,指导照顾者减少老年卧床患者卧床时间及预防并发症的发生;对照组给予口头指导并告知患者家庭康复注意事项,定期电话随访。比较两组患者出院时及出院后3、6、9、12个月时Barthel指数评分与并发症发生情况。结果重复测量结果显示,干预措施与时间对Barthel指数评分的影响不存在交互作用(F=0.139,P=0.710);干预措施对Barthel指数评分的影响有统计学意义(F=10.272,P=0.002);时间对Barthel指数评分的影响有统计学意义(F=14.515,P<0.01)。干预12个月内压疮、尿路感染、肺炎、肌肉萎缩、便秘、尿失禁的发生率间差异均有统计学意义(P<0.01)。结论对老年卧床患者由医生、护士、康复治疗师和营养师进行评估,由经过康复专科培训的护士进行家庭跟进照料,能提高老年卧床患者的日常生活能力,减少压疮、尿路感染、肺炎、肌肉萎缩、便秘、尿失禁并发症的发生。Objective To investigate the effect of family follow-up care model on the family rehabilitation of elderly bedridden patients. Methods We enrolled 120 elderly bedridden patients who discharged from the Guangdong General Hospital from October 2012 to July 2013. According to the sequence number of discharge,we assigned the patients with odd sequence numbers into trial group and the patients with even sequence numbers into control group,with 60 patients in each group. For trial group,a family rehabilitation plan was made at discharge based on the state of illness by doctors,nutritionists,rehabilitation therapists and specialist nurses of rehabilitation,family follow-up care model was undertaken to ensure the plans being carried out,and guidance was provided to caregivers in order to reduce the bedridden time of the patients and prevent the occurrence of complications; for control group,verbal instruction about family rehabilitation was given and the matters that need attention were told to the family members of the patients,and regular telephone follow-up was conducted. Comparison was made between the two groups in Barthel score and the incidence rates of complications at discharge, and 3,6,9,12 months after discharge.Results The results of repeated measurements showed the follow results： there was no interaction effect between intervention measure and time in terms of their influence on Barthel score（ F = 0. 139,P = 0. 710）; intervention measure had significant influence on Barthel score（ F = 10. 272,P = 0. 002）; time had significant influence on Barthel score（ F = 14. 515,P 0. 01）.Within 12 months after intervention, the two groups were significantly different in pressure sores, urinary tract infection,pneumonia,muscle atrophy,constipation and urinary incontinence（ P 0. 01）. Conclusion The evaluation of bedriddenelderly patients by doctors,nurses,therapists and nutritionists and the family follow-up care model provided by nurses who have received specialist rehabilitation training can improve the

关 键 词：老年人 寄养家庭照护 康复护理 出院后医疗 日常生活活动 并发症 

分 类 号：R473.2[医药卫生—护理学]