自我效能干预对合并脑白质病变的急性缺血性卒中患者日常生活活动能力和转归的影响  

Effects of self-efficacy intervention on activities of daily living and outcomes in patients with acute ischemic stroke complicated with white matter lesions

作　　者：姜桂萍[1] 武彦斌 刘芸芸[1] 李敏[1] 伏兵[1] 杜娟[1] Jiang Guiping;Wu Yanbin;Liu Yunyun;Li Min;Fu Bing;Du Juan(Department of Neurology,the Second People 's Hospital of Lianyungang,Lianyungemg 222023,China;Department of Rehabilitation,the Second People's Hospital of Lianyungang,Lianyungang 222023,China)

机构地区：[1]连云港市第二人民医院神经内科,222023 [2]连云港市第二人民医院康复科,222023

出　　处：《国际脑血管病杂志》2019年第1期17-20,共4页International Journal of Cerebrovascular Diseases

基　　金：连云港市社会发展项目(SH1538);江苏大学医学临床科技发展基金(JLY20160I27).

摘　　要：目的探讨自我效能干预对合并脑白质病变(white matter lesions,WMLs)的急性缺血性卒中患者日常生活活动能力和转归的影响。方法前瞻性纳入2016年3月至2017年6月期间在连云港市第二人民医院神经内科住院的合并WMLs的急性缺血性卒中患者,随机分为干预组与对照组。对照组采用常规治疗及护理,干预组在对照组基础上实施自我效能干预,随访至发病后90 d。应用卒中自我效能量表(Stroke Self-Efficacy Questionnaire,SSEQ)评估患者自我效能水平,采用巴塞尔指数(Barthel index,BI)评价患者日常生活活动能力,应用美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)和改良Rankin量表(modified Rankin Scale,mRS)评估患者转归。结果干预组90 d时SSEQ评分显著高于入院时及对照组90 d时(P均<0.01)。干预组90 d时BI显著高于对照组[(66.51±22.35)分对(58.41±23.17)分;t=3.473,P=0.001],NIHSS评分显著低于对照组[(5.51±2.98)分对(6.95±2.94)分;t=-2.094,P=0.040],而且转归良好(mRS评分0~2分)的患者比例显著显著高于对照组(73.7%对56.6%;χ^2=4.896,P=0.027)。结论对于合并WMLs的急性缺血性卒中患者,积极的自我效能干预可提高日常生活活动能力,并有助于改善患者转归。Objective To investigate the effects of self-efficacy intervention on activities of daily living and outcomes in patients with acute ischemic stroke complicated with white matter lesions(WML).Methods From March 2016 to June 2017,patients with acute ischemic stroke complicated with WML admitted to the Departments of Neurology,the Second People's Hospital of Lianyungang were enrolled prospectively.They were randomly divided into intervention group and control group.The control group received routine treatment and nursing,and the intervention group implemented self-efficacy intervention on the basis of the control group.They were followed up until 90 d after onset.Stroke Self-Efficiency Questionnaire(SSEQ)was used to assess the stroke self-efficacy level.The Barthel Index(BI)was used to assess the activities of daily living(ADL)of the patients.The National Institutes of Health Stroke Scale(NIHSS)and the modified Rankin Scale(mRS)were used to assess the outcomes of the patients.Results The SSEQ scores in the intervention group were significantly higher than those at the time of admission and in the control group at 90 d(all P<0.01).The BI in the intervention group was significantly higher than that in the control group(66.51±22.35 vs.58.41±23.17;t=3.473,P=0.001),and the NIHSS score was significantly lower than the control group(5.51±2.98 vs.6.95±2.94;t=-2.094,P=0.040),and the proportion of patients with good outcomes(mRS score 0-2)was significantly higher than that of the control group(73.7%vs.56.6%;χ^2=4.896,P=0.027).Conclusion For patients with acute ischemic stroke complicated with WML,active self-efficacy intervention could improve the ADL and it was helpful to improve the outcomes of patients.

关 键 词：卒中 脑缺血 自我效能 白质 日常生活活动 治疗结果 

分 类 号：R473.74[医药卫生—护理学]