基于信息-动机-行为技巧模型的延续护理在脑卒中溶栓患者中的应用  

Effects of Information-Motivation-Behavioral Skill Model-based continuing care on stroke patients after thrombolytic therapy

作　　者：王萍[1] 裴静[1] 孔祥锋[1] 常海霞[1] 高华[1] 祁玉霞 热比古丽 杜琳[1] 张丽娟 Wang Ping;Pei Jing;Kong Xiangfeng;Chang Haixia;Gao Hua;Qi Yuxia;Re Biguli;Du Lin;Zhang Lijuan(Department of Neurology, the Fifth Hospital Affiliated of Xinjiang Medical University, Urumqi 830011, China)

机构地区：[1]新疆医科大学第五附属医院神经内科,乌鲁木齐830011

出　　处：《中国实用护理杂志》2019年第16期1201-1206,共6页Chinese Journal of Practical Nursing

基　　金：新疆维吾尔自治区自然科学基金计划(2018D01C304).

摘　　要：目的探讨基于信息-动机-行为技巧模型(IMB)的延续护理对脑卒中溶栓患者神经功能和生命质量的改善效果。方法将拟行溶栓治疗的缺血性脑卒中患者按照随机数字表法分为IMB组和对照组,每组35例,对照组接受常规溶栓护理,IMB组在对照组基础上给予基于IMB的延续性护理方案。护理干预6个月后,采用美国国立卫生研究院卒中量表(NIHSS)和改良Rankin量表(MRS)评价患者神经功能,采用Fugl-Meyer运动功能评定量表(FMA)和Barthel指数(BI)评价患者运动功能,采用简明健康调查量表(SF-36)评价患者生命质量。结果干预前,2组患者NIHSS、MRS、FMA、BI、SF-36得分比较差异无统计学意义(P>0.05)。干预3、6个月后,IMB组NIHSS、MRS得分分别为(7.84±2.20)、(5.00±1.60)分和(3.48±0.84)、(3.07±0.69)分,明显低于对照组的(9.75±1.82)、(8.21±1.37)分和(4.06±1.08)、(3.91±0.71)分,差异有统计学意义(t=2.417~8.647,P<0.01或0.05);干预1、3、6个月后,IMB组FMA分别为(65.86±5.67)、(76.41±8.47)、(78.79±8.58)分,BI分别为(46.29±7.29)、(58.09±10.20)、(67.50±9.44)分,SF-36分别为(33.13±4.64)、(43.09±6.70)、(49.83±8.56)分,明显高于对照组的(58.53±8.92)、(64.47±7.56)、(71.81±8.90)分,(42.47±5.67)、(48.74±5.39)、(56.03±6.55)分和(29.63±4.06)、(35.91±5.93)、(41.02±9.05)分,差异有统计学意义(t=2.333~5.972,P<0.01或0.05)。重复测量方差分析显示,IMB组和对照组NIHSS、MRS、FMA、BI、SF-36得分存在组间和时间的交互作用(F=13.556~133.994,P<0.01)。结论以IMB为基础制订的延续性护理方案,可以促进脑卒中溶栓患者后期神经功能恢复,提高患者生命质量。Objective To investigate the application value of Information-Motivation-Behavioral Skill Model (IMB)-based continuing care on the recovery of nerve function and life quality in patients with stroke after thrombolytic therapy. Methods Stroke patients who underwent thrombolytic therapy were randomly assigned to IMB group(35 cases) and control group(35 cases) according to the method of random number table. The control group recieved routine thrombolysis nursing, IMB group was given IMB-based continuing care. After six months of intervention, nerve function was evaluated by National Institute of Health Stroke Scale(NIHSS) and Modified Rankin Scale(MRS), the active ability was performed by Fugl-Meyer Assessment Scale(FMA) and Barthel Index(BI), the quality of life was assessed by the item short from health survey(SF-36), respectively. Results Before intervention, the scores of NIHSS, MRS, FMA, BI, SF-36 between two groups was no significant difference (P>0.05). After three and six months of nursing, the NIHSS, MRS was (7.84±2.20),(5.00±1.60) points and (3.48±0.84),(3.07±0.69) points in IMB group, and (9.75±1.82),(8.21±1.37) points and (4.06±1.08),(3.91±0.71) points in control group, there was significant difference between two groups (t =2.417-8.647, P<0.01 or 0.05). After one, three and six months of intervention, FMA was (65.86±5.67),(76.41±8.47),(78.79±8.58) points, BI was (46.29±7.29),(58.09±10.20),(67.50±9.44) points, SF-36 was (33.13±4.64),(43.09±6.70),(49.83±8.56) points in IMB group,(58.53±8.92),(64.47±7.56),(71.81±8.90) points,(42.47±5.67),(48.74±5.39),(56.03±6.55) points and (29.63±4.06),(35.91±5.93),(41.02±9.05) points in control group, there was significant difference between two groups (t =2.333-5.972, P< 0.05). Moreover, in the repeated measures ANOVA showed the differences of NIHSS, MRS, FMA, BI, SF-36 were statistically significant for the group by time interaction(F=13.556-133.994, P<0.05). Conclusions IMB-based continuing care can promotes the recovery of nerve function and

关 键 词：生活质量 卒中 信息-动机-行为技巧模型 延续护理 溶栓 

分 类 号：R473.74[医药卫生—护理学]