基于PEO模式的作业治疗对脑卒中照顾者的影响  

作　　者：林玲[1] 陈琪琪 苏丽丽 周颖[1] 徐乐义[1] 李海燕[1] 

机构地区：[1]温州医科大学附属第一医院,325000

出　　处：《浙江临床医学》2020年第8期1113-1115,共3页Zhejiang Clinical Medical Journal

基　　金：国家自然科学基金资助项目(81501954);浙江省温州市公益性科技计划项目(Y20190378)。

摘　　要：目的 研究基于人-环境-作业(PEO)模式的作业治疗对脑卒中照顾者的负荷、焦虑和生活质量的影响.方法 选取50例脑卒中患者及其照顾者为观察对象,设为对照组与干预组,每组各25例,分别接受常规手上肢作业治疗和基于PEO模式的作业治疗.采用改良Barthel指数(MBI)评定量表、照顾者负荷量表(CBI)、生活质量量表(SF-36)和焦虑自评量表(SAS)分别对患者的日常生活能力、照顾者负荷、照顾者生活质量和照顾者焦虑情况进行评估.结果 治疗后4周,干预组患者改良Barthel指数MBI评分高于对照组,差异具有统计学意义(P<0.05).干预组照顾者CBI除社交性负荷和情感性负荷评分与对照组无明显差异(P>0.05),其余三个维度评分均低于对照组(P<0.05),干预组SF-36除社会功能评分与对照组无明显差异(P>0.05),其余各项评分均高于对照组(P<0.05),干预组SAS评分均低于对照组(P<0.05).出院后2个月回访,干预组和对照组MBI评分均有明显提高,并且两组间差异具有统计学意义(P<0.05).CBI评分、SF-36评分和SAS评分结果均与治疗后4周结果一致.Pearson相关性分析结果显示,CBI评分与MBI评分呈负相关关系(r=-0.667,P<0.05),SAS评分与MBI评分呈负相关关系(r=-0.365,P<0.05),SF-36评分与MBI评分呈正相关关系(r=0.849,P<0.05).结论 基于PEO模式的作业治疗,对提高患者日常生活能力,减轻照顾者的大部分负荷、缓解焦虑,以及改善生活质量方面具有积极并且持续影响.Objective To observe the effects of occupational therapy based on PEO model on burden,anxiety and quality of life of stroke survivors'caregivers.Methods Fifty stroke survivors and their caregivers were selected as subjects.They were randomly divided into control group(n=25)and experimental group(n=25).Patients in experimental group participated in occupational therapy based on PEO model,while the control group accepted routine occupational therapy focused on exercise of upper extremity.Modified Barthel Index(MBI),Caregiver Burden Inventory(CBI),Short Form Health Survey(SF-36)and Self-Rating Anxiety Scale(SAS)were adopted to evaluate the ability of daily living,burden of caregivers,quality of caregivers'life and anxiety of caregivers.Results After 4 weeks,MBI score in experimental group was significantly higher than control group(P<0.05).CBI scores were significantly lower in the experimental group than control group(P<0.05)except scores of social and emotional loads(P>0.05).SF-36 scores were significantly higher in the experimental group than control group(P<0.05)except the score of social function(P>0.05).SAS score was significantly lower in the experimental group than control group(P<0.05).2 months after discharge,the followup visit showed both groups of MBI scores were significantly improved(P<0.05),and the difference between two groups was significant(P<0.05).The results of scores of CBI,SF-36 and SAS were the same as that of 4 weeks after treatment.Pearson correlation analysis showed that CBI scores were negatively correlated with MBI scores(r=-0.667,P<0.05),SAS scores were negatively correlated with MBI scores(r=-0.365,P<0.05),but SF-36 scores were positively correlated with MBI scores(r=0.849,P<0.05).Conclusion Occupational therapy based on PEO model has significant and conti nu ous impacts on enhancing the stroke patient's ability of daily living,lightening most of loads on caregiver,relieving the anxiety of caregiver,and improving the quality of caregiver's life.

关 键 词：人类-环境-作业模式 作业治疗 日常生活能力 照顾者负荷 生活质量 焦虑 

分 类 号：R47[医药卫生—护理学]