脑卒中患者早期运动康复护理方案的构建  

Construction of early motor rehabilitation nursing program based on Modified Barthel Index grading for stroke patients

作　　者：金静芬[1] 李梅 陈圆圆[2] 陈金花[2] 王俭苗 张玉萍[1] 杨红燕[2] JIN Jingfen;LI Mei;CHEN Yuanyuan;CHEN Jinhua;WANG Jianmiao;ZHANG Yuping;YANG Hongyan

机构地区：[1]浙江大学医学院附属第二医院护理部,杭州市310009 [2]浙江大学医学院附属第二医院神经内科,杭州市310009

出　　处：《中华护理杂志》2020年第9期1360-1365,共6页Chinese Journal of Nursing

基　　金：国家自然科学基金面上项目(81871839)。

摘　　要：目的构建基于改良Barthel指数分级的脑卒中患者早期运动康复护理方案,用于指导临床护士对脑卒中患者实施早期运动康复,为制订脑卒中康复护理指南提供依据。方法在文献研究和专家小组会议的基础上,构建脑卒中患者早期运动康复护理方案草案。采用德尔菲法进行2轮专家函询,按照专家函询意见对条目进行修改。结果第1轮函询了17名专家,有效回收率为94.12%;第2轮函询了16名专家,有效回收率为100%。专家权威系数为0.90,第2轮各条目变异系数为0~0.24,肯德尔和谐系数为0.226(P<0.001),重要性赋值均数为4.13~5.00,最终形成基于改良Barthel指数分级的早期运动康复护理方案,包括5项一级指标(完全依赖、重度依赖、中度依赖、轻度依赖、生活基本自理)、47项二级指标。结论本研究形成的脑卒中患者早期运动康复护理方案科学可靠,可以为开展脑卒中运动康复护理研究及实践提供借鉴。Objective An early motor rehabilitation nursing program for stroke patients based on Modified Barthel Index(MBI) grading was constructed to guide clinical nurses to perform precise early motor rehabilitation for stroke patients,in order to provide a basis for developing guidelines for rehabilitation nursing care of stroke patients. Methods Based on literature review and expert meetings,a draft of motor rehabilitation nursing program for stroke patients was constructed. The Delphi method was used to conduct 2 rounds of expert consultations to determine the early rehabilitation nursing program for stroke patients. Results In the first round,17 experts were consulted,and the response rate was 94.12%;in the second round,16 experts were consulted,and the response rate was 100%. The expert authority coefficient was 0.90. After 2 rounds,the coefficient of variation of items was 0 to 0.24,Kendall’s coefficient was 0.226(P<0.001) and the importance value was 4.13 to 5.00. Finally,an early motor rehabilitation nursing program classified by MBI was formed,including 5 first-level indicators(fully dependent,heavily dependent,moderately dependent,mildly dependent and basic self-care) and 47 second-level indicators(rehabilitation). Conclusion The nursing program constructed in this study is reliable and scientific,and it can provide references for the research and practice of rehabilitation training for stroke patients.

关 键 词：脑卒中 运动康复 早期康复 护理 德尔菲技术 

分 类 号：R473.74[医药卫生—护理学]