脑心健康管理师对脑卒中患者管理效果影响因素研究  

Study on effect and influencing factors for management by brain and heart health managers on stroke patients

作　　者：陈雪梅[1] 李丽[1] 伍燕[1] 段燕[1] Chen Xuemei;Li Li;Wu Yan;Duan Yan(The First People's Hospital of Yibin,Yibin,Sichuan,644000,China)

机构地区：[1]四川省宜宾市第一人民医院,四川宜宾644000

出　　处：《西南国防医药》2021年第6期519-522,共4页Medical Journal of National Defending Forces in Southwest China

基　　金：宜宾市卫健委2020年科研课题项目。

摘　　要：目的探索全方位脑心健康管理模式对脑卒中患者预后的效果极其影响因素。方法随机选取200例在宜宾市第一人民医院入院的脑卒中患者,根据入院后脑心健康管理师介入对患者进行全方位健康管理分为对照组(88例)和观察组(112例),比较两组患者预后效果及生活质量影响因素。结果所有入组患者入院时的出血情况差异显著(P <0.05),其余基线信息无显著差异。脑心健康管理师全方位健康管理介入后两组各指标情况在入院时差异不显著,随着脑心健康管理介入,观察组患者的神经受损情况在出院后6月、12月显著改善,日常生活能力在出院后6月、12月评分>80分的病例数显著高于对照组(P=0.030)。两组患者的焦虑和抑郁发病率也显著降低,观察组脑卒中6月内复发率显著低于对照组(P <0.05)。建立卒中档案(OR=2.86,1.63~5.11,P <0.01),加入卒中管理群组(OR=2.92,1.48~5.83,P <0.05),短暂性脑缺血发作(OR=2.33,1.24~4.25,P <0.01),具备专业陪护(OR=0.32,0.07~0.84,P=0.019)是出院后患者生活质量的影响因素;加入卒中管理群组(OR=2.51,1.09~5.89,P <0.05)和具有专业陪护(OR=2.51,0.074~0.759,P=0.03)是患者出院后生活质量的独立相关因素。结论脑心健康管理师全方位健康管理模式的介入,可显著改善患者预后,提高患者生活质量,关键在于建立完善的卒中档案,定制个性化康复方案,并且通过建立就地卒中管理群组和长期的随访监测修订患者康复计划。Objective To explore the effect and influencing factors for comprehensive brain and heart health management mode on the prognosis of stroke patients. Methods A total of 200 patients with stroke admitted to the First People’s Hospital of Yibin were randomly selected and divided into a control group(n=88) and an observation group(n=112) according to post-admission intervention of comprehensive health management by the brain and heart health managers. The prognostic effect and influencing factors for life quality were compared between the two groups. Results There was a significant difference in hemorrhage among all enrolled patients(P=0.005) at admission, and no significant difference in other baseline information. There was no significant difference in indexes between the two groups at admission. With the intervention of comprehensive health management by the brain and heart health managers, the neurological impairment was significantly improved among the patients of the observation group at six and 12 months after discharge, and the patients with Barthel index above 80 were significantly more than that of the control group(P=0.030)at six and 12 months after discharge. The incidence of anxiety and depression of both groups also decreased significantly, and the recurrence rate of stroke among patients of the observation group was significantly lower than that of the control group within six months(P=0.005). For discharged patients, the influencing factors for their life quality included establishment of stroke records(OR=2.86, 1.63-5.11, P=0.001), joining into the stroke management group(OR=2.92, 1.48-5.83, P=0.002), transient ischemic attack(OR=2.33, 1.24-4.25, P=0.010) and special nursing care(OR=0.32, 0.07-0.84, P=0.019);and joining into the stroke management group(OR=2.51, 1.09-5.89, P=0.03) and special nursing care(OR=2.51, 0.074-0.759, P=0.03) were independent factors associated with their life quality. Conclusion The intervention of comprehensive health management mode by the brain and heart health manager

关 键 词：脑卒中 脑心健康管理师 神经受损情况评分 日常生活能力指数、焦虑自评量表 抑郁自评量表 

分 类 号：R743.3[医药卫生—神经病学与精神病学]