可视化自主学习法应用于老年首次脑卒中患者的居家护理教育  

Application of visualized autonomous learning method in home nursing education of elderly patients with first stroke

作　　者：易小林[1] 毛惠娜[1] 朱卉娟[1] 张杰彪 Yi Xiaolin;Mao Huina;Zhu Huijuan;Zhang Jiebiao(General Surgery,Zhujiang Hospital of Southern Medical University,510282,China)

机构地区：[1]南方医科大学珠江医院普通外科,510282

出　　处：《国际护理学杂志》2021年第13期2483-2488,共6页international journal of nursing

基　　金：广州市海珠区2017年度科普专项(海科工商信计2018-62);南方医科大学护理重点科研项目(Z2017003)。

摘　　要：目的探讨可视化自主学习法对老年首次脑卒中患者生活质量和无医学教育背景家属居家护理技能水平的影响。方法采用整群抽样法,2016年6月14日、7月12日、8月16日共3次调查南方医科大学珠江医院神经内科、神经外科多次住院老年脑卒中自理能力中重度依赖患者和无医学教育背景家属105对,在10个居家护理项目中遴选家属需求量最高的7个培训项目。录制通俗易懂的居家护理技能短视频,每个视频≤8 min,重点环节采用特写镜头和字幕提示。采集400对老年首次脑卒中住院患者及其家属,数字随机对照法分为试验组和对照组各200例。试验组和对照组均出院前发放文字版(含图片)健康教育手册;试验组增加拷贝居家护理技能视频给家属自行观看学习,随访护士通过电话、QQ或微信远程答疑。观察两组患者出院12 w Barthel指数和并发症发生率及家属抑郁评分。结果认知训练、康复锻炼、预防跌倒、语言训练、观察病情、喂食技巧和压疮护理等7个项目需求率>60%,胃管护理、尿管护理和服药管理等3个项目需求率<60%。语言训练、压疮护理、胃管护理、尿管护理等4个项目需求情况与患者自理能力指数相关,差异均有统计学意义(均P<0.05)。试验组患者出院12 w自理能力指数(46.83±23.201)、肺炎8例、泌尿系感染5例、压疮9例、跌倒6例、家属抑郁评分(6.48±3.883),对照组出院12 w自理能力指数(34.42±20.926)、肺炎21例、泌尿系感染14例、压疮28例、跌倒16例、家属抑郁评分(10.42±6.008),试验组优于对照组,差异均有统计学意义(均P<0.05)。结论单一的健康教育手册不能满足出院护理指导需求,老年首次脑卒中患者的无医学教育背景家属亟待专业化家庭护理技能培训。可视化自主学习法简便、经济、高效,提高家属居家护理技能水平,减轻抑郁症状;改善老年脑卒中患者自理能力,减少并发�Objective To explore the effects of visual autonomous learning on the quality of life and home nursing skills of elderly patients with first stroke and their families without medical education background.Methods Cluster sampling method was used to investigate a total of 105 pairs of elderly stroke patients with moderate and severe dependent self-care ability and their family members without medical education who were repeatedly hospitalized in the Department of Neurology and Neurosurgery of Zhujiang Hospital of Southern Medical University on June 14,July 12,and August 16,2016.Seven training programs with the highest family needs were selected from 10 home care programs.Short videos of easy to understand home nursing skills were recorded.Each video was less than 8 minutes.Close-ups and subtitles were used for key links.A total of 400 elderly inpatients with first stroke and their families were collected and divided into experimental group and control group with 200 cases in each by digital randomized control method.Both the experimental group and the control group were issued text version(including pictures)of health education manual before discharge.The experimental group added videos of home nursing skills for family members to watch and learn by themselves,and the follow-up nurses answered questions remotely through telephone,QQ or WeChat.Barthel index,incidence of complications and depression scores of family members were observed 12 weeks after discharge in 2 groups.Results The demand rate of seven items(cognitive training,rehabilitation exercise,fall prevention,language training,disease observation,feeding skills and pressure sore care)was more than 60%,and the demand rate of three items(gastric tube care,urinary tube care and medication management)was less than 60%.The demands of language training,pressure ulcer care,gastric tube care and urinary tube care were correlated with the self-care ability index of patients,and the differences were statistically significant(P<0.05).At 12 weeks after discharge,the s

关 键 词：可视化 自主学习 脑卒中 居家护理 

分 类 号：R473.74[医药卫生—护理学]