基于循证护理的认知行为干预对脑卒中患者早期康复锻炼依从性的影响  

Infl uence of evidence-based nursing based cognitive behavioral intervention on early rehabilitation exercise compliance of stroke patients

作　　者：高艳 刘悦 魏婷婷 GAO Yan;LIU Yue;WEI Tingting(The Third People's Hospital Affiliated to Bengbu Medical College,Bengbu,233000,China)

机构地区：[1]蚌埠医学院附属蚌埠第三人民医院卒中病区,安徽省蚌埠市233000

出　　处：《护理实践与研究》2022年第5期692-695,共4页Nursing Practice and Research

基　　金：蚌埠医学院科研基金(编号:BYKY2019286ZD)。

摘　　要：目的鉴于临床脑卒中患者主动康复功能锻炼依从性低,进而导致康复预后差的现状,采取具有循证护理依据的认知行为疗法对脑卒中患者进行干预,以达到提高患者对早期康复锻炼的依从性,改善患者的整体治疗效果的目的。方法通过分析近年来的文献报道和Meta分析的结论,以循证护理的最佳证据为基础,制定认知行为疗法的临床护理决策。选取2017年6月—2019年6月收治的缺血性脑卒中伴偏瘫患者60例,按照组间基本特征具有可比性的原则将患者分为对照组和观察组,每组30例。观察组给于基于循证护理的认知行为干预;对照组给于一般主动康复功能锻炼。评价患者的功能锻炼依从性、运动功能、日常生活活动能力和抑郁状况。结果干预后,观察组患者对主动康复功能锻炼的依从性明显好于对照组,两组患者治疗后日常生活能力、肢体运动功能和抑郁情绪均有不同程度提高,但观察组的效果改善情况好于对照组,差异有统计学意义(P<0.05)。结论采用循证护理为基础的认知行为干预方法可以促进脑卒中后患者早期康复锻炼的依从性,提高肢体运动功能,改善患者抑郁情绪和生活质量。Objective Considering the low compliance of active rehabilitation exercise in clinical stroke patients, which leads to poor prognosis of rehabilitation, to adopt the evidence-based nursing based cognitive behavioral therapy for stroke patients intervention, to improve the compliance of patients with early rehabilitation exercise, change the aim of good patient’s overall treatment effect. Methods Clinical nursing decisions of cognitive behavioral therapy were made based on the best evidence of evidence-based nursing by analyzing the literature reports and conclusions of Meta analysis in recent years. A total of 60 cases of ischemic stroke patients with hemiplegia admitted from June 2017 to June 2019 were selected and divided into a control group and an observation group according to the principle of comparability of basic characteristics between groups,with 30 cases in each group. The observation group was given the cognitive behavioral intervention based on evidence-based nursing, the control group was given the general active rehabilitation exercise. Functional exercise compliance, motor function, daily living activities and depression were evaluated. Results After intervention,the compliance of patients in the observation group active rehabilitation exercise was signifi cantly better than the control group. After treatment, the daily living ability, limb movement function and depression mood of patients in the two groups were comparatively improved, but the improvement of the ef fect in the observation group was better than the control group, the dif ference was statistically signifi cant(P<0.05). Conclusion Evidence-based nursing based cognitive behavioral intervention could promote early rehabilitation exercise compliance of patients after stroke, improve limb motor function, improve depression and quality of life of patients.

关 键 词：缺血性脑卒中 循证护理 认知行为疗法 早期主动锻炼 

分 类 号：R473.5[医药卫生—护理学]