个案管理在脑卒中介入患者健康管理中的应用研究  

Application of case management in rehabilitation outcomes of patients with cerebral intravascular interventional therapy

作　　者：李晓静 孙丽霞 杨兴菊 王利平 段红伟 LI Xiaojing;SUN Lixia;YANG Xingju;WANG Liping;DUAN Hongwei

机构地区：[1]济南市人民医院重症医学科,济南市271100 [2]济南市人民医院院感科,济南市271100 [3]济南市人民医院护理部,济南市271100 [4]济南市人民医院神经内科,济南市271100

出　　处：《中华护理教育》2023年第7期840-845,共6页Chinese Journal of Nursing Education

基　　金：济南市卫生健康委员会2021年委科技计划项目。

摘　　要：目的探讨个案管理在脑卒中介入患者健康管理中的应用效果。方法采用方便抽样的方法,选取2021年1月—6月在某三级甲等医院收治的53例脑卒中介入患者为对照组,2021年7月—12月收治的57例患者为试验组。对照组采取常规住院护理及出院随访,试验组在对照组基础上采取个案管理。比较两组出院后2周、1个月、3个月、6个月日常生活活动能力、神经功能恢复情况,出院后3个月和6个月时复诊率及出院后6个月内再入院率。结果两组日常生活活动能力组间与时间存在交互效应(F=4.561,P=0.019),简单效应分析显示,出院后3、6个月试验组Barthel指数得分均高于对照组(P<0.05);广义估计方程结果显示改良Rankin量表得分组间与时间存在交互效应(Wald χ^(2)=23.972,P<0.001),组间单独效应分析显示,出院后1、3、6个月试验组神经功能恢复情况优于对照组,差异具有统计学意义(P<0.05);试验组出院后3个月时的复诊率高于对照组(P<0.05)。结论个案管理能有效提高患者日常生活活动能力,促进其神经功能的恢复,提高出院后3个月时复诊率。Objective To explore the effect of case management in patients of cerebral intravascular interventional therapy.Methods Through convenience sampling,53 patients of cerebral intravascular interventional therapy from January 2021 to June 2021 were selected as control group,which were given routine nursing.After that,another 57 patients were selected from July 2021 to December 2021 as the experimental group,who were given case management intervention.The ability of daily living and neurdogical function recovery at the time point of two weeks,one,three,and six months after discharge were compared between two groups.In addition,return visit rate at three and six-month and readmission rate in six months after discharge were also compared between the two groups.Results There was an interaction effect between the two groups in activities of daily living and time(F=4.561,P=0.019).Simple effect analysis showed that the activities of daily living of the experimental group was higher than that of the control group at three and six months after discharge(P<0.05).The generalized estimating equation showed that there was an interaction effect between the two groups of MRS and time(Wald χ^(2)=23.972,P<0.001),the intergroup effect showed that the recovery of neurological function in the experimental group was better than in the control group,and the differences between the two groups were statistically significant at one,three and six months after discharge(P<0.05).The return visit rate of the patients in the experimental group at three months after discharge was higher than that in the control group(P<0.05).Conclusion The case management intervention can effectively improve the ability of daily living,promote the recovery of neurological function,improve the return visit rate at three-month after discharge in patients of cerebral intravascular interventional therapy.

关 键 词：病人医护管理 卒中 日常生活活动 病人再入院 神经功能 

分 类 号：R473.74[医药卫生—护理学]