基于信息化老年综合评估的多学科管理护理模式在脑梗死患者中的应用效果  

The effectiveness of multidisciplinary management nursing model based on informatized elderly comprehensive assessment in patients with cerebral infarction

作　　者：刘晓梅 罗永梅[2] 傅瑜[2] Xiaomei Liu;Yongmei Luo;Yu Fu(Department of Neurology,Tongzhou District People's Hospital,Nantong 226300,China;Department of Neurology,Peking University Third Hospital,Beijing 100091,China)

机构地区：[1]江苏省南通市通州区人民医院神经内科,226300 [2]北京大学第三医院神经内科,100091

出　　处：《中华脑血管病杂志（电子版）》2024年第3期255-264,共10页Chinese Journal of Cerebrovascular Diseases(Electronic Edition)

基　　金：北京大学第三医院临床队列建设项目(BYSYDL2023014)。

摘　　要：目的探讨基于信息化老年综合评估的多学科管理护理模式在脑梗死患者中的应用效果。方法选取江苏省南通市通州区人民医院神经内科2022年6月至2023年6月住院的老年脑梗死患者为研究对象,分别在本院神经内科病区1和神经内科病区2随机抽取干预组和对照组患者各63例。对照组给予常规的护理干预措施,包括入院后的健康宣教、病情观察、治疗护理以及出院前指导等内容。干预组给予基于信息化的老年综合评估的多学科管理护理干预。采用χ^(2)检验比较2组患者住院期间的并发症发生率,采用t检验比较干预前后的肢体简化Fugl-Meyer运动功能和平衡功能评分、日常生活能力Barthel评分、焦虑抑郁水平HAMD/HAMA评分以及生活质量量表评分等指标的变化。结果(1)干预组患者住院期间的并发症总发生率为3.17%,低于对照组的12.70%,差异具有统计学意义(χ^(2)=3.682,P=0.024)。(2)干预后,2组患者的上下肢简化Fugl-Meyer运动功能评分和平衡功能评分均高于干预前,且干预组的上下肢简化Fugl-Meyer运动功能评分[上肢:(49.64±10.12)分 vs(43.88±9.33)分;下肢:(52.90±11.81)分 vs(45.21±10.75)分]以及简化Fugl-Meyer平衡功能评分[上肢:(9.17±0.98)分 vs(12.45±1.19)分;下肢:(12.45±1.19)分 vs(8.91±1.11)分]均比对照组高,差异均具有统计学意义(t=3.255,P=0.041;t=3.493,P=0.036;t=3.670,P=0.032;t=3.945,P=0.027)。(3)干预后2组患者的Barthel评分均高于干预前,同时干预组Barthel评分[(92.70±19.15)分]较对照组[(77.57±18.47)分]更高,差异具有统计学意义(t=3.369,P=0.031)。(4)干预后干预组的HAMD与HAMA评分均低于干预前,同时也低于对照组[(36.57±4.61)分 vs(49.24±5.42)分;(37.44±3.72)分 vs(51.74±4.32)分],差异具有统计学意义(t=5.324,P=0.007;t=4.845,P=0.012)。(5)干预前2组患者的独立性、生理功能、社会关系、环境、精神、心理状态6项生活质量量表评分比较,差异均Objective To explore effectiveness effect of a multidisciplinary management nursing model based on an information-based comprehensive geriatric assessment in patients with cerebral infarction.MethodsElderly patients with cerebral infarction admitted to the Neurology Department of Tongzhou District People's Hospital in Nantong City, Jiangsu Province from June 2022 to June 2023 were included as the research subjects. A total of 63 patients in the intervention group and 63 patients in the control group were randomly included from Neurology Ward 1 and Neurology Ward 2 of our hospital. The control group received routine nursing interventions, including health education after admission, condition observation, treatment nursing, and pre-discharge guidance. The intervention group received multidisciplinary management nursing interventions based on information-based comprehensive geriatric assessment. A chi-square test were used to compare the incidence of complications during hospitalization between two groups. A t-test was used to compare the changes in indicators such as the Fugl-Meyer motor and balance function scores for limb function, the Barthel scores for daily living ability, the HAMD/HAMA scores for anxiety and depression levels, and quality of life scale scores before and after intervention.Results(1) The total incidence of complications during hospitalization in the intervention group was 3.17%, lower than 12.70% in the control group, and the difference was statistically significant (χ^(2)=3.682, P=0.024). (2) After intervention, both groups showed an increase in the Simplified Fugl-Meyer motor function score and the Simplified Fugl-Meyer balance function score compared to pre-intervention levels. And the intervention group demonstrated higher scores [upper limb: (49.64±10.12) points vs (43.88±9.33) points;lower limb: (52.90±11.81) points vs (45.21±10.75) points], as well as the simplified Fugl Meyer balance function score [upper limb: (9.17±0.98) points vs (12.45±1.19) points;lower limb: (12.45±1.19)

关 键 词：老年综合评估 多学科合作 脑梗死 护理 

分 类 号：R743.9[医药卫生—神经病学与精神病学]