基于适应性领导框架的脑卒中恢复期患者健康行为指导方案的构建  

Development of a health behavior guidance program for stroke rehabilitation patients based on the adaptive leadership framework

作　　者：王明月 吴彩琴[2] 江洁汀 孙洁 孙滨海 厉坤鹏 Wang Mingyue;Wu Caiqin;Jiang Jieting;Sun Jie;Sun Binhai;Li Kunpeng(Cardiac Care Unit,Huadong Hospital,Fudan University,Shanghai 200040,China;School of Nursing,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;School of Rehabilitation,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]复旦大学附属华东医院心脏监护室,上海200040 [2]上海中医药大学护理学院,上海201203 [3]上海中医药大学康复学院,上海201203

出　　处：《中华现代护理杂志》2024年第27期3678-3684,共7页Chinese Journal of Modern Nursing

基　　金：中华医学会杂志社2021-2022年护理学科研究课题(CMAPH-NRD2021011);华东医院青苗人才计划(HLQM2203);上海市残疾人联合会康复政策研究专项(2023ZC1015)。

摘　　要：目的基于适应性领导框架构建脑卒中恢复期患者健康行为指导方案。方法在国内外网站对脑卒中健康行为相关指南的检索、筛选、纳入及推荐意见的提取, 以适应性领导框架为指导, 构建脑卒中恢复期患者健康行为指导方案初稿。2022年1-3月, 通过2轮德尔菲专家咨询法, 根据专家意见进行方案修改, 形成脑卒中恢复期患者健康行为指导方案。结果最终纳入10篇指南, 提取73条指南推荐意见, 归纳形成6个维度、25个条目内容的健康行为指导方案初稿。2轮专家咨询均发放问卷15份, 回收有效问卷15份, 有效回收率均为100.00%;专家权威系数均>0.8。根据专家建议及小组讨论, 最终形成包含运动、饮食营养、服药、烟酒、体重、人际与压力、睡眠、定期健康咨询8个维度, 31个条目的方案。结论基于适应性领导框架的脑卒中恢复期患者的健康行为指导方案, 引入了适应性及技术性问题合理分工的新护理角度, 符合我国临床实践情况, 具有一定的科学性和实用性, 为脑卒中患者健康行为的促进及健康教育提供了新视角及参考依据。Objective To develop a health behavior guidance program for stroke rehabilitation patients based on the adaptive leadership framework(ALF).Methods Relevant stroke health behavior guidelines were systematically retrieved,screened,included,and recommendations extracted from domestic and international websites.The initial draft of the health behavior guidance program for stroke rehabilitation patients was developed in light of the ALF.From January to March 2022,the draft was refined through two rounds of Delphi expert consultation,resulting in the finalized health behavior guidance program.Results A total of 10 guidelines were included,and 73 guideline recommendations were extracted.These recommendations were categorized into six dimensions and 25 specific items.In both rounds of expert consultation,15 questionnaires were distributed and all were returned,yielding an effective recovery rate of 100.00%,with an expert authority coefficient greater than O.8.Based on expert feedback and group discussions,the final program included eight dimensions and 31 items,adding sleep management and regular health consultations to the original six dimensions.Conclusions The health behavior guidance program for stroke rehabilitation patients,based on the ALF,introduces a new perspective on nursing by reasonably dividing adaptive and technical problems.This approach aligns with clinical practice in China,providing scientific and practical value for promoting health behaviors and offering a new perspective for health education in stroke patients.

关 键 词：卒中 适应性领导 健康行为 康复指导 方案构建 

分 类 号：R473.74[医药卫生—护理学]