基于掌上天坛应用程序的卒中患者延续性护理服务模式的构建  

Construction of continuous nursing service model for stroke patients based on the APP

作　　者：陈娜[1] 陈义彤[1] 崔晓 李兴 武美茹[1] 邓永梅[1] Na Chen;Yitong Chen;Xiao Cui;Xing Li;Meiru Wu;Yongmei Deng(Neurology Center,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院神经病学中心,100070

出　　处：《中华脑血管病杂志(电子版)》2025年第1期32-41,共10页Chinese Journal of Cerebrovascular Diseases(Electronic Edition)

基　　金：首都医科大学附属北京天坛医院管理专项课题(TYGL202223)。

摘　　要：目的构建基于掌上天坛应用程序(APP)的卒中患者延续性护理服务模式,为“互联网+”延续性护理提供依据。方法本研究选取2023年1月至2023年12月首都医科大学附属北京天坛医院收治的病情稳定的卒中患者80例作为研究对象,根据随机数字表法,将患者分为研究组(n=40)与对照组(n=40),其中研究组采用基于掌上天坛APP的延续性护理,对照组采用常规护理,记录2组患者出院时及出院后3个月的日常生活活动能力[巴塞尔指数(BI)]、生存质量[脑卒中专用生存质量量表(SS-QOL)]以及心理抑郁情况[健康问卷抑郁量表(PHQ-9)],并采用t检验比较2组差异。其中基于掌上天坛APP的延续性护理模式的构建是通过选取来自北京市5家综合三级甲等医院神经内科临床护理、护理管理领域的15名专家作为函询对象,基于互联网延续性护理质性研究调查结果,在文献回顾与小组讨论的基础上形成模式初稿并拟定专家函询表,采用德尔菲专家咨询法,进行2轮函询,最终修订形成模式内容。采用专家权威系数(Cr)进行2轮专家权威性评价,采用和谐系数(Kendall&apos;s W)表示专家意见的协调程度。结果2轮专家权威性评价显示权威系数分别为0.90、0.91,第1轮和第2轮专家意见的协调程度和谐系数(Kendall&apos;s W)分别0.189、0.120。最终形成了包含8个一级指标、28个二级指标、115个三级指标的基于掌上天坛APP的卒中患者延续性护理服务模式。出院时2组患者BI评分、SS-QOL评分以及PHQ-9评分比较,差异均无统计学意义(P均>0.05);出院后3个月,研究组患者的BI、SS-QOL评分高于对照组[(82.53±6.25)分vs(70.52±6.07)分,(151.20±17.48)分vs(133.14±16.89)分],而研究组患者PHQ-9评分低于对照组[(3.34±1.04)分vs(5.05±1.22)分],差异均具有统计学意义(t=8.718、4.699、6.746、P均<0.001)。结论掌上天坛APP作为一种新型的延续性护理工具,在卒中患者出院后的康Objective To construct a continuous nursing service model for stroke patients based on Palmtop APP,and to provide a an evidence base for&quot;Internet+&quot;continuous nursing.Methods This study recruited 80 stable stroke patients admitted to Beijing Tiantan Hospital,Capital Medical University from January 2023 to December 2023.Patients were randomly assigned to a study group(n=40)and a control group(n=40)using a random number table.The study group received continuous care based on the Beijing Tiantan Hospital application(APP),while the control group received routine care.The daily living activity ability(Barthel index,BI),quality of life(stroke specific quality of life scale,SS-QOL),and psychological depression(patient health questionnaire-9,PHQ-9)between the two groups were assessed at discharge and 3 months after discharge,and compared by t test.The continuous nursing service model was developed through consultation with 15 experts in clinical nursing and nursing management from neurology departments of five tertiary hospitals in Beijing.The initial draft of the model was formulated based on qualitative research findings,literature review,and group discussions.The Delphi method was employed for two rounds of expert consultation to refine the model content.Expert authority was evaluated using the expert authority coefficient(Cr),and the harmony of expert opinions was assessed using Kendall&apos;s W.Results The expert authority coefficient(Cr)for the two rounds of expert authority evaluation were 0.90 and 0.91.The harmony coefficients(Kendall&apos;s W)were 0.189 and 0.120 for the first and second rounds,respectively.The final continuous nursing service model for stroke patients based on the APP was ultimately formed,which includes 8 primary indicators,28 secondary indicators,and 115 tertiary indicators.At 3 months post-discharge,the study group exhibited significantly higher BI(82.53±6.25)and SS-QOL(151.20±17.48)scores compared to the control group(BI:70.52±6.07;SSQOL:133.14±16.89).The PHQ-9 score of the stu

关 键 词：卒中 延续性护理 模式构建 

分 类 号：R743.9[医药卫生—神经病学与精神病学]