阶段性干预对脑卒中患者居家环境改变的社会认知与行为的影响

目的探讨阶段性护理干预对脑卒中患者居家环境改变的社会认知与健康行为影响。方法 2016年12月至2017年3月,便利抽样法选择在某院神经内科治疗的脑卒中患者61例为研究对象。按照随机数字表将其分为观察组(n=34)和对照组(n=27)。观察组患者出院前采用家庭环境优化的阶段性干预,对其预防跌倒的健康行为进行干预。而对照组患者在出院前接受常规出院教育。出院宣教前后及出院1个月后采用《老年脑卒中患者居家环境改变社会认知评估调查表》调查患者的认知改变情况,以环境危险因素的条目数评价其行为改变情况。结果出院宣教前,两组患者在社会认知评分方面的差异均无统计学意义(P0.05)。出院宣教后,除消极预期、行动计划评分外,观察组患者在其他社会认知评分上优于对照组,差异有统计学意义(P0.05)。出院时,患者修正版跌倒效能量表评分差异无统计学意义(P0.05);但出院1个月后,观察组患者为(8.28±0.27)分,高于对照组的(7.12±1.46)分,差异有统计学意义(t=4.545,P0.01)。在健康行为改变方面,出院1个月时,观察组再次评估出环境危险因素的条目数由出院时的116条减少为74条,而对照组由出院时患者自评的38条增长为研究护士系统评价的163条,两组在出院1个月时的改进条目分别为80条(观察组)和46条(对照组),差异均有统计学意义(均P0.05)结论针对认知与行为的阶段性干预有助于提高患者对健康的危险认知,促进健康行为的建立。

Effect of Staged Intervention on Social-cognitive and Behavior of the Home Environment Changes in Stroke Patients

Objective To discuss the effect of staged intervention on social-cognitive and behavior of the home environ-ment changes in stroke patients.Methods By convenience sampling,61 cases were selected and randomly divided into ob-servation group (n=34)and control group (n=27).The observation group received staged intervention,while the control group received routine nursing education before discharge.The social-cognitive and behavior of the home environment chan-ges in elderly stroke patients scale was used to analysis the cognition changes among patients.Results Before discharge health education,no statistical significance of social-cognitive score was found between two groups (P >0.05).After dis-charge health education,except passive expectation and action plan scores,the other social-cognitive scores in observation group were higher than that of control group (P <0.05).At the time of discharge,no statistical significance of revised fall efficacy scale score was found (P>0.05).One month after discharge,the score in observation group was (8.28±0.27),and (7.12±1.46)in control group (t =4.545,P <0.01).In the aspect of health action change,after 1 months of discharge,the number of environment risk factor assessed by observation group reduced from 116 to 74,while the number in control group increased from 38 to 163.The revised content in observation group was 80,and 46 in control group at 1 month of discharge (all P<0.05).Conclusion The intervention according to the different stages'social-cognition and behavior change can help patients to improve the risk cognition towards health,and promote the establishment of health behavior.