中国全科医学2017，Vol.20Issue(26)：3210-3215,6.DOI:10.3969/j.issn.1007-9572.2017.09.004
社区脑卒中后残疾患者协同健康管理模式构建及管理效果研究
Development and Effects of Collaborative Health Management Model for Community Patients with Disabilities due to Stroke
摘要
Abstract
Objective To development a collaborative health management model for community patients with disabilities due to stroke,and evaluate its management effects.Methods This study was conducted between January and June 2016.By convenience sampling,from 2 communities in Daqing,we enrolled 60 participants with disabilities due to stroke who returned to home after receiving treatment from hospitals or community health service centers (stations) and equally divided them into the control group (n =30) and the management group (n =30) based on the random number table.Patien ts in both groups received regular family visit and commuaity-based health education,and those in the management group additionally received the collaborative health management model of services (personalized rehabilitation management,emotional management,information-based management,and patient self-management) by a collaborative health management team (researchers,rehabilitation therapists,psychologists,and community health service center managers).The effects of intervention achieved in both groups were assessed by surveying the patients by the Modified Barthel Index (MBI),Self-rating Depression Scale (SDS),General Self-efficacy Scale (GSES),APGAR Scale and Functional Activities Questionnaire (FAQ) before intervention,3 and 6 months after intervention.Results Repeated measures analysis of variance showed that,intervention method and duration of intervention exerted significant main effects as well as notable interaction effects on the scores of MBI,SDS,GSES,APGAR and FAQ (P ＜0.05).Simple effects analysis demonstrated that,the scores of MBI,GSES and APGAR were higher while those of SDS and FAQ were lower in the management group than in the control group at the end of 3 and 6 months of intervention (P ＜0.05).In the control group,the scores of MBI varied by the assessing time (P ＜ 0.05),while those of SDS,GSES,APGAR and FAQ did not (P ＞ 0.05).In the management group,the scores of MBI,SDS,GSES,APGAR and FAQ varied by the assessing time (P ＜ 0.05).Conclusion By using the collaborative health management model,improved activities of daily living,family function,ameliorated defective functional activity can be achieved in community patients with disabilities due to stroke.Therefore,it is of great clinical significance for the development of community-based health management services.关键词
卒中/残疾人/协同健康管理/康复/抑郁Key words
Stroke/Disabled persons/Collaborative health management/Rehabilitation/Depression分类
医药卫生引用本文复制引用
孙秋雪,吕雨梅,张文越,赵守梅,孙丽丽,李娟,许海莲..社区脑卒中后残疾患者协同健康管理模式构建及管理效果研究[J].中国全科医学,2017,20(26):3210-3215,6.基金项目
国家自然科学基金资助项目(71303072) （71303072）
