5A自我管理支持法在脑卒中患者自我管理中的价值研究OACSTPCD
Research on the value of 5A self-management support method in the management of stroke patients
目的:探讨5A(询问、建议、评估、帮助和随访)自我管理支持法在脑卒中患者管理中的应用效果.方法:制定脑卒中患者5A自我管理支持方案,随机抽取2020年11月至2021年4月入住首都医科大学附属北京世纪坛医院神经内科的75例脑卒中患者,按照干预方法不同,将其分为对照组(38例)和观察组(37例),对照组采用常规护理干预方法,观察组采用5A自我管理支持法.干预时间截至到患者出院后3个月,从自我管理行为、自我效能、日常生活活动能力及抑郁和焦虑情况评分评价两组的干预效果.结果:观察组患者出院后3个月的自我管理行为和自我效能的每周锻炼时间、认知症状管理、与医生交流、症状管理自我效能和疾病共性管理自我效能评分分别为(180.92±102.38)分、(3.68±1.32)分、(3.29±1.41)分、(7.15±3.44)分和(6.82±2.10)分,均明显高于对照组,其差异有统计学意义(t=5.63、4.10、4.37、6.40、7.60,P＜0.05);出院后3个月观察组患者改良Barthel指数(MBI)评分为(68.06±12.80)分,显著高于对照组,其差异有统计学意义(t=7.27,P＜0.05);出院后3个月观察组患者的抑郁和焦虑情况评分均低于对照组,其差异有统计学意义(t=2.38、2.64,P＜0.05).结论:5A自我管理支持法能明显提高出院后脑卒中患者的自我管理行为和日常生活活动能力,有效改善患者焦虑和抑郁状况,提高出院后脑卒中患者的自我管理效果.
Objective:To explore the application effect of 5A self-management support method in the management of patients with stroke.Methods:A 5A self-management support program for stroke patients was developed from the five dimensions of Ask,Advice,Assess,Assist and Arrange.A total of 75 stroke patients admitted to the Neurology Department of Beijing Shijitan Hospital from November 2020 to April 2021 were randomly selected and divided into a control group(38 cases)and an observation group(37 cases)according to different intervention methods.The control group adopted routine intervention method,the observation group adopted 5A self-management support method.The intervention time expired 3 months after the patient was discharged.The intervention effects of the two groups were evaluated from the scores of self-management behavior,self-efficacy,activities of daily living and depression and anxiety situation.Results:At the end of the third month after discharge,the self-management behavior and self-efficacy scores for weekly exercise time,cognitive symptom management,communication with doctors,symptom management self-efficacy and disease common management self-efficacy scores of patients in the observation group scored(180.92±102.38),(3.68±1.32),(3.29±1.41),(7.15±3.44)and(6.82±2.10),respectively,which were significantly higher than those of the control group,the differences were statistically significant(t=5.63,4.10,4.37,6.40,7.60,P<0.05).At the end of the third month after discharge,the modified Barthel index(MBI)score of the patients in the observation group was(68.06±12.80),which was significantly higher than that of control group,the difference was statistically significant(t=7.27,P<0.05);the depression and anxiety scores of patients in the observation group were lower than those of the control group,the difference was statistically significant(t=2.38,2.64,P<0.05).Conclusion:The 5A self-management support method can significantly improve the self-management behavior and the ability of daily living activities of stroke patients after discharge,and effectively improve the anxiety and depression of patients,and improve the self-management effect of stroke patients after discharge.
王芳;王欣;刘俐惠;李巍
首都医科大学附属北京世纪坛医院神经与精神科 北京 100038
临床医学
脑卒中患者自我效能自我管理行为日常生活活动能力心理健康
Stroke patientsSelf-efficacySelf-management behaviorActivities of daily livingMental health
《中国医学装备》 2024 (001)
141-146 / 6
首都医科大学附属北京世纪坛医院科研课题(2018-q33) Research Project of Beijing Shijitan Hospital,Capital Medical University(2018-q33)
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