缺血性脑卒中患者延续性护理需求调查及影响因素分析

目的 调查缺血性脑卒中患者出院后对延续性护理服务的需求情况,分析其影响因素.方法 采用《脑卒中患者护理需求调查表》,对2014年4-12月在神经内科住院的136例缺血性脑卒中患者进行问卷调查.结果 电话随访是最易被患者接受的延续性护理方式.延续护理内容需求依次为:安全用药(86.0%)、血压自我监测(83.1%)、饮食指导(83.1%)、康复锻炼的方法(80.1%)、脑卒中知识(75.7%).患者延续护理需求的影响因素为:有疾病既往史的患者对"安全用药"干预需求增加,是无疾病既往史的7.15倍(OR=7.15,95%CI:1.83~27.94);有疾病既往史患者对"康复锻炼方法"措施的需求是无疾病既往史患者的4.68倍(OR=4.68,95%CI:1.40~15.63).60岁以上的患者对"饮食指导"措施的需求是年龄50岁及以下患者的11.41倍(OR=11.41,95%CI:1.75~74.46).结论 对于缺血性脑卒中患者的延续性护理,可采用电话随访的方式.对有疾病既往史的、年龄较大的患者,应重点开展延续性护理.

Objective To investigate the transitional care needs of ischemic stroke patients when they were discharged and analyze the influencing factors.Methods Transitional care needs of stroke patients questionnaires were conducted in 136 ischemic stroke patients in the department of neurology from April 2014 to December 2014.Results Telephone follow-up was the easiest way of transitional care to be accepted by patients. The transitional care needs included five aspects:safe medication(86.0%),blood pressure self monitoring(83.1%),diet guiding(83.1%),rehabilitating exercise(80.1%) and stroke knowledge(75.7%). The influencing factors of transitional care needs were:the patients with previous medical history demanded much more on the safe medication intervention than the patients without history disease. The demand of the patients with previous medical history was 7.17 times as much as that of the patients without previous medical history (OR=7.15,95%CI:1.83-27.94).The demand of the patients with previous medical history on "rehabilitation exercise" was 4.68 times as much as that of the patients without previous medical history (OR=4.68,95%CI:1.40-15.63). The demand of the patients over 60 years old on "diet guiding" was 11.41 times as much as patients under 50 years old (OR=11.41,95%CI:1.75-74.46).Conclusions For ischemic stroke patients,telephone follow-up can be used as the method of transitional care. Older patients and patients with previous medical history are the main patients who need transitional care.