Feng Weijiao, Yu Hui, Wang Jun, Xia Jingfang
Department of Neurology, Affiliated Hospital of Jiangnan University, Wuxi, China.
Ann Palliat Med. 2021 Apr;10(4):4670-4677. doi: 10.21037/apm-21-602.
Disabled elderly with stroke usually have difficulty in obtaining professional rehabilitation intervention after being discharged from the hospital, and their self-health management ability is low, so their illness is prone to relapse. The hospital community-integrated service model (HCISM) is a scientific model designed to meet the needs of home care after discharge from the hospital, improve the quality of life of patients after discharge from the hospital, ease the burden on the family, and improve the service capabilities of community medical staff. The purpose of this study is to explore the effect of HCISM in home rehabilitation of stroke disabled elderly.
From September 2019 to September 2020, 120 the disabled elderly patients with stroke admitted to Affiliated hospital of Jiangnan University were selected and divided into two groups with a random number table method, with 60 cases in each group. Both groups underwent home rehabilitation after discharge, the control group was given routine intervention, and the observation group was given HCISM intervention. The changes of self-care ability, compliance behavior, self-efficacy, and adverse mood before and after intervention were compared between the two groups.
The modified Barthel Index (MBI) score of the observation group after 3 months of intervention was higher than that of the control group (P<0.05). In the observation group, the changes in the proportion of medication, reasonable diet, moderate exercise, and regular return visits after 3 months were higher than those in the control group (P<0.05). The General Self-efficacy Scale (GSES) score of the observation group was higher than that of the control group after 3 months of intervention (P<0.05). Zung's Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) scores in the observation group were low after 3 months of intervention than those in the control group (P<0.05).
HCISM applied to the home rehabilitation of the disabled elderly patients with stroke can improve life self-care ability and self-efficacy, improve medical compliance behavior, and reduce negative emotions, thus making it worthy of further promotion.
脑卒中残疾老年人出院后通常难以获得专业康复干预，自我健康管理能力较低，因此病情容易复发。医院社区一体化服务模式（HCISM）是一种科学模式，旨在满足出院后居家护理需求，提高出院后患者生活质量，减轻家庭负担，并提高社区医务人员的服务能力。本研究旨在探讨HCISM在脑卒中残疾老年人居家康复中的效果。
选取2019年9月至2020年9月在江南大学附属医院收治的120例脑卒中残疾老年患者，采用随机数字表法分为两组，每组60例。两组患者出院后均进行居家康复，对照组给予常规干预，观察组给予HCISM干预。比较两组干预前后自理能力、依从行为、自我效能感和不良情绪的变化。
干预3个月后，观察组改良Barthel指数（MBI）评分高于对照组（P<0.05）。观察组3个月后用药、合理饮食、适度运动及定期复诊比例的变化高于对照组（P<0.05）。干预3个月后，观察组一般自我效能感量表（GSES）评分高于对照组（P<0.05）。干预3个月后，观察组Zung氏自评焦虑量表（SAS）和自评抑郁量表（SDS）评分低于对照组（P<0.05）。
HCISM应用于脑卒中残疾老年患者居家康复中，可提高生活自理能力和自我效能感，改善医疗依从行为，减轻负面情绪，因此值得进一步推广。
