Wang Xiuqin, Wang Xiaoyan, Bai Hui, Zhang Yingxue, Si Junzeng
Department of Neurology, Jinan People's Hospital Affiliated to Shandong First Medical University Jinan 271199, Shandong Province, China.
Department of Obstetrics, Jinan People's Hospital Affiliated to Shandong First Medical University Jinan 271199, Shandong Province, China.
Am J Transl Res. 2021 Oct 15;13(10):11728-11736. eCollection 2021.
To investigate the effect of programmed nursing combined with cognitive behavioral intervention on clinical efficacy and neurological function of patients with intracerebral hemorrhage (ICH).
In this retrospective study, 96 patients with ICH admitted to our hospital were enrolled and divided into a programmed group and a joint group, with 48 cases in each group. Patients in the programmed group were treated with programmed nursing while those in the joint group were given cognitive behavior intervention based on programmed nursing, for 28 days. The Fugl-Meyer (FM) Assessment Scale was used to evaluate the motor function of patients, the Barthel index to analyze the activities of daily living (ADL), and the National Institutes of Health Stroke Scale (NIHSS) and Glasgow Outcome Scale (GOS) to assess the neurological function. The quality of life of patients was evaluated by the World Health Organization quality of life Brief Version (WHOQOL-BREF), and the nursing satisfaction of patients or their families was investigated by the self-made satisfaction scale. The incidence of adverse reactions during treatment was recorded and compared.
FM Assessment Scale and Barthel index did not differ significantly between the two groups before nursing (t =0.059, t =0.033, both P>0.05); after nursing, the two scores increased in both groups, with higher scores in the joint group (t =3.331, t =2.735, both P<0.05). Before nursing, there was no difference in NIHSS and GOS scores between the two groups (t =0.257, t =0.553, both P>0.05); after nursing, however, the NIHSS score decreased and the GOS score increased in both groups, with statistically significant differences between the two groups (t =5.158, t =5.303, both P<0.05). The total effective rate in the joint group was significantly higher than that in the programmed group (91.67% vs. 77.08%; χ=4.511, P=0.034). No significant difference was observed in the World Health Organization Quality of Life Scale Brief Version (WHOQOL BREF) score between the two groups (t=0.049, P=0.960) before nursing; after nursing, the score increased significantly in both groups, with a significant difference between the two groups (t=15.970, P<0.001). The satisfaction was 95.83% in the joint group, which was higher than that of 83.33% in the programmed group (χ=3.913, P=0.048). The joint group also had fewer adverse reactions than the programmed group (χ=7.401, P=0.007).
Programmed nursing combined with cognitive behavioral intervention can improve the clinical efficacy of patients with ICH, improve limb motor ability, and reduce neurological deficits, with high safety.
探讨程序化护理联合认知行为干预对脑出血（ICH）患者临床疗效及神经功能的影响。
本回顾性研究纳入我院收治的96例ICH患者，分为程序化组和联合组，每组48例。程序化组采用程序化护理，联合组在程序化护理基础上给予认知行为干预，为期28天。采用Fugl-Meyer（FM）评估量表评估患者运动功能，Barthel指数分析日常生活活动能力（ADL），美国国立卫生研究院卒中量表（NIHSS）和格拉斯哥预后量表（GOS）评估神经功能。采用世界卫生组织生活质量简表（WHOQOL-BREF）评估患者生活质量，自制满意度量表调查患者或其家属的护理满意度。记录并比较治疗期间不良反应的发生率。
护理前两组FM评估量表及Barthel指数差异无统计学意义（t =0.059，t =0.033，均P>0.05）；护理后两组评分均升高，联合组更高（t =3.331，t =2.735，均P<0.05）。护理前两组NIHSS及GOS评分差异无统计学意义（t =0.257，t =0.553，均P>0.05）；护理后两组NIHSS评分降低，GOS评分升高，两组间差异有统计学意义（t =5.158，t =5.303，均P<0.05）。联合组总有效率显著高于程序化组（91.67% 对77.08%；χ=4.511，P=0.034）。护理前两组世界卫生组织生活质量量表简表（WHOQOL BREF）评分差异无统计学意义（t=0.049，P=0.960）；护理后两组评分均显著升高，两组间差异有统计学意义（t=15.970，P<0.001）。联合组满意度为95.83%，高于程序化组的83.33%（χ=3.913，P=0.048）。联合组不良反应也少于程序化组（χ=7.401，P=0.007）。
程序化护理联合认知行为干预可提高ICH患者临床疗效，改善肢体运动能力，减轻神经功能缺损，安全性高。
