朱翠平+吴美华+徐晓芳+陆安妹+褚惠芳

摘 要 目的：探讨农村家庭护理干预对脑卒中偏瘫患者自我护理能力的影响。方法：2014年9—12月选取社区中脑卒中偏瘫正处于恢复期或后遗症期患者84例，按分为干预组42例，按“家庭康复护理干预方案”进行12个月的家庭康复护理干预，对照组42例，按常规照顾模式进行居家自行护理，定期测量血压，常规进行随访。于干预1、3、6、12个月时对两组患者自我护理能力（综合性、知识性、决策性、行为性）进行评定。结果：干预1、3、6、12个月时，干预组的综合性、知识性、决策性、行为性得分和提高分均显著高于对照组（P均<0.001）。结论：培训社区护士开展家庭康复护理干预可提高农村脑卒中偏瘫患者的自我护理能力。

关键词 脑卒中；康复护理；自理能力

中图分类号：R743.3 文献标志码：A 文章编号：1006-1533（2017）02-0056-03

Influence of rural home nursing intervention on self care ability of patients with stroke

ZHU Cuiping， WU Meihua， XU Xiaofang， LU Anmei， CHU Huifang

（Xinchang Community Health Service Center of Pudong New District， Shanghai 201314， China）

ABSTRACT Objective： To explore the effect of rural home nursing intervention on the self care ability of patients with hemiplegia after stroke. Methods： From Sept to Dec. 2014， 84 cases of patients with cerebral apoplexy hemiplegia in the stage of recovery or sequelae were selected in the community and randomly divided into an intervention group with 42 cases who were given the home rehabilitation nursing intervention for 12 months according to “home rehabilitation nursing intervention plan”， and a control group with 42 cases who were given the home nursing， regular measurement of blood pressure and routine followup according to the conventional nursing mode. The self care ability （comprehensiveness， knowledge， decision making and behavior） of the patients in the two groups were evaluated in 1， 3， 6 and 12 months after intervention. Results： The scores of self care ability of the intervention group were significantly higher than those of the control group（P<0.001）. Conclusion： Training community nurses to carry out home rehabilitation nursing intervention can improve the self care ability of the patients with hemiplegia after stroke in rural areas.

KEY WORDS stroke； rehabilitation nursing； self care ability

脑卒中是中老年人的常见病、多发病之一，发病急、病程长，疗效慢，致残率高，特别是农村地区的脑卒中患者，由于经济条件的限制，缺乏基本的康复知识，使很多患者不能得到及时、有效、规范的治疗和康复，降低了患者的生活质量，给患者造成心理压力，还给家庭及社会带来较沉重的经济负担[1]。本研究以Orem自理模式为指导，在家庭康复现状基线调查基础上对本社区脑卒中偏瘫患者进行家庭康复护理干预，探讨其对患者自我护理能力的影响。

1 资料和方法

1 . 1 一般资料

2014年9-12月选取本社区脑卒中偏瘫正处于恢复期或后遗症期患者84例。患者均符合：①第四届脑血管病诊断标准[2]，并经CT或MRI证实，均有肢体功能障碍；②病程≤2年、处于康复期或后遗症期；③年龄≤80岁；④目前在家中康复；……