万宝珍+李雪明+蔡玉屏

[摘要] 目的 探討应用家庭动力学对高血压性脑卒中患者进行护理干预的效果。 方法 将2014年10月～2016年7月在我院治疗后好转出院的符合纳入条件的高血压性脑卒中患者400例，随机分为干预组和对照组，每组各200例，对照组给予常规护理，干预组在对照组常规护理基础上，应用家庭动力学理论进行护理干预，比较两组患者的遵医行为、血压达标率、康复训练干预效果。 结果 出院时，两组的血压达标率比较，差异无统计学意义（P>0.05）；出院半年后，干预组的血压达标率明显高于对照组，干预组的康复训练效果（患肢活动功能明显改善、坐站平衡及步行稳、无废用性肌萎缩及软组织挛缩、有社交活动）明显优于对照组，干预组遵医情况明显高于对照组，差异均有统计学意义（P<0.05）。结论 应用家庭动力学对高血压性脑卒中患者进行出院后护理干预，能达到改善患者遵医行为，有效控制血压，增强康复训练效果的目的。

[关键词] 家庭动力学；高血压；脑卒中；护理

[中图分类号] R473.74 [文献标识码] A [文章编号] 2095-0616（2017）08-144-04

[Abstract] Objective To discuss the effect of the application of family dynamics in hypertensive stroke nursing intervention. Methods 400 cases of patients with hypertensive stroke discharged from our hospital from October 2014 to July 2016 were chosen and randomly divided into experimental group and control group，with 200 cases in each.Patients in control group were treated with routine nursing care.Patients in experimental group were treated with nursing intervention with application of family dynamics based on nursing routine.Patients compliance，patients blood pressure standard reaching rate and effect of rehabilitation of the two groups were compared. Results The blood pressure standard reaching rate on discharge had no significant statistical difference between the two groups （P>0.05）. 6 months after discharge，the patients blood pressure standard reaching rate in experimental group was apparently higher than that in control group.Moreover，the function of movements of patients affected extremity，sit-stand balance and walking stability，no disuse myatrophy and soft tissue contracture，effect of rehabilitation with social activities and patients medical compliance in experimental group were all obviously higher than those in control group （P<0.05）. Conclusion The nursing intervention with application of family dynamics on patients with hypertensive stroke after discharge can achieve the aim of improving patients compliance，effective control blood pressure，and enhance the effect of rehabilitation.

[Key words] Family Dynamics；Hypertension；Stroke or cerabrovascular accident （CVA）；Nursing

数据调查表明，我国高血压患者发病人数不断增加，由于健康知识缺乏、生活方式不良，成为导致脑卒中发病的重要因素[1]。脑卒中是以猝然昏倒，不省人事，伴发半身不遂为主要症状的一类脑血液循环障碍性疾病。脑卒中是人口死亡的第二大原因，也是长期致残的主要原因[2]。研究发现绝大多数高血压性脑卒中患者在住院期间均能正确按照要求进行治疗，但在出院后其遵医程度却大大下降。遵医程度低与致残率高、复发率高及并发症风险增加相关。家庭动力学理论把家庭功能作为一个互动的护理干预方法，分析以家庭为背景家庭成员对患者个人健康问题的作用，强调家庭对个体健康的影响[3]。为……