闫子璇　杨辉

[摘要] 目的 探讨延续性护理干预在脑卒中患者知信行方面的应用效果。 方法 选取2015年3月～2016年3月某三级甲等医院110例脑卒中出院患者，采用随机数字表法将其分为对照组和干预组，对照组予常规护理，干预组包括常规护理和延续护理干预方案。在干预前和干预后6周、3个月，采用《脑卒中知识问卷》、《慢性病管理自我效能量表（SSC）》和《脑卒中患者自我管理行为评定量表》分别评估患者的知信行水平，同时分析其变化。结果 干预后6周、3个月时，两组患者脑卒中知识、SSC及行为得分均有一定程度提高（P<0.05）。其中，对照组干预6周以及3个月自我效能得分分别为（20.50±2.94）分、（27.60±3.56）分，干预组分别为（37.80±4.67）分、（50.90±3.72）分，两组比较差异具有统计学意义，干预组的自我效能得分明显优于对照组（P<0.05），且得分升高趋势更加明显。 结论 延续性护理干预有效改善脑卒中患者知信行水平，值得临床推广及进一步应用。

[关键词] 延续护理；脑卒中患者；知信行；自我管理

[中图分类号] R473.5 [文献标识码] B [文章编号] 1673-9701（2017）16-0149-03

[Abstract] Objective To explore the application effect of continuity nursing intervention on knowledge， belief and practice of stroke patients. Methods A total of 110 stroke patients discharged from a tertiary hospital from March 2015 to March 2016 were randomly divided into control group and intervention group， using random number table method. The control group was treated with routine nursing， the intervention group was treated with continuity nursing intervention program on the basis of routine nursing. The levels of knowledge， belief and practice of patients were assessed by the "Stroke Knowledge Questionnaire"， the "Self-Efficacy Scale in Chronic Disease Management（SSC）" and the "Self-administered Behavior Rating Scale for Stroke Patients" before intervention and at 6 weeks and 3 months after intervention. Meanwhile the changes were analyzed. Results The knowledge， SSC scores and practice scores of patients in the two groups had some degree of improvement at 6 weeks and 3 months after intervention（P<0.05）. At the 6th week and the third month， the self-efficacy scores were（20.50±2.94） points and（27.60±3.56） points respectively in the control group， and the self-efficacy scores were（37.80±4.67） points and（50.90±3.72） points respectively in the intervention group. The self-efficacy score of the intervention group was significantly better than that of the control group（P<0.05）， and the trend was more obvious with the increase of score. Conclusion Continuity nursing intervention effectively improves the level of knowledge， belief and practice of stroke patients， and is worthy of clinical promotion and further application.

[Key words] Continuity nursing； Stroke patients； Knowledge， belief and practice； Self-management

脑卒中是一种发病紧急、以局部性神经功能损失为共性特点的急性脑血管疾病，它具有高致残率、高复发率等特点。近几年来发病率不断呈上升趋势[1]，给社会和家庭带来沉重的负担。患者在出院后往往因医院护理服务中断，导致康复延迟以及并发症和疾病复发[2]。高质量的延续护理是以患者为中心、由医院延续家庭护理的一系列康复活动，它是通过按预定目标为患者提供专门的規范化护理干预、实施安全有效指导的一个连续性服务过程[3]。因此本研究通过对脑卒中出院患者进行延续性护理干预，探讨改进其知信行水平的可行性与有效性，为以后临床的护理工作者提供参考依据。

1 资料与方法

1.1 一般资料

选取2015年3月～2016年3月某三级甲等医院110例脑卒中患者。……