作者：何芳，李玉梅，归玉萍，李萍，李祉桄，陆琼兰

单位：

1.广西壮族自治区钦州市第二人民医院护理部2.广西壮族自治区钦州市第二人民医院重症医学科3.广西壮族自治区钦州市第二人民医院神经外科4.广西壮族自治区钦州市第二人民医院神经内科

Units：

1.Nursing Department, the Second People's Hospital of Qinzhou, Qinzhou 535000, China 2.Department of Critical Medicine, the Second People's Hospital of Qinzhou, Qinzhou 535000, China 3.Neurosurgery Department, the Second People's Hospital of Qinzhou, Qinzhou 535000, China 4.Department of Neurology, the Second People's Hospital of Qinzhou, Qinzhou 535000, China

关键词：

缺血性卒中; 护理; 潮汐理论模型;

Keywords：

Ischemic stroke; Nursing care; Tidal theoretical model

CLC：

DOI：

10.12114/j.issn.1008-5971.2023.00.065

Funds：

广西壮族自治区卫生健康委员会自筹经费科研课题（Z-N20221905）；钦州市科学研究与技术开发计划项目（20223625）

摘要：

目的 分析基于潮汐理论模型的护理干预在缺血性脑卒中（IS）患者中的应用效果。方法 选择2021年3—10月钦州市第二人民医院收治的IS患者110例为研究对象。采用随机数字表法将患者分为对照组和观察组，各55例。对照组进行常规护理干预，观察组进行基于潮汐理论模型的护理干预。比较两组干预前、干预后1个月焦虑自评量表（SAS）、抑郁自评量表（SDS）、脑卒中康复自我效能量表（SSEQ）（生活活动效能、自我管理效能）评分和脑卒中行为改变问卷（SBCI）评分（生活方式、遵医服药行为改变得分）及出院后3、6、12个月复发率。结果 干预后1个月，两组SAS、SDS评分分别低于本组干预前，且观察组低于对照组（P<0.05）。干预后1个月，两组生活活动效能、自我管理效能评分分别高于本组干预前，且观察组高于对照组（P<0.05）。观察组生活方式、遵医服药行为改变得分高于对照组（P<0.05）。出院后12个月，观察组复发率低于对照组（P<0.05）。结论 基于潮汐理论模型的护理干预可有效减轻IS患者焦虑、抑郁症状，提高其康复自我效能、生活方式与遵医服药行为改变的依从性，同时可降低患者复发风险。

Abstract：

　Objective To analyze the application effect of nursing intervention based on tidal theoretical model in patients with ischemic stroke (IS) . Methods A total of 110 patients with IS admitted to the Second People's Hospital of Qinzhou from March to October 2021 were selected as the study subjects. The patients were divided into control group and observation group by random number table method, with 55 cases in each group. The control group received routine nursing intervention, while the observation group received nursing intervention based on tidal theoretical model. The Self-rating Anxiety Scale (SAS) , Self-rating Depression Scale (SDS) and Stroke Self-Efficacy Questionnaire (SSEQ) (life activity efficacy, self-management efficacy) scores before intervention and 1 month after intervention, Stroke Behavior Change Inventory (SBCI) scores (change scores of lifestyle and medication compliance) , and the recurrence rates at 3, 6, 12 months after discharge were compared between the two groups. Results One month after intervention, the SAS and SDS scores of the two groups were lower than those before intervention respectively, and the SAS and SDS scores of the observation group were lower than those of the control group (P < 0.05) . One month after intervention, the scores of life activity efficacy and self-management efficacy in the two groups were higher than those before intervention respectively, and the scores of life activity efficacy and self-management efficacy in the observation group were higher than those in the control group (P < 0.05) . The change scores of lifestyle and compliance behavior in observation group were higher than those in control group (P < 0.05) . At 12 months after discharge, the recurrence rate of observation group was lower than that of control group (P < 0.05) . Conclusion Nursing intervention based on tidal theoretical model can effectively reduce anxiety and depression symptoms of IS patients, improve their rehabilitation self-efficacy, compliance with changes in lifestyle and medication compliance, and reduce the risk of relapse.

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