作者：程树锦1 ，钟美容1，2 ，吕开月1 ，周晓燕3 ，吴国凤1 ，李江兰3 ，农瑾雯3

单位：

1.530200广西壮族自治区南宁市，广西中医药大学护理学院　 2.530011 广西壮族自治区南宁市，广西中医 药大学附属瑞康医院护理部　3.530011 广西壮族自治区南宁市，广西中医药大学附属瑞康医院康复医学科

Units：

1.School of Nursing, Guangxi University of Chinese Medicine, Nanning 530200, China 2.Department of Nursing, Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning 530011, China 3.Department of Rehabilitation Medicine, Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning 530011, China

关键词：

卒中；偏瘫；跌倒恐惧；智谋理论；健康教育

Keywords：

Stroke; Hemiplegia; Fear of falling; Resourcefulness theory; Health education

CLC：

R 743 R 256.69

DOI：

10.12114/j.issn.1008-5971.2024.00.026

Funds：

广西壮族自治区卫生健康委员会自筹经费科研课题（Z20200752）；广西中医药大学研究生教育创新计划项目 （YCSY2023053）；广西壮族自治区中医药管理局自筹经费科研课题（GXZYZ20210364）

摘要：

　目的　分析基于智谋理论的健康教育在脑卒中偏瘫伴跌倒恐惧（FOF）患者中的应用效果。方法　 选取广西中医药大学附属瑞康医院康复医学科2022年3—9月收治的脑卒中偏瘫伴FOF患者45例为常规组，2022年10 月—2023年4月收治的脑卒中偏瘫伴FOF患者45例为智谋理论组。常规组患者接受常规健康教育和康复训练，智谋理 论组患者在常规组的基础上接受基于智谋理论的健康教育，干预时间为8周。比较两组干预前、干预4周、干预8周修 订版跌倒效能量表（MFES）评分，干预前及干预后智谋量表（RS）评分、中文版患者积极度量表（PAM）评分、 改良Barthel指数（mBI）评分。结果　最终88例患者完成研究，其中常规组44例、智谋理论组44例。干预方法与时间 在MFES评分上存在交互作用（P＜0.05）；干预方法、时间在MFES评分上主效应显著（P＜0.05）；智谋理论组干预 4、8周MFES评分高于常规组（P＜0.05）；常规组、智谋理论组干预4、8周MFES评分分别高于本组干预前，干预8周 MFES评分分别高于本组干预4周（P＜0.05）。智谋理论组干预后个人智谋、社会智谋维度得分及RS总分高于常规组 （P＜0.05）；常规组、智谋理论组干预后个人智谋、社会智谋维度得分及RS总分分别高于本组干预前（P＜0.05）。 智谋理论组干预后中文版PAM评分高于常规组（P＜0.05）；常规组、智谋理论组干预后中文版PAM评分分别高于本组 干预前（P＜0.05）。智谋理论组干预后mBI评分高于常规组（P＜0.05）；常规组、智谋理论组干预后mBI评分分别高 于本组干预前（P＜0.05）。结论　基于智谋理论的健康教育可提高脑卒中偏瘫伴FOF患者自我跌倒效能水平、智谋水 平、自我管理积极度、日常生活活动能力。

Abstract：

Objective To analyze the application effect of health education based on resourcefulness theory in patients with hemiplegia after stroke and fear of falling (FOF) . Methods A total of 45 patients with hemiplegia after stroke and FOF admitted to the Department of Rehabilitation Medicine of Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine from March to September 2022 were selected as the routine group, and 45 patients with hemiplegia after stroke and FOF from October 2022 to April 2023 were selected as the resourcefulness theory group. Patients in the routine group received routine health education and rehabilitation training, and patients in the resourcefulness theory group received health education based on resourcefulness theory on the basis of the routine group. The intervention time was 8 weeks. Modified Falls Efficacy Scale (MFES) score before intervention, at 4 weeks of intervention and at 8 weeks of intervention, and Resourcefulness Scale (RS) score, Chinese version of Patient Activation Measure (PAM) score and modified Barthel Index (mBI) score before and after intervention were compared between the two groups. Results Finally, 88 patients completed the study, including 44 cases in the routine group and 44 cases in the resourcefulness theory group. There was interaction between intervention method and time on MFES score (P < 0.05) . Intervention method and time had significant main effect on MFES score (P < 0.05) . MFES score of the resourcefulness theory group was higher than that of the routine group at 4 and 8 weeks of intervention (P < 0.05) . In the routine group and resourcefulness theory group, MFES scores at 4 and 8 weeks of intervention were higher than those before intervention, and MFES scores at 8 weeks of intervention were higher than those at 4 weeks of intervention, respectively (P < 0.05) . After intervention, the scores of personal intelligence and social intelligence item and total score of RS in the resourcefulness theory group were higher than those in the routine group (P < 0.05) . After intervention, the scores of personal intelligence and social intelligence item and total score of RS in routine group and resourcefulness theory group were higher than those before intervention, respectively (P < 0.05) . Chinese version of PAM score of the resourcefulness theory group was higher than that of the routine group after intervention (P < 0.05) . Chinese version of PAM scores of the routine group and the resourcefulness theory group after intervention were higher than those before intervention, respectively (P < 0.05) . mBI score of the resourcefulness theory group was higher than that of the routine group (P < 0.05) . mBI scores of the routine group and the resourcefulness theory group after intervention were higher than those before intervention, respectively (P < 0.05) . Conclusion Health education based on resourcefulness theory can improve the level of self-fall efficacy, resourcefulness, self-management activeness and daily living ability of patients with hemiplegia after stroke and FOF.

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