中国全科医学 ›› 2021, Vol. 24 ›› Issue (27): 3489-3493.DOI: 10.12114/j.issn.1007-9572.2021.00.565

所属专题: 指南/共识最新文章合集 神经系统疾病最新文章合集

• 专题研究 • 上一篇    下一篇

相关领域专家对缺血性脑卒中居家康复效果评价看法与建议的质性研究

马佳佳,毛雅芬,牛淑珍,王莉,王斌,吴松起,施雁*   

  1. 200072上海市,同济大学附属第十人民医院护理部
    *通信作者:施雁,教授,博士生导师;E-mail:shlzk2002@163.com
  • 出版日期:2021-09-20 发布日期:2021-09-20
  • 基金资助:
    基金项目:国家自然科学基金面上项目(71774117);上海市医院协会医院管理研究基金项目(X1901123)

Expert Opinions and Suggestions Regarding Home-based Rehabilitation for Ischemic Stroke:a Qualitative Study 

MA Jiajia,MAO Yafen,NIU Shuzhen,WANG Li,WANG Bin,WU Songqi,SHI Yan*   

  1. Department of Nursing,Tenth People's Hospital of Tongji University,Shanghai 200072,China
    *Corresponding author:SHI Yan,Professor,Doctoral supervisor;E-mail:shlzk2002@163.com
  • Published:2021-09-20 Online:2021-09-20

摘要: 背景 开展居家康复是降低缺血性脑卒中复发率和致死率、改善患者预后、减轻我国卒中负担的必然趋势,而客观评价缺血性脑卒中患者居家康复效果有助于居家康复方案的良性、持续改进,但目前关于缺血性脑卒中患者居家康复效果评价的研究报道少见。目的 了解相关领域专家对缺血性脑卒中患者居家康复效果评价的看法与建议,为进一步构建缺血性脑卒中居家康复效果评价体系提供参考依据。方法 采用立意抽样法,于2020年10—12月邀请来自全国7个省市的缺血性脑卒中居家康复领域的护理管理专家、神经内科临床专家及康复专家共22名作为受访者。采用描述性现象学研究方法,对受访者进行面对面半结构式深度访谈。采用Colaizzi七步分析法、Nvivo 12质性研究软件分析访谈资料,提炼主题。结果 共提炼出4个主题:(1)开展缺血性脑卒中患者居家康复效果评价是医患双方共同的迫切需求;(2)缺血性脑卒中患者健康结局是居家康复效果评价的核心内容;(3)知-信-行水平是缺血性脑卒中患者居家康复效果评价的重要维度;(4)应根据患者自身特点灵活开展缺血性脑卒中患者居家康复效果评价工作。结论 患者的健康结局、患者及其主要照顾者的知-信-行水平是缺血性脑卒中患者居家康复效果评价的重点。建议组建多学科联合的专业团队,细化各团队成员职责与分工,提高评价团队的专业水平,提高评价结果的准确性和效率;加强信息化建设,搭建区域内多元合作平台,推动缺血性脑卒中患者居家康复效果评价工作顺利开展。

关键词: 卒中;脑缺血;康复;医务人员;家庭医疗保健服务, 基于医院的;结果评价, 卫生保健;病人结局评价;定性研究

Abstract: Background It is necessary to carry out home-based rehabilitation for ischemic stroke to reduce the recurrence rate and fatality rate,improve the prognosis,and decrease the burden of stroke in China. Objective evaluation of the effect of home-based rehabilitation for ischemic stroke will contribute to the sound and sustainable development of home-based rehabilitation program,but there are few relevant reports. Objective To investigate expert opinions and recommendations regarding home-based rehabilitation for ischemic stroke,to provide a reference for the development of a home-based rehabilitation for ischemic stroke assessment system. Methods From October to December,2020,by use of purposive sampling,22 experts in home-based rehabilitation for ischemic stroke(involving nursing management,clinical neurology treatment,and rehabilitation)were selected from seven regions of China,and invited to attend an individual interview using a semi-structured framework. The interview results were analyzed using Colaizzi's descriptive phenomenological method,and thematic analysis with Nvivo 12. Results Four themes emerged:(1)the evaluation of home-based rehabilitation for ischemic stroke is an urgent need for both doctors and patients;(2)patient health outcome is the core content of the evaluation;(3)the level of knowledge-attitude-practice is an important evaluation dimension;(4)the evaluation should be carried out flexibly according to the patient's own characteristics. Conclusion Patient health outcome,and levels of knowledge-attitude-practice of patients and their primary caregivers are key points in the evaluation of home-based rehabilitation. To improve the accuracy and efficiency of the evaluation,it is suggested to set up an evaluation team consisting of multidisciplinary professionals with clear and detailed determination of each member's responsibility and duty,and to improve the team professional level continuously. Moreover,to facilitate the implementation of the evaluation,it is suggested to strengthen the informatization construction,and build a multi-cooperation platform within the region.

Key words: Stroke;Brain ischemia;Rehabilitation;Medical staff;Home care services, hospital-based;Outcome assessment, health care;Patient outcome assessment;Qualitative research