Friedman家庭评估模式结合社区康复模式对社区脑卒中后吞咽障碍患者的吞咽功能恢复的效果观察

摘要

Objective To explore the effect of Friedman family assessment model combined with community rehabilitation model on swallowing function recovery of patients with dysphagia after stroke.Method 80 patients with dysphagia after stroke were selected from February 2016 to February 2017 in our hospital.According to the different intervention methods,they were divided into control group (n=40) and observation group (n=40).The control group was given routine rehabilitation nursing,the observation group was given the Friedman family evaluation model to guide the family rehabilitation nursing on the basis of the control group,and the intervention of community rehabilitation model; Including rehabilitation training,rehabilitation training program and the implementation of rehabilitation goals and other community-based rehabilitation measures.After 3 months of intervention,the Barthel index (the Barthelindex of ADL) was used to evaluate the daily living ability of the patients in the two groups; And the Watian drinking water test Method to evaluate the two groups before and after intervention in patients with swallowing function changes; The quality of life of two groups of patients was investigated by short (the MOS item from health,SF-36); The total effective rate of rehabilitation nursing of two groups was compared.Result The ADL score and swallowing function of the observation group were significantly improved compared with the control group (P< 0.05); The scores of SF-36 in observation group were significantly higher than those in control group (P<0.05); To observe the swallowing function rehabilitation nursing group the total effective rate was 95% (38/40) was significantly higher than the control group 77.50% (31/40) (P<0.05).Conclusion The ability of daily life of patients with dysphagia Friedman family assessment model combined with community rehabilitation model can effectively improve the community after stroke,improve the quality of life of patients,is conducive to promoting the recovery of swallowing function,can improve the rehabilitation effect.%目的 探讨Friedman家庭评估模式结合社区康复模式对社区脑卒中后吞咽障碍患者的吞咽功能恢复的效果.方法 选取本院2016年2月至2017年2月收治的社区脑卒中后吞咽障碍患者80例,根据干预方法分为对照组和观察组,每组40例.对照组给予常规康复护理,观察组在对照组的基础上给予Friedman家庭评估模式指导家庭康复护理,并结合社区康复模式干预,包括康复训练人员培训、康复训练方案的制定及康复目标的实施等社区康复措施.干预3个月后,分别采用Barthel指数(Barthe lindex of ADL)评定两组患者的日常生活能力,并采用洼田氏饮水试验法评估干预前后两组患者的吞咽功能变化情况,采用健康调查简表(MOS item short from health survey,SF-36)对两组患者的生活质量进行调查,并比较两组患者康复护理的总有效率.结果 观察组患者ADL评分及吞咽功能均较对照组明显改善(P<0.05);且观察组SF-36各项评分均较对照组明显增高(P<0.05);观察组吞咽功能康复护理的总有效率为95.00%(38/40)明显高于对照组77.50%(31/40)(P<0.05).结论 Friedman家庭评估模式结合社区康复模式可有效的改善社区脑卒中后吞咽障碍患者的日常生活能力,提高患者生存质量,有利于促进恢复吞咽功能,可显著的提高康复治疗效果.