家庭跟进式分级护理对居家帕金森病病人的影响

摘要

[目的]观察家庭跟进式分级护理对居家帕金森病病人运动和非运动症状、心理状态和生活质量的影响.[方法]将160例帕金森病病人随机分为常规组和干预组,每组80例.常规组予以常规护理,干预组予以家庭跟进式分级护理.比较两组病人干预后6个月运动症状、非运动症状、社会活动功能、日常生活活动能力及生活质量改善情况,同时调查两组病人依从性和护理服务满意度.[结果]两组病人干预后蒙特利尔认知评估量表(MoCA)评分较干预前均明显增高,汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、社会功能活动问卷(FAQ)、帕金森病致残量表-夜间量表(SCOPA-NS)和日间量表(SCOPA-DS)评分均较干预前明显降低(P＜0.05),且干预后干预组MoCA评分高于常规组,FAQ、HAMD、HAMA、SCOPA-DS、SCOPA-NS评分低于常规组(P＜0.05);两组病人干预后改良Ashworth量表、统一帕金森病评估量表(UPDRS-Ⅲ)、帕金森病生活质量问卷39项(PDQ-39)评分较干预前均明显降低,平衡及步态评价量表(FGA)、改良Barthel指数量表(MBI)评分较干预前明显增高(P＜0.05),且干预后干预组Ashworth、UPDRSⅢ、PDQ 39评分明显低于常规组,FGA、MBI评分明显高于常规组(P＜0.05);干预后干预组依从率和护理满意率明显高于常规组(P＜0.05).[结论]家庭跟进式分级护理应用于帕金森病人居家护理可明显改善其负性心理、运动及非运动症状,提高其社会活动功能、日常生活活动能力,提高其整体生活质量.%Objective:To observe the influence of family follow up grading nursing on motor and non motor symptoms,mental status and quality of life in patients with Parkinson' s disease at home.Methods:A total of 160 patients with Parkinson's disease were randomly divided into routine group and intervention group,80 cases in each group.The patients in routine nursing group were given routine nursing,and the patients in intervention group were given family follow-up grading nursing.The motor symptoms,non motor symptoms,social activities,activities of daily living and quality of life of patients in the two groups were compared before and after the intervention 6 months.Meanwhile,the compliance and nursing service satisfaction of the two groups were investigated.Results:The Montreal Cognitive Assessment(MoCA) score was significantly higher thanthat before intervention,Hamilton Depression Scale (HAMD),Hamilton Anxiety Scale (HAMA),social function (Functional Activities Questionnaire,FAQ),Scales for Outcomes in Parkinson' s Disease-Night Sleep (SCOPA-NS) and Scales for Outcomes in Parkinson's Disease-Daytime Sleep(SCOPA-DS) scores were significantly lower than those before intervention(P＜0.05).After intervention,the MoCA score of intervention group was higher than that of conventional group,and the scores of FAQ,HAMD,HAMA,SCOPA-DS and SCOPA-NS were lower than those of conventional group(P＜0.05).The modified Ashworth scale,Unified Parkinson s Disease Rating Scale(UPDRS-Ⅲ),39-item Parkinson' s Disease Questionnaire(PDQ-39) scores were significantly lower than those before intervention,the balance and gait assessment scale(FGA),Modified Barthel Index(MBI) scores were significantly higher than those before intervention(P＜0.05).After intervention,the scores of Ashworth,UPDRS-Ⅲ and PDQ-39 in the intervention group were significantly lower than those in the conventional group,FGA,MBI scores was significantly higher than that in the conventional group(P＜0.05).After intervention,the compliance rate and nursing satisfaction rate in intervention group were significantly higher than those of the conventional group(P＜0.05).Conclusions:The application of family follow-up grading nursing in home care of patients with Parkinson disease could significantly improve the negative psychological,motor and non motor symptoms,improve the social function and activities of daily living,improve the overall quality of life.