标题：知信行模式健康教育联合多学科合作连续康复护理在脑卒中偏瘫患者中的应用

      作者：周丽娜 1，万映雪 2，吴芳 3    南阳市第一人民医院门诊部 1、中医科 2、神经内科 3，河南 南阳 473000

      卷次： 2022年33卷6期

      【摘要】 目的 探讨知信行(KAP)模式健康教育联合多学科合作连续康复护理在脑卒中偏瘫患者中的应用价值。方法 选取2019年1月至2020年2月南阳市第一人民医院收治的280例脑卒中偏瘫患者，根据信封抽签法分为对照组和观察组各140例。对照组患者接受常规康复护理指导，观察组患者接受KAP模式健康教育联合多学科合作连续康复护理干预。分别采用Barthel指数、Fugl-Meyer量表、Herth希望水平量表(HHI)、脑卒中自我效能感问卷(SSEQ)、遵医行为量表以及脑卒中专用生活质量量表(SS-QOL)对两组患者入院时、出院后2个月的日常生活能力、患肢功能、希望水平、自我效能感、遵医行为以及生活质量进行评估。此外，患者出院后2个月采用护理满意度问卷调查两组患者的护理满意度。结果 两组患者护理前的Barthel指数、Fugl-Meyer积分、HHI评分、SSEQ评分以及SS-QOL评分比较差异均无统计学意义(P>0.05)；护理后，两组患者的Barthel指数、Fugl-Meyer评分、HHI评分、SSEQ评分以及SS-QOL评分均明显高于护理前，且观察组的上述各项指标明显高于对照组，差异均有统计学意义(P<0.05)。两组患者护理前的遵医行为各维度评分及总分比较差异均无统计学意义(P>0.05)；护理后，两组患者的功能锻炼、系统治疗、并发症预防、健康生活行为评分及总分明显高于护理前，且观察组患者的上述各项指标明显高于对照组，差异均有统计学意义(P<0.05)；观察组患者的护理满意度问卷各因子(服务态度、健康教育、业务水平、护理管理、关爱患者)评分及总分明显高于对照组患者，差异均有统计学意义(P<0.05)。结论 与常规康复护理比较，脑卒中偏瘫患者采用KAP模式健康教育联合多学科合作连续康复护理，不仅能进一步改善患者的运动功能，提高希望水平、遵医行为以及生活质量，还可提升患者满意度。
      【关键词】 脑卒中；偏瘫；知信行模式健康教育；多学科合作；自我效能；生活质量
      【中图分类号】 R473.74 【文献标识码】 A 【文章编号】 1003—6350（2022）06—0805—05

Application of health education based on knowledge-attitude-practice model combined with continuousrehabilitation nursing based on multidisciplinary cooperation in stroke patients with hemiplegia.
ZHOU Li-na 1,WAN Ying-xue 2, WU Fang 3. Outpatient Department 1, Department of Traditional Chinese Medicine 2, Department of InternalMedicine-Neurology 3, Nanyang First People's Hospital, Nanyang 473000, Henan, CHINA
【Abstract】 Objective To explore the application value of health education based on knowledge-attitude-prac-tice (KAP) model combined with continuous rehabilitation nursing based on multidisciplinary cooperation in stroke pa-tients with hemiplegia.Methods A total of 280 stroke patients with hemiplegia treated in Nanyang First People's Hospi-tal from January 2019 to February 2020 were selected. According to the envelope lottery, they were divided into an ob-servation group and a control group, with 140 cases in each group. The patients in the control group received routine re-habilitation nursing guidance, and the patients in the observation group received health education based on KAP modelcombined with ontinuous rehabilitation nursing based on multidisciplinary cooperation. Barthel index, Fugl-Meyer Scale,Herth Hope index (HHI), Stroke Self-efficacy Questionnaire (SSEQ), Compliance Behavior Scale, and Stroke SpecificQuality of Life Scale (SS-QOL) were used to evaluate the ability of daily living, limb function, hope level, self-efficacy,compliance behavior, and quality of life of the two groups at admission and 2 months after discharge. In addition, 2 monthsafter discharge, the nursing satisfaction questionnaire was used to investigate the nursing satisfaction of the two groups.Results There was no significant difference in Barthel index, Fugl-Meyer score, HHI score, SSEQ score, and SS-QOLscore between the two groups before nursing (P>0.05). After nursing, Barthel index, Fugl-Meyer score, HHI score,SSEQ score, and SS-QOL score between the two groups were higher than those before nursing (P<0.05), and the aboveindexes of the observation group were significantly higher than those of the control group, all with statistically signifi-cant difference (P<0.05). There was no significant difference in each dimension score and total score of compliance be-havior between the two groups before nursing (P>0.05). After nursing, the scores of functional exercise, systematic treat-ment, complication prevention, healthy life behavior and total scores in the two groups were higher than those beforenursing (P<0.05), and the above indexes of the observation group were significantly higher than those of the controlgroup, all with statistically significant difference (P<0.05). The scores of each factor (service attitude, health education,professional level, nursing management, and caring for patients) and total scores of the nursing satisfaction questionnaire　　　·护理·doi:10.3969/j.issn.1003-6350.2022.06.035基金项目：河南省医学科技攻关计划项目(编号：201603635)