Effects of continuous nursing on rehabilitation of patients with hypertensive cerebral hemorrhage after puncture drainage / 中国实用护理杂志

ABSTRACT

Objective@#To observe the effects of continuous nursing(CN) on rehabilitation of patients with hypertensive intracerebral hemorrhage (HICH) and to explore the effective interventive measures for CN.@*Methods@#Totally 129 admitted HICH patients from January to December 2017 were selected and randomly divided into study group (63 cases) and control group (66 cases), the control group was handed with Handbook of stroke prevention and control before discharge, the study group received CN intervention, which included pre-discharge health education, family visits, patient management and video interview via WeChat App, group lecture and psychological support, self-nursing ability, motor function and ability of daily life and emotional condition were evaluated before and post discharge, and the disabled ratio 6 months after discharge between the 2 groups were compared.@*Results@#The 2 groups with the scores of exercise of self-care agency scale (ESCA) were increased significantly compared with before discharge (all P<0.05) ; the study group with the ESCA scores 3 months and 6 months after discharge were significantly higher than the control group [3months:118.5±8.2 vs. 112.3±7.5; 6 months: 127.7±8.7 vs. 119.3±9.1] (all P<0.05) . Fugl Meyer score and Barthel index of the 2 group after discharge were both lower than the pre-discharge levels (all P<0.05); Fugl Meyer score and Barthel index of the study group 3 months and 6 months after discharge were significantly higher than the control group [3 months: Fugl Meyer score 73.3±7.3 vs. 69.4±6.9; Barthel index 56.5±8.0 vs. 51.8±7.3; 6 months: Fugl Meyer score77.6±8.0 vs. 74.5±7.2; Barthel index 67.5±8.7 vs. 63.0±7.4] (all t=2.291-3.454, P<0.05). Two groups with HAD score after discharge were significantly decreased compared with before discharge (P<0.05); the study group with the HAD-A and HAD-D scores 3 and 6 months after discharge were significantly lower than the control group[3 months: HAD-A 6.75±2.23 vs. 8.02±2.85; HAD-D 6.07±1.75 vs. 7.23±1.94; 6 months: HAD-A 5.93±2.04 vs. 6.84±2.37; HAD-D 5.86±1.47vs. 6.75±1.76] (all P<0.05) . The study group with the re-admission rate and disabled ratio within 6 months after discharge were both lower than the control group, but the differences without statistical significance (all P>0.05).@*Conclusion@#The HICH patients added with CN can significantly improve self-care ability, improve prognosis; patient management via WeChat App and group lecture & psychological support are effective measures to carry out CN.