脑卒中引起的偏瘫恢复期心理护理探讨

　　［摘要］  目的  提高脑卒中引起的偏瘫恢复期患者的心理护理效果，最大限度地促进患者康复。方法  脑卒中偏瘫恢复期患者56例，随机分为康复组和对照组各28例。康复组实施以自我效能理论为指导的规范化康复护理方案，对照组给予传统康复护理，入选时和干预1个月、2个月后采用脑卒中后抑郁多模式方法诊断、焦虑自评量表进行评定。结果  两组脑卒中后抑郁多模式方法诊断、焦虑自评分均较前一阶段显著性降低（P<0.01）。焦虑自评分：1个月、2个月后康复组降低分均显著大于对照组（P<0.01）；脑卒中后抑郁多模式方法诊断评分：1个月后，康复组降低分显著大于对照组（P<0.05）；2个月后，康复组降低分显著大于对照组（P<0.01）。结论  脑卒中偏瘫恢复期心理护理有助于患者心理功能改善。

　　［关键词］  心理护理；偏瘫；恢复期

　　Study on psychological nursing to patients with hemiplegia after stroke in rahabilitation period

　　MENG Hong-yu,GU Ling,LI Li-hua,et al.Geriatrics Hospital,Yangpu District,Shanghai 200090,China

　　［Abstract］  Objective  To improve the effects of psychological nursing to hemiplegic patients with stroke in rehabilitation period.Methods  56 cases of hemiplegic patients with stroke in rehabilitation period were divided into experimental group and control group randomly.For the experimental group,we adopted standard rehabilitation nursing directed by “Self-Efficacy Theory”,for the control group, we adopted traditional rehabilitation nursing. Evaluations were done beginning,one and two months afterwards by Multimodel Approach to Diagnosis of Post-Stroke Depress,Self Rating Anxiety Scale.Results  Two groups Multimodel Approach to Diagnosis of Post-Stroke Depress,Self Rating Anxiety Scale score were lower than former phrase significantly（P<0.01）.Self Rating Anxiety Scale:one and two months later,experimental groups decline score were higher than those in control group（P<0.01）.Multimodel Approach to Diagnosis of Post-Stroke Depress :one month later,experimental groups decline score was higher than control group（P<0.05）,two months later,experimental groups decline score was higher than control group（P<0.01）.Conclusion  The standard rehabilitation nursing to hemiplegic inpatients with stroke in rehabilitation period can improve patientspsychological function.

　　［Key words］  stroke;hemiplegia;psychological nursing
   
　　脑卒中是一类危害人类健康问题的常见病、多发病，其发病率、患病率、致残率均相当高，我国脑卒中的发病率为每年150／10万［1］。由于临床对脑血管疾病诊断、抢救和治疗技术的提高，使急性期病死率大幅度下降，而存活率、致残率明显上升，约为86.5％，患者留有不同程度的运动、认知、情感障碍等，给家庭和社会带来沉重的负担［2］。由于不少患者遗留了严重残疾，严重影响其生活质量和日常生活活动能力，降低了患者的生活信心与克服疾病的意志。脑卒中后抑郁（post-stroke depression，PSD）、焦虑是脑卒中常见的情感障碍并发症，发病率达20%～60%［3］。情感障碍加重患者已存在的生理康复，严重影响康复效果。