Abstract: Objective　To observe the psychological status and quality of life in elderly stroke patients in recovery period under family and institutional care models, and to compare the advantages and disadvantages of different care models. Methods　A total of 314 elderly people who had been diagnosed with stroke for 1-3 months in Lianyungang City from January 2019 to March 2021 were selected. They were divided into a family care group and an institutional care group according to different elderly care models. The patients in the institutional care group were from many elderly care institutions and social welfare institutions in Lianyungang City. There were 169 cases in the family care group, 88 males and 81 females, aged (75.64±6.15) years; there were 145 cases in the institutional care group, 70 males and 75 females, aged (73.71±6.70) years. After 12 months, the anxiety, depression, and quality of life were assessed in the two groups, and the psychological state and quality of life were compared. χ² test was used for the count data, and t test was used for the measurement data. Results　The proportion of urban residents choosing institutional care services was 53.7% (109/203), which was significantly higher than that of rural residents [32.4% (36/111)], with a statistically significant difference (P<0.05). The scores of Hamilton Anxiety Scale and Hamilton Depression Scale in the family care group were (10.35±2.62) and (12.15±4.85), respectively, which were lower than those in the institutional care group [(15.81±5.22) and (17.65±5.88)], with statistically significant differences (both P<0.05). The scores of daily living ability and memory and thinking ability in the institutional care group were (58.98±7.09) and (78.19±7.85), respectively, which were higher than those in the family care group [(44.43±10.21) and (67.62±9.58)], and the scores of sensory and affective control, participation ability, and hand function were (32.98±4.23), (12.67±5.74), and (49.62±3.68), respectively, which were lower than those in the family care group [(40.91±6.65), (20.96±3.56), and (51.85±6.02)], with statistically significant differences (all P<0.05). The comparison of adverse risk events between the two groups showed that the incidences of accumulation pneumonia, pressure ulcers, and pipe shedding in the institutional care group were significantly lower than those in the family care group, with statistically significant differences (all P<0.05). Conclusions　The proportion of urban residents choosing institutional care service is higher. Institutional care is inferior to family care in emotional states such as anxiety and depression, sensory and affective control, and participation ability. In terms of daily living ability, memory and thinking ability, and avoiding the incidence of accumulation pneumonia, pressure ulcers, and pipe shedding, institutional care is superior to family care.

Key words: Care model, Stroke, The elderly, Psychological state, Life style

摘要： 目的　分析居家和机构照护模式下老年脑卒中恢复期患者心理状况、生活质量，比较2种照护模式的优势和缺陷。方法　选取2019年1月至2021年3月连云港市确诊脑卒中后1～3个月的老年人314例，按照护模式不同分为居家照护组和机构照护组，机构照护组患者来自于连云港市多家养老机构、社会福利院。居家照护组169例，男88例、女81例，年龄（75.64±6.15）岁；机构照护组145例，男70例、女75例，年龄（73.71±6.70）岁。12个月后对两组患者进行焦虑、抑郁、生活质量等量表评估，比较两组患者心理状态、生活质量。计数资料采用χ²检验，计量资料采用t检验。结果　城镇居民选择机构照护服务的比例为53.7%（109/203），显著高于农村居民的32.4%（36/111），差异有统计学意义（P<0.05）。居家照护组焦虑、抑郁评分分别为（10.35±2.62）分、（12.15±4.85）分，均低于机构照护组［（15.81±5.22）分、（17.65±5.88）分］，差异均有统计学意义（均P<0.05）。机构照护组日常生活能力、记忆思维能力评分分别为（58.98±7.09）分、（78.19±7.85）分，均高于居家照护组［（44.43±10.21）分、（67.62±9.58）分］，感觉和情感控制力、参与能力、手功能评分分别为（32.98±4.23）分、（12.67±5.74）分、（49.62±3.68）分，均低于居家照护组［（40.91±6.65）分、（20.96±3.56）分、（51.85±6.02）分］，差异均有统计学意义（均P<0.05）。两组不良风险事件比较发现，机构照护组坠积性肺炎、压疮、管路脱落发生率均明显低于居家照护组，差异均有统计学意义（均P<0.05）。结论　机构照护在城镇居民比例较高，在焦虑、抑郁等情感状态、感觉和情感控制力、参与能力等方面劣于居家照护。在日常生活能力、记忆思维能力，避免坠积性肺炎、压疮、管路脱落发生率等方面，机构照护优于居家照护。

关键词: 照护模式, 脑卒中, 老人, 心理状况, 生活方式