Abstract:

Objective　To investigate the effect of target management mode under chronic disease trajectory framework on recovery of stroke patients after interventional operation, so as to provide new management strategies for clinical nursing. Methods　A total of 152 patients who underwent interventional operation for stroke in The Third People's Hospital of Hubei Province Affiliated to Jianghan University from February 2021 to February 2022 were reviewed. The 76 patients admitted from February to July 2021 were selected as a control group [39 males and 37 females, aged (57.85±6.33) years], who were given routine nursing intervention. The other 76 patients admitted from August 2021 to February 2022 were selected as an observation group [40 males and 36 females, aged (58.29±7.44) years], who were given target management mode under chronic disease trajectory framework on the basis of the control group. The postoperative recovery, neurocognitive function, self-management ability, and quality of life were compared between the two groups. t test and χ² test were used. Results　The time of first anal exhaust [(26.48±5.44) h], the time of eating [(1.05±0.37) d], the time of out-of-bed activities [(7.35±2.15) d], and the hospital stay [(10.25±1.43) d] in the observation group were all shorter than those in the control group [(30.06±4.83) h, (1.33±0.45) d, (9.26±2.33) d, and (12.48±2.52) d], with statistically significant differences (all P<0.05). After intervention, the score of National Institutes of Health Stroke Scale (NIHSS) [(8.01±1.54) points] in the observation group was lower than that in the control group [(10.33±1.46) points], and the score of Montreal Cognitive Assessment Scale (MoCA) [(24.30±2.54) points] was higher than that in the control group [(20.16±2.80) points], with statistically significant differences (both P<0.05). After intervention, the scores of self-responsibility [(20.05±4.52) points], self-care knowledge [(30.33±4.95) points], self-care concept [(20.01±2.01) points], and self-care skills [(39.38±5.22) points] in the observation group were higher than those in the control group [(18.05±3.25) points, (26.46±3.87) points, (17.96±1.94) points, and (36.34±5.11) points], with statistically significant differences (all P<0.05). After 2 and 4 weeks of intervention, the life quality scores of the observation group [(82.31±5.27) points and (125.48±8.46) points] were higher than those of the control group [(78.46±4.33) points and (114.36±7.94) points], with statistically significant differences (both P<0.05). Conclusion　Applying target management mode under chronic disease trajectory framework to stroke patients after interventional operation can not only shorten the hospital stay and promote the recovery, but also improve the patients' neurocognitive function, perception of healthy behaviors, and negative emotion management, thereby improving the quality of life.

Key words:

Stroke, Interventional operation, Postoperative recovery, Neurocognitive function, Self-concept, Chronic disease trajectory framework, Target management mode

摘要：

目的　探讨慢性病轨迹框架下的目标管理模式对脑卒中介入术患者术后恢复的影响，以期为临床护理提供新的管理策略。方法　回顾性选取2021年2月至2022年2月江汉大学附属湖北省第三人民医院收治的152例接受脑卒中介入术治疗患者，其中2021年2月至7月为对照组（76例），男39例、女37例，年龄（57.85±6.33）岁，予以常规护理干预；2021年8月至2022年2月为观察组（76例），男40例、女36例，年龄（58.29±7.44）岁，在对照组基础上实施慢性病轨迹框架下的目标管理模式。对比两组患者术后恢复情况、神经认知功能、自我管理能力及生活质量变化情况。采用t检验、χ²检验。结果　观察组术后首次肛门排气时间［（26.48±5.44）h］、进食时间［（1.05±0.37）d］、下床活动时间［（7.35±2.15）d］、住院时间［（10.25±1.43）d］均短于对照组［（30.06±4.83）h、（1.33±0.45）d、（9.26±2.33）d、（12.48±2.52）d］，差异均有统计学意义（均P<0.05）。干预后，观察组美国国立卫生研究院卒中量表（NIHSS）评分［（8.01±1.54）分］低于对照组［（10.33±1.46）分］，蒙特利尔认知评估表（MoCA）评分［（24.30±2.54）分］高于对照组［（20.16±2.80）分］，差异均有统计学意义（均P<0.05）。干预后，观察组自我责任感［（20.05±4.52）分］、自我护理知识［（30.33±4.95）分］、自我护理概念［（20.01±2.01）分］、自我护理技能评分［（39.38±5.22）分］均高于对照组［（18.05±3.25）分、（26.46±3.87）分、（17.96±1.94）分、（36.34±5.11）分］，差异均有统计学意义（均P<0.05）。干预后2周、4周，观察组生活质量评分［（82.31±5.27）分、（125.48±8.46）分］均高于对照组［（78.46±4.33）分、（114.36±7.94）分］，差异均有统计学意义（均P<0.05）。结论　慢性病轨迹框架下的目标管理模式用于脑卒中介入术患者术后恢复中，不仅能缩短住院时间，促进康复，还能改善神经认知功能，提高其对健康行为的感知及负性情绪管理，对于其生活质量的提升具有重要意义。

关键词:

脑卒中, 介入术, 术后恢复, 神经认知功能, 自我概念, 慢性病轨迹框架, 目标管理模式