Abstract:

Objective　To explore the application effect of physician - nurse - rehabilitation therapist integrated management model based on SBAR (Situation, Background, Assessment, and Recommendation) in promoting early rehabilitation of stroke patients. Methods　Using a pre-post control study method with different cases, 30 stroke patients admitted to Jieyang People's Hospital from June 2020 to February 2021 were selected as a control group, including 11 males and 19 females, with an age of (63.77±13.26) years old, who received traditional physician - nurse - rehabilitation therapist integrated management model; 30 stroke patients admitted to Jieyang People's Hospital from March 2021 to December 2021 were as selected an observation group, including 21 males and 9 females, with an age of (59.20±17.20) years old, who received SBAR-based physician - nurse - rehabilitation therapist integrated management model. The modified Barthel index scores (activities of daily living) and simple three-level balance assessment results before and after intervention, and patient satisfaction with nursing services were compared between the two groups. t test and χ² test were used. Results　The modified Barthel index score of the observation group was significantly higher than that of the control group at discharge [(50.23±28.63) points vs. (31.63±23.31) points], with a statistically significant difference (P<0.01). The sitting and standing balance assessment results of the observation group were better than those of the control group at 2 weeks of hospitalization and discharge, with statistically significant differences (all P<0.05). There were 7 dimensions of patient nursing service satisfaction, among which the scores of perceived quality and patient complaint were (42.70±3.76) and (4.47±0.68) points in the control group, and (45.53±0.73) and (4.80±0.41) points in the observation group, respectively, with statistically significant differences (both P<0.05); the scores of hospital brand, disease pressure, patient satisfaction, and patient loyalty were (4.47±0.57), (4.63±0.56), (9.37±1.03), and (9.20±1.00) points in the control group, and (4.90±0.31), (4.93±0.25), (9.97±0.18), and (9.87±0.35) points in the observation group, respectively, with statistically significant differences (all P<0.01); the patient expectation score of the control group was (14.40±1.33) points, and that of the observation group was (14.87±0.35) points, with no statistically significant difference (P>0.05). Conclusion　The physician - nurse - rehabilitation therapist integrated management model based on SBAR can improve the activities of daily living of stroke patients, improve the limb function, and improve the satisfaction of nursing services, which has high clinical promotion value.

Key words:

Stroke, Rehabilitation nursing, Quality of life, SBAR theory

摘要：

目的　探究基于SBAR［Situation（现状）、Background（背景）、Assessment（评估）、Recommendation（建议）］的医护康一体化管理模式在促进脑卒中患者早期康复中的应用效果。方法　采用不同病例前-后对照的研究方法，选取揭阳市人民医院2020年6月至2021年2月收治的30例脑卒中患者作为对照组，其中男11例，女19例，年龄（63.77±13.26）岁，实施传统医护康一体化管理模式；选取揭阳市人民医院2021年3月至2021年12月收治的30例脑卒中患者作为观察组，其中男21例，女9例，年龄（59.20±17.20）岁，实施基于SBAR的医护康一体化管理模式。比较干预前后两组患者改良Barthel指数评分（日常生活活动能力）、简易三级平衡评定及患者护理服务满意度。采用t检验、χ²检验。结果　出院时观察组患者改良Barthel指数评分明显高于对照组［（50.23±28.63）分比（31.63±23.31）分］，差异有统计学意义（P<0.01）。住院2周及出院时观察组患者的坐、站立平衡均优于对照组，差异均有统计学意义（均P<0.05）。患者护理服务满意度共7个维度，其中感知质量、患者抱怨，对照组得分分别为（42.70±3.76）、（4.47±0.68）分，观察组得分分别为（45.53±0.73）、（4.80±0.41）分，差异均有统计学意义（均P<0.05）；医院品牌、疾病压力、患者满意和患者忠诚，对照组得分分别为（4.47±0.57）、（4.63±0.56）、（9.37±1.03）、（9.20±1.00）分，观察组得分分别为（4.90±0.31）、（4.93±0.25）、（9.97±0.18）、（9.87±0.35）分，差异均有统计学意义（均P<0.01）；而对照组患者预期得分（14.40±1.33）分，观察组得分（14.87±0.35）分，差异无统计学意义（P>0.05）。结论　基于SBAR的医护康一体化管理模式可提高脑卒中患者日常生活活动能力，改善肢体功能、提高护理服务满意度，具有较高的临床推广价值。

关键词:

脑卒中, 康复护理, 生活质量, SBAR理论