| [Objectives]1.To investigate the current status and influencing factors of health behaviors in young stroke patients;2.To develop the discharge planning model(DPM) and improve inter-agency continuity of care;3.To explore the effectiveness of a nurse-led discharge planning model in the continuous care of young stroke patients, such as health behaviors, activities of daily living, self-efficacy, body mass index, frequency of acute exacerbation, readmission, and so on.[Methods]The research design in this study is a randomized controlled trial. A total of120young stroke patients were randomly assigned into intervention group (n=59) and control group (n=61) from the neurology department of Tianjin Huanhu Hospital since Oct2010to Jul2011. The participants in the control group received the routine guidance, and the participants in the intervention group received the routine care and a nurse-led discharge planning model intervention of continuous care including assessment of health needs, coordination discharged place, health education manual. The effects were evaluated at the6th month after intervention. All the patients were investigated with Health-Promoting Lifestyle Profile Ⅱ (HPLP Ⅱ), Barthel Index (B1), General Self-efficacy Scale (GSES) and biochemical indicators(lipids, homocysteine), et al. Chi-square test, ANOVA, T-test, Mann-Whitney U test and multiple stepwise regression were used to analyze the data with SPSS16.0.[Results]1.The mean score of health behavior was (114.00±19.67),83.4%had unhealthy lifestyle. It was significantly lower than that in elderly stroke patients, as well as the normal crowd. The score index was54.81%. Among the six dimensions, spiritual growth and interpersonal relations scored highest, while health responsibility and physical activity scored lowest.2.Multiple regression analysis showed that self-efficacy, activities of daily living, the general knowledge, monthly income and social support were influencing factors of health behaviors, which could explained56.1percent of the variance.3.Effect of discharge planning together with continuous nursing intervention:①The analysis between groups indicated that the intervention group had higher scores on health behaviors at month6post-intervention than those in the control group, except spiritual growth and interpersonal relations domains(P<0.01);②There was significant difference in self-efficacy and social support after intervention between the two groups (P<0.05);③No statistical significance was found in BMI before and after intervention for the two groups (P>0.05), but the results showed that the decline of BMI by month6after intervention for patients in the experimental group (P<0.05);④There was no significant difference on the general knowledge and Barthel index pre-intervention (P>0.05), while the general knowledge and Barthel index were enhanced post-intervention and statistical significance was showed both between-group and within-group (P<0.01);⑤Compared with the control group, the participants in the intervention group had a better control of serum total cholesterol (TC), high-density lipoprotein(HDL), low-density lipoprotein(LDL), homocysteine(Hcy), acute exacerbation and readmis-sion, and there was significant difference between pre-and post-intervention (P<0.05).[Conclusion]1. Unhealthy lifestyle was common in the population of early-onset stroke patients. Health behavior was related to the level of self-efficacy, the general knowledge, monthly income, social support and BI index.2.A nurse-led discharge planning model in the continuous care for young stroke patients played a positive role in the improvement of health behaviors and functional status, and could enhance the sense of self-efficacy, social support, and aslo was helpful to develop stroke awareness and general knowledge within six months.3.Compared to the routine model, during the six months, the discharge planning nursing model could decrease the blood level of liquid, Hey, frequency of acute exacerbation, readmission of the young stroke patients effectively. |
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