| Objective1.To understand the status quo of disability acceptance in stroke patients and analyze the influencing factors of disability acceptance in stroke patients.2.Develop therapeutic communication plans according to the level of disease awareness,degree of depression,level of social support and coping ability of stroke patients,and explore the effect of therapeutic communication on improving disability acceptance of ischemic stroke patients,so as to provide strategic basis for improving disability acceptance of stroke patients.Methods1.Cross-sectional study: 205 cases of stroke patients hospitalized in a grade Iii a general hospital in Tianjin from January 2018 to October 2018 were selected as the study subjects.After screening for inclusion criteria,baseline investigation was conducted after the patients’ condition was stable,including the questionnaire on general condition of patients and disability acceptance scale.Frequency and composition ratio were used to describe the general demographic data and clinical data,(?) ± s measurement data,one sample T test and multiple linear regression analysis to explore the influencing factors on disability acceptance of stroke patients.2.A randomized controlled study: select in November 2018 to August 2019 in tianjin a certain level of first-class comprehensive hospital,113 cases of patients with ischemic stroke disability as the research object,and randomly divided into experimental group and the control group,the baseline survey after the illness is smooth,including general data questionnaire,stroke health knowledge questionnaire,medical coping questionnaire,understanding social support scale,depression self rating scale,disability acceptance scale,quality of life scale for stroke.After baseline investigation,routine nursing general communication was given to the control group,while routine nursing therapeutic communication was given to the experimental group.After discharge,intervention was continued through We Chat group for 3months,and scale retest was conducted by telephone or outpatient follow-up at 1month and 3 months after discharge.Using chi-square test to the comparison of two sample data,using independent sample t test are compared,and two sample mean group compared with single factor analysis of variance,and before and after the intervention and the hospital hospital 1 month,3 months with the difference of the two groups of repetitive measure analysis of variance methods are compared,the results with P < 0.05 for the difference was statistically significant.Results1.Cross-sectional study: The disability acceptance of stroke patients was at a medium level,with a total score of(83.43±11.86),and the scores of expanded dimension,transformation dimension,inclusion dimension and subordinate dimension were respectively(25.2±4.33)(23.52±3.84)(22.68±4.11)(11.99±2.46)points.According to one sample T test and multiple linear regression analysis,MRS score and per capita family monthly income were the influencing factors of disability acceptance in stroke patients.2.Randomized controlled study(1)The influence of therapeutic communication on depression in patients with ischemic stroke: the t-test results of two independent samples showed that there was no statistical difference in depression scores between the two groups before intervention(P>0.05);Depression scores of patients in the experimental group were lower than those in the control group after intervention,1 month after discharge,and3 months after discharge,with statistically significant differences(P<0.05).The results of repeated measurement ANOVA showed that there were statistically significant differences in the interaction between groups,time and × time(P<0.05).(2)The influence of therapeutic communication on the level of social support in patients with ischemic stroke: the t-test results of two independent samples showed that there was no statistically significant difference in the scores of social support between the two groups before intervention(P>0.05);Social support scores of patients in the experimental group were higher than those in the control group after intervention,1 month after discharge,and 3 months after discharge,with statistically significant differences(P<0.05).The results of repeated measurement ANOVA showed that the interaction differences of social support scores among groups,time and time × time were statistically significant(P<0.05).(3)The effect of therapeutic communication on the coping ability of patients with ischemic stroke: the t-test results of two independent samples showed that there was no statistical difference in the scores of coping dimensions between the two groups before intervention(P>0.05);After intervention,1 month after discharge and 3months after discharge,patients in the experimental group had higher scores in the dimension of facing,and lower scores in the dimension of avoidance and yield than those in the control group,with statistically significant differences(P<0.05).The results of repeated measurement ANOVA showed that there were statistically significant differences in the intergroup,time,and time × time interactions between the face dimension,avoidance dimension,and yield dimension scores(P<0.05).(4)Therapeutic communication disability acceptance in patients with ischemic stroke:the influence of two independent samples t test,according to the results of intervention in the first two groups of patients with disability acceptance score no statistical difference(P>0.05),and after the intervention,the hospital hospital 1month,3 months of test group patients disability acceptance score were higher than control group,the difference was statistically significant(P<0.05).The results of repeated measurement an OVA showed that the differences in the interaction between groups,time and time × time were statistically significant(P<0.05).(5)Therapeutic communication on the quality of life of patients with ischemic stroke:two independent samples t test,according to the results of two groups of patient quality of life scores before intervention has no statistically significant difference(P>0.05),and one month after the intervention,the hospital discharged 3 months group patients quality of life score were higher than control group,the difference was statistically significant(P<0.05).The results of repeated measurement ANALYSIS of variance(ANOVA)showed that the differences in the interaction between groups,time and time × time were statistically significant(P<0.05).Conclusion1.There is a significant positive correlation between disability acceptance and quality of life in hospitalized stroke patients.Medical workers should pay attention to and evaluate disability acceptance of patients as soon as possible,and take targeted intervention measures to improve disability acceptance of patients,promote mental health and improve quality of life.2.Therapeutic communication can improve the depressed state of ischemic stroke patients,improve the level of social support and coping ability,effectively improve the disability acceptance of patients,and further improve the quality of life of patients,which is worthy of further promotion and application by clinical nurses. |
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