| Objective:1.Taking the “Timing it Right” as the framework,use the method of literature review to conclude the care needs of patients with ischemic stroke at different stages of the disease,and make a Discharge Planning based on the “Timing it Right” for patients with ischemic stroke.2.To explore the effect of the Discharge Planning on activities of daily living(ADL),compliance with medical behavior and the incidence rate of second stroke.Providing references for Discharge Planning and continuous care of patients with ischemic stroke.Method:1.Research object selection: from June to December 2019,a total of 140 patients with ischemic stroke who met the inclusion criteria of the study in the Department of Neurology of Grade 3A General Hospital in Shanxi province were chosen.They were divided into two groups randomly: the experimental group(n = 70)and the control group(n = 70).2.Intervention methods: through a questionnaire survey of 30 subjects,the nursing needs of the subjects at different stages of the disease were identified.Combined the literature reviews with the clinical characteristics of patients,make a Discharge Planning for patients with ischemic stroke based on the “Timing it Right”.The Discharge Planning was verified by the consultation of experts.And then forming a formal research scheme by the pre-test and the revision the research scheme.Patients in the control group received routine hospitalization care for patients with ischemic stroke,while patients in the experimental group received routine nursing care for patients with ischemic stroke and Discharge Planning based on the “Timing it Right”.3.Evaluation of effect: firstly,the Barthel index(BI)score of the two groups were measured at admission(t0),2 days before discharge(t1),3 months after discharge(t2)and6 months after discharge(t3),reflecting the patients’ activities of daily living;Secondly,the compliance with medical behavior was evaluated by comparing two groups’ compliance of taking medicine punctually,reasonable diet,tobacco and alcohol control,self-monitoring,rehabilitation training and regular follow-up visit at the three point: 2 days before discharge,3 months after discharge and 6 months after discharge.Finally,the incidence rate of secondary stroke was compared between the two groups after 6 months discharge.Results:1.Before the intervention,there was no significant difference in general data(age,gender,marital status,education level,form of medical insurance,occupation)and clinical data(complications and NIHSS score)between the two groups.2.Activities of daily living: the results of repeated measures analysis of variance showed that after the end of the study,the BI index scores of the two groups of patients has a significantly increase than those at admission(P<0.05);There is interaction effect between time and group,which indicates that the effect of time factor varies with different groups,which means the increasing trend of BI scores of the two groups is different over time,and the increasing trend of BI score is more obvious after the implementation of Discharge Planning.The results of t-test at the same time between the two groups showed that there was no significant difference between the two groups at admission(t0),2 days before discharge(t1)and 3 months after discharge(t2).However,there was a significant difference in the score of BI index between the two groups after six months discharge(t3)(P < 0.05).3.Compliance: with regard to two days before discharge(t1),there was no significant difference in compliance of six dimensions between the experimental group and the control group(P > 0.05);With regard to three months after discharge(t2),there was a significantly statistical difference in compliance with instructions in three dimensions of self-monitoring,regular follow-up and rehabilitation training between the two groups.About 6 months after discharge(t3),there was a significant difference in compliance of each dimension between the two groups(P < 0.05).4.Secondary stroke incidence rate: the incidence of secondary stroke in the experimental group was significantly lower than that in the control group,and the difference was statistically significant after 6 months discharge(P < 0.05).Conclusion:The results of this study showed that after 6 months of discharge planning intervention based on “Timing it Right”,the activities of daily living and compliance of patients with ischemic stroke have been improved,which shows that the Discharge Planning based on “Timing it Right”can improve the activities of daily living of patients with ischemic stroke,promote patients compliance with medical behavior,and reduce the incidence of secondary stroke.And then improve the quality of life of patients. |
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