The Study Of Construction And Application On Programme Of Discharge Planning For Stroke Patients

PartⅠ CONSTRUCTION ON PROGRAMME OF DISCHARGE PLANNING FOR STROKE PATIENTSPurpose This research aims to build a programme of operabeable discharge planning that is suitable for stroke patients based on the hospital level,which is suitable for China’s national conditions and can provide continuing care.Methods 1.Method of Literature Review and Content Analysis Find out the domestic and foreign guidelines on discharge planning,clinical practice guidelines for stroke patients,and analyze the contents,so as to provide a scientific basis for the structure of discharge planning for stroke patients.2.Method of Focus Group Discussion Through focus group discussion,understand the medical staff’s knowledge of the discharge planning.After the initial construction of the programme,the scientific and feasibility of the program will be demonstrated and evaluated,and revised opinions will be proposed.3.Qualitative Research Method Qualitative interview is used to conduct semi-structured discussion with patients with stroke,so as to understand their needs for discharge planning services,and to provide a basis for determining the service content of discharge planning.Results 1.Through the literature review and content analysis of the discharge planning guide, clinical practice guidelines for stroke patients,it provides a scientific basis for constructing the purpose,contents,methods,processes and other elements of the discharge planning.2.Through focus group discussion,the recognition of discharge planning by medical staff is understood.After the preliminary construction of programme,the rationality and feasibility of discharge planning are discussed and evaluated,and the revised opinions on the roles,responsibilities,implementation process and implementation methods of program members are put forward.3.A semi-structured interview is conducted with 16 patients with stroke by qualitative interview method,and Colaizzi’s 7-step analysis method is used to analyze the data.Five subjects of discharge plan service demand of patients with stroke are extracted: information demand,activity demand,security demand,psychological demand and home care service demand,which provided a basis for the construction of discharge planning.Conclusion Based on the hospital level,this research constructs a discharge planning that can provide continuous nursing for patients with stroke,which is suitable for China’s national conditions,is able to help patients achieve a smooth transition from hospital environment to family environment,and provide new methods for nursing intervention of stroke patients.PartⅡ APPLED RESEARCH ON PROGRAMME OF DISCHARGE PLANNING FOR STROKE PATIENTSPurpose The discharge planning of stroke patients can be able to initially applied to the clinic and its application effect is evaluated.Methods According to convenient sampling method,80 patients with stroke in stroke ward of a tertiary first-class hospital in Jinan are randomly selected and divided into intervention group and control group with 40 cases in each.The control group undergoes routine treatment and nursing.On the basis of this,the intervention group implements the discharge planning service,and compare the differences between the two groups in general self-consciousness,activities of daily living,physiological indicators of risk factors,and readmission rate,eventually evaluate the effect of the discharge planning.Results A total of 73 patients has completed the data collection,of which 37 are discharged from the hospital in the intervention group and 36 are in the control group.The results of the research shows that the self efficacy scores of the intervention group are significantly improved(P=0.000),the BI index scores are significantly improved(P=0.001),and some of the risk factors are also improved(including Hb A1 c P=0.002,HDL-C P=0.001,LDL-C P=0.001,TG P=0.002),but there is no significant difference in Bp,BS,TC index and stroke readmission rate compared with the control group(P>0.05).Conclusion The discharge planning for stroke patients can significantly improve the level of general self-efficacy and daily life activities of patients,improve the physiological indicators of some risk factors of patients,help patients to achieve a smooth transition from hospital to family or community,and have a positive effect on secondary prevention of stroke.