The Intervention Study Of Hope Therapy Combined With Targeted Rehabilitation Training Contract On Hemiplegia Patients With First Stroke

Objective: To investigate the effects of hope therapy combined with targeted rehabilitation training contract on hope level,negative emotion,coping style and self-care ability of hemiplegia patients with first stroke.Methods: Seventy first-episode stroke patients with hemiplegia who were hospitalized in the Department of Neurology of Jiangbin Hospital of Guangxi Zhuang Autonomous Region from March 2021 to October 2021 were selected as the research subjects.According to random number table method,35 patients were divided into control group and observation group respectively.The control group received conventional nursing and targeted rehabilitation training,rehabilitation training 1-2 times/day,30-40minutes/time.On the basis of routine nursing,the observation group was given the intervention of hope therapy combined with targeted rehabilitation training contract.Based on Snyder’s hope theory model,the targeted individual problems of patients were evaluated and analyzed,problem-oriented,and based on literature review,expert consultation and pre-test.According to the individual differences of patients,individualized targeted rehabilitation training contract plan is developed for each patient,and rehabilitation training is carried out with goals and plans.Group intervention and one-to-one intervention were taken for 8 times.The rehabilitation training was the same as the control group,and the intervention time was 4 weeks.The changes of Herth Hope Index Scale(HHI),Self-rating Depression Scale(SDS),Medical Coping Questionnaire(MCMQ),modified Barthel Index Rating Scale(MBI)and National Institutes of Health Stroke Scale(NIHSS)scores were observed and compared between the two groups before intervention,4 weeks after intervention,and 12 weeks after intervention.Twelve weeks after intervention,the incidence of complications in the two groups was comprehensively analyzed.The effects of hope therapy combined with targeted rehabilitation training contract on hope level,negative emotion,coping style,neurological recovery,self-care ability and incidence of complications in first-episode stroke hemiplegia patients were comprehensively analyzed.SPSS23.0 software was used for statistical analysis,and the significance levels of statistical tests were all P <0.05,indicating statistical significance.The measurement data of normal distribution were expressed as mean ±standard deviation(` x±s).Enumeration data is represented by case number and composition ratio.Two independent samples t-test was used for measurement data that were independent,normally distributed and homogeneous in variance in comparison between groups.Chi-square test was used for dichotomous,disordered multi-classification and grade data.Repeated measure ANOVA and SNK multiple comparison were used to compare the changes in scores of each evaluation index at three different time points before intervention,4weeks after intervention and 12 weeks after intervention.Results: A total of 67 subjects completed data collection,including 33 in the observation group and 34 in the control group.(1)Comparison of general data and disease-related data between the two groups: the results showed no statistical significance(P>0.05),which was balanced and comparable.(2)Hope level: The total score of HHI,positive attitude towards reality and future,positive action and maintaining close relationship with others in the two groups showed an upward trend compared with before intervention,while the decrease was smaller in the control group,and the difference between the two groups was statistically significant(P<0.05).Interaction effects of different time points and groups showed statistically significant differences in HHI total score and scores of all dimensions(P<0.05),indicating that there was an interaction effect between intervention methods and time.It can be considered that intervention effects are different with different groups and different intervention times,and the observation group is superior to the control group.(3)Negative emotion: SDS score(standard score)of the observation group showed a downward trend compared with before intervention,and the difference was statistically significant(P<0.05).The interaction effect of different time points and groups showed that SDS score(standard score)showed statistically significant difference(P<0.05),indicating the interaction effect of intervention method and time.It can be considered that different groups,different intervention time,intervention effect is different,and the observation group is better than the control group.(4)Coping style: The MCMQ face dimension score of the two groups increased compared with that before intervention,and the difference was statistically significant(P<0.05).The interaction effect of different time points and groups showed that MCMQ faced dimension score had statistical significance(P<0.05);The scores of MCMQ avoidance dimension and yield dimension in the observation group showed a downward trend compared with before intervention,and the differences were statistically significant(P<0.05).The interaction effects of different time points and groups showed that the scores of MCMQ avoidance dimension and yield dimension were significantly different(P<0.05).It can be considered that different groups,different intervention time,coping style intervention effect is also different,and the observation group is better than the control group.(5)Self-care ability: MBI scores in both groups showed an upward trend compared with before intervention,with statistical significance(P<0.05).The interaction effects of different time points and groups showed differences in MBI scores There was statistical significance(P<0.05),indicating that there was an interaction effect between the intervention method and time.It can be considered that the intervention effect was different with different groups and different intervention time,and the observation group was superior to the control group.(6)Recovery of neurological function: NIHSS scores in both groups showed a downward trend compared with before intervention,with statistical significance(P<0.05);the interaction effects of different time points and groups showed that NIHSS scores difference was statistically significant(P<0.05),indicating that there is an interactive effect between intervention method and time.It can be considered that different groups have different intervention time and intervention effect,and the observation group is better than the control group.(7)Incidence of complications: 12 weeks after intervention,the incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).(8)Ehabilitation training compliance: 4 weeks after intervention and 12 weeks after intervention,the rehabilitation training compliance of the observation group was better than that of the control group,the difference was statistically significant(P < 0.05).Conclusion: Hope therapy in combination with targeted rehabilitation training contract intervention can improve the level of the hope of starting in stroke patients with hemiplegia,alleviate the negative mood,to guide its active rehabilitation training,and promote the recovery of neural function in patients with,reduce the incidence of complications,eventually improve the ability of independent living,a better return to the family and return to society.