A Study On The Construction Of Self-Management Intervention Programme For Stroke Patients With Motor Dysfunction

Purpose:To summarize the evidence on self-management of stroke patients with motor dysf unction at home and abroad and to construct a self-management program for stroke pati ents with motor dysfunction that is consistent with China’s national conditions through t he Delphi method in order to standardize and guide clinical stroke self-management pra ctice.Methods:1.Systematic search,screening and evaluation of the literature on self-management of patients with motor dysfunction in stroke at home and abroad,extraction and integrat ion of evidence to form a summary of the best evidence on self-management of patients with motor dysfunction in stroke.2.The first draft of the self-management program for patients with motor dysfuncti on in stroke was prepared based on the evidence-based results,and the first draft of the s elf-management program was revised by the Delphi method,and the content of indicato rs at all levels was revised and improved according to the results of expert consultation,and the self-management program for patients with motor dysfunction in stroke was fin ally established.Result:1.After a rigorous literature search,screening and quality evaluation,a total of 36 r elevant articles were finally included,including 9 guidelines,4 expert consensuses,5 sy stematic reviews,5 quasi-experimental studies and 13 randomised controlled studies.Th e evidence was summarised into 6 areas of organization and management,assessment,e xercise instruction,health education,psychological support,monitoring and follow-up,and 34 pieces of best evidence.2.After the two rounds of correspondence,there was a gradual convergence of expe rt opinion on the content of the programme.The number of experts in the two rounds of consultation was 16 and 15 respectively,and the effective return rate of the questionnair e was 94.12% and 93.75% respectively.The authority coefficients of experts were 0.92 and 0.91 respectively,and the Kendall’s harmony coefficients were 0.137 and 0.120 resp ectively(P < 0.001).The means were 4.00～5.00 and 4.13～5.00,respectively,and the pe rfect scores were 43.75%～100.00% and 40.00%～100.00%,respectively.The final const ructed self-management intervention programme included organisational management c onstruction,symptom assessment,exercise management,health education management,social and psychological support,and health monitoring,with a total of 6 primary indic ators,16 secondary indicators and 44 tertiary indicators.Conclusion:This study constructs a self-management intervention programme for stroke patient s with motor dysfunction through the Delphi method on the basis of evidence,which is scientific and reliable and can provide a basis for the clinical practice of self-manageme nt for stroke patients with motor dysfunction.