| Purpose:1.In this study,an intervention plan for senile stroke patients with frailty was developed based on the empowerment theory through literature search and Delphi method of expert correspondence consultation.2.To study the effect of constructing intervention programs for senile stroke patients with frailty based on the empowerment theory,in order to provide reference for the management practice of senile stroke patients with frailty.Method:1.A multidisciplinary team was set up,based on literature search and combined with clinical status,to develop an intervention program for senile stroke patients with frailty and a routine intervention program for the control group based on the enabling theory.Then,two rounds of Delphi expert letter consultation were conducted for the intervention scheme based on the empowerment theory to determine the final version of intervention scheme based on the empowerment theory.2.The experimental design was adopted in this study,which was convenient to select the neurology department of a third-class A general hospital in Qingdao as the study site.The neurology department of the hospital was divided into two wards(marked as Ward A and Ward B).The study began to use coin toss to set ward A as the intervention group(enabling theory group)and Ward B as the control group(routine education group).From June 2022 to December 2022,according to the time of admission,elderly patients with first stroke combined with frailty were continuously included,with 64 cases in each ward.The basic data questionnaire,The Eysenek Personality Questionnaire,FRAIL scale,Modified Rankin Scale(m RS),Activities of Daily Living scale(ADL),and health empowerment scale for geriatric chronic diseases were used as research tools.Data were collected at admission,6 weeks after discharge,and 12 weeks after discharge,and the results were analyzed statistically.3.In this study,descriptive statistics were conducted on the adoption rate and composition ratio of counting data.Chi-square test was used for the comparison between groups and within groups.The mean value and standard deviation of the measurement data were used for descriptive statistics.Before the intervention,Eysenek Personality Questionnaire,FRAIL scale,ADL scale,m RS Scale and health Enabling scale of chronic senile diseases in the two groups were compared by t test.After the intervention,FRAIL scales,ADL scales,m RS Scales,and Health empowerment scales for chronic senile diseases in different time periods of the two groups of patients were compared by T-test and repeated measurement variance analysis with general linear model(GLM).Bilateral probabilities were taken for all P values,and P<0.05 was considered statistically significant.Result:1.In this study,an intervention program for elderly patients with stroke complicated with frailty based on the empowerment theory was initially established.After two rounds of expert letter consultation by Delphi method,the questionnaire recovery rates were 92%and 91.3%,respectively.The coefficient of authority was 0.87 and 0.88,the coefficient of variation was 0.04 ～ 0.20 and 0.00 ～ 0.14,and the Kendall harmony coefficient was 0.509(X 2=560.966,P<0.001)and 0.514(X 2=468.58,P < 0.001),respectively.The final intervention plan for senile stroke patients with frailty based on the enabling theory includes 5 first-level indicators,8 second-level indicators and 40 third-level indicators.2.The general data of the two groups showed no significant differences in age,sex,educational level,marital status,family per capita monthly income,and medical insurance payment method(P>0.05).3.Eysenek Personality Questionnaire was conducted on the two groups of subjects,and the results showed as follows: There were no significant differences in inner and outer Mongolia scores,neuroticism scores,psychogenic scores,and total EPQ scores(P>0.05).The EPQ scores of the two groups were at the same baseline level.The results showed that the intervention group was comparable to the control group.4.FRAIL scale scores of the two groups of patients,the independent sample T-test results showed that there was no statistical difference on FRAIL scale scores of the two groups of patients at admission(P>0.05),6 weeks after discharge and 12 weeks after discharge the intervention group was lower than the control group,the difference was statistically significant(P<0.05).The repeated measurement analysis of variance showed that FRAIL scale score had significant statistical significance(P<0.05)on time effect(F time=313.50,P<0.001),intervention effect(F intervention=10.675,P<0.001)and interaction effect(F interaction =34.604,P < 0.001).5.The results of independent sample t test showed that there was no significant difference in the scores of ADL between the two groups at admission and 6 weeks after discharge(P>0.05),but there was significant difference in the scores of ADL between the two groups at 12 weeks after discharge(P<0.05).Repeated measures of variance showed that the time effect(F time =102.135,P<0.001)and interaction effect(F interaction=15.604,P<0.001)of ADL score were statistically significant(P<0.05).The intervention effect(F intervention=0.612,P= 0.435)was not statistically significant(P>0.05).Further analysis showed that the simple effect of intervention was not significant at admission(F intervention=0.006,P=0.939)and 6 weeks after discharge(F intervention=0.351,P=0.555).12 weeks after discharge(F intervention=4.177,P=0.033),the simple effect of the intervention was significant(P < 0.05).6.The results of independent sample t test showed that there was no significant difference in the scores of m RS Between the two groups at admission and 6 weeks after discharge(P>0.05),but there was significant difference in the scores of ADL between the two groups at 12 weeks after discharge(P<0.05).The results of repeated measurement variance analysis showed that: The time effect(F time =163.787,P<0.001)and interaction effect(F interaction =19.176,P<0.001)of m RS Scale score had significant statistical significance(P<0.05),while the intervention effect(F intervention =1.156,P=0.284)had no significant statistical significance(P>0.05).Further analysis showed that the simple effect was insignificant at admission(F intervention=0.265,P=0.607)and 6 weeks after discharge(F intervention=0.159,P=0.691),but significant at 12 weeks after discharge(F intervention =10.468,P=0.002)(P<0.05).7.Scores of health Enabling Scale for chronic senile diseases in the two groups,independent sample T-test results showed: At admission,there were no statistically significant differences in the total score of the health empowerment scale for senile chronic diseases and scores of each dimension between the two groups(P>0.05).6 weeks and 12 weeks after discharge,the total score of the health empowerment scale for senile chronic diseases and scores of each dimension in the intervention group were higher than those in the control group,with statistical significance(P<0.05).The results of repeated measurement variance analysis showed that: The time effect(F time =1588.35,P<0.001),intervention effect(F intervention =316.57,P<0.001)and interaction effect(F interaction=306.62,P<0.001)of the total score of the health empowerment scale for senile chronic diseases in 2 groups were statistically significant(P<0.05).The time effect,intervention effect and interaction effect of each dimension score were statistically significant(P<0.05).Conclusion:1.The intervention program for senile stroke patients with frailty based on the enabling theory can effectively improve the frailty state of patients,improve the prognosis of patients,and improve the management ability of patients to manage their own diseases.2.The intervention program for senile stroke patients with frailty based on the enabling theory has positive significance for senile stroke patients with frailty,has good clinical applicability,and can be used as a scientific practical tool for clinical management of senile stroke patients with frailty. |
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