Development And Experimental Research Of Early Rehabilitation Environmental Nursing Model Of Traumatic Brain Injury

Traumatic brain injury has become one of the major healthy and economic problemsall over the world because of its high morbidity, mortality and disability, which pose aserious threat to human health. In recent years, domestic and international rehabilitationmedicine studies have shown that early rehabilitation of medical care can enable therehabilitation of patients to maximize. There were a lot of studies about early rehabilitationnursing of the patients with traumatic brain injury at home and abroad, and mostly ofwhich focused on functional exercise, however, the environment as an important factoraffecting their rehabilitation has not been attracted enough attention. In the field of nursing,environment as one of the four basic concepts of nursing, which is close contact withpeople, health and nursing. In the field of neurobiology, enriched environment as one ofthe main external factor affecting the neural plasticity has become a research hotspotfollowed the in-depth researches on neural plasticity after brain injury. Enrichedenvironment theory has been used for a variety of basic researches and clinicalrehabilitation researches on early rehabilitation of central nervous system injury model.Based on Nightingale environmental theory, the science of unitary human being ofRogers and the enriched environment theory, this study aims to develop early rehabilitationenvironmental nursing model of traumatic brain injury. While drawing on the basis studythat enriched environment affects on the neuronal plasticity in the field of neurobiology,this study want to discuss how does the rehabilitation environment affect on brain plasticity.Then further confirmed the important role of the rehabilitation environment to therehabilitation of traumatic brain injury. Provide a reliable theoretical basis for makingclinical nursing interventions of early rehabilitation to the patients with traumatic braininjury. Enrich and development of the environmental theory of nursing. Pa·rtⅠPRELIMINARY DEVELOPMENT OF EARLY REHABILITATIONENVIRONMENTAL NURSING MODEL OF TRAUMATIC BRAIN INJURYObjective Preliminary develop the early rehabilitation environmental nursing modelof traumatic brain injury, and provide a reliable theoretical basis for making clinicalnursing interventions of early rehabilitation to the patients with traumatic brain injury.Methods Using the methods of documentary research and theoretical study, to define therelated concepts of the environment, nursing environment and early rehabilitation, thenreview the literature about environmental nursing and rehabilitation nursing practice,rehabilitation therapy related environmental nursing and rehabilitation nursing practice.And combined with Nightingale environmental theory, the science of unitary human beingof Rogers as well as the enriched environment theory to conduct the study. ResultsPreliminary development the theoretical framework of early rehabilitation environmentalnursing model of traumatic brain injury. Conclusion The model provide new ideas forthe early rehabilitation of patients with traumatic brain injury through the perspective of“patient-centered” and holistic nursing care.PartⅡEXPERIMENTAL STUDY OF THE EFFECTS OF THE EARLYREHABILITATION ENVIRONMENTAL MODEL ON TRAUMATIC BRAININJURYObjective Discuss the effects of the environmental model of early rehabilitation totraumatic brain injury. Methods Using modified Feeney’s free-fall injury device to copythe rat model of traumatic brain injury,32wistar rats were randomly divided into fourgroups, intervened the Sham operation+Rehabilitation environment group (SO+RE group)and traumatic brain injury+rehabilitation environment group(TBI+RE group) after24hwith early rehabilitation environment interventions, at the same time, sham operation+standard environment group(SO+SE group) and traumatic brain injury+standard enviro-nment group (TBI+SE group) without no intervention. Using modified neurologicalseverity score scale (mNSS), water maze test and detection of brain-derived neurotrophicfactor (BDNF) expression by immunohistochemical method at different time points aftersurgery to evaluate. Results On the7th day and14th day, the mNSS score of TBI+RE group were significantly lower than TBI+SE group(P<0.05), which showed that rehabil-itation environment intervention can improve the neural behavior function of the injuredrats. During the process of Morris Water Maze, on the14th~18th day, the escape latencyof TBI+SE group and TBI+RE group were significantly longer than the SO+SE group andSO+RE group(P<0.05). On the16th~18th day, the escape latency of TBI+RE group weresignificantly shorter than TBI+SE group(P<0.05). On the18th day, the times of crossingthe platform position and the time searched in the platform quadrant were significantlyincreased in the TBI+RE group compared the TBI+SE group(P<0.05), all of which showedthat rehabilitation environment intervention can improve the damaged learning andmemory function. The integrated optical density of BDNF in every group were nosignificantly differences(P>0.05). Conclusion Early environment intervention canimprove the damaged neurobehavioral functions, damaged learning and memory functionand effected the expression of BDNF, which showed that early environment interventioncan improve the recovery of neurological function with neuroprotective effects.