A Applying Research On Rehabilitation With Four Station Type Service For Patients With Stroke Sequela In Baoshan Community

Objectives:This paper through Baoshan community rehabilitation "in patients with stroke sequela in four stations" service, make patients with sequela of stroke in community rehabilitation service standardization and systematization, and evaluation of application effect.Methods:The design before and after the intervention and parallel control, quantitative and qualitative research methods. ① The establishment of the Baoshan community and Gonghexin Community respectively for the intervention group and the control group, the cardiovascular and cerebrovascular diseases reporting system in Shanghai City, according to the sample into the stratified sampling on from 2011 January to 2012 March community onset within 1 years, has been discharged back into the community of the ischemic stroke patients and exclusion criteria, the intervention group and the control group of 50 subjects.②Carry out on-site survey of 100 objects of study, understand the community rehabilitation personnel basic situation, the stroke patients’ rehabilitation services, the needs of patients and the utilization and satisfaction degree etc.;③According to the results of field investigation, and qualitative interviews and expert panel method and other methods, to determine the community rehabilitation "four stations" service plan, establishing service standard, process, content, system, for the patients in the ward, outpatient, site and family every station to provide corresponding rehabilitation service; ④ Utilization of rehabilitation "four stop" service information management database, the intervention group to implement the "four stop" service for 50 patients, the intervention for 4 months;⑤ "Evaluation of the application effect of four stations" service scheme:the intervention group and the control group were carried out two questionnaire survey to understand the satisfaction of patients, the awareness rate of utilization, rehabilitation services, and through the limb functional rating scale, activity of daily living scale, functional comprehensive assessment (FCA), rehabilitation effect.Results: ① Patients in the study prior to the implementation of awareness, intervention group and control group on the stroke of community rehabilitation and treatment satisfaction and there is no statistically significant difference, two groups of comparable. In the project implementation, patients in the intervention group on service awareness, satisfaction in control group, and there was a statistically significant difference (P<0.05);(2)The implementation of the subject before and after the intervention group patients with stroke sequela "four stations " overall utilization group have significant difference compared with the control (P< 0.01), in the clinic, the site difference is more obvious; in the overall utilization project site treatment than in the control group there were significant differences (P<0.01), with joint mobilization, low frequency microwave, ultra short wave, and massage the difference is more obvious; in the overall utilization of outpatient treatment project than in the control group there were significant differences (P< 0.01) with hemiplegia, training, speech therapy, joint mobilization, exercise therapy, low frequency, microwave, ultra short wave massage difference is more obvious; in the use of house therapy program there was a significant group differences in physical therapy, massage;utilization unit treatment project was significant group of occupational therapy, microwave and massage difference; ③Patients in the study prior to the implementation, the intervention group and the control group FMA showed no statistical significance differences, the two groups were comparable. In the project implementation, two groups of patients with FMA significantly improved, research group FMA than in the control group improved more obviously (P<0.05);④ Patients in the study prior to the implementation, the study group and the control group MB I showed no statistical significance differences, the two groups were comparable. In the project implementation, two groups of patients with MBI significantly improved, research group MBI than in the control group improved more obviously (P<0.05).Conclusions:The incidence of stroke with high rate of disability, rehabilitation intervention and whether early intervention, is essential for the effect of patients with functional recovery and quality of life. In the face of the current general hospital beds less universal patients, patients with sequelae of stroke rehabilitation often not recurrent, status and recovery of function, through the design and Study on community "four stop" rehabilitation service scheme, and the use of information technology in Baoshan Community to realize the full program management unit, outpatient the site, as well as the house, in promoting the rehabilitation of cognitive level in patients with stroke in a certain extent, set up more effective rehabilitation ways, providing theoretical and practical basis for the better development of community rehabilitation service.