Effects Of Continuity Of Care On Stroke Patients’ Functional Rehabilitation

Objective To observe the effectiveness of continuity of care on neurological function and the activities of daily living in stroke patients; To observe the influence of continuity of care on family function, compliance and care compliance adherence of stroke patients and their family members.Methods During January 2013 to September 2013, selected 120 cases of clinically diagnosed of stroke with hemiplegia from neurology patients in Haibin People’s Hospital of Tianjin. They were randomly assigned to the intervention group of 60 patients and the control group of 60 patients. The control group received conventional rehabilitation treatment and care, while the intervention group implemented continuity of care on the basis of conventional rehabilitation treatment and care, including the formation of continuity of care team, different stage rehabilitation care program with hospitalization, before and after discharge), Scenario health education were intervened during hospitalization, After discharged from hospital, conducted follow-up home four times, telephone follow-up five times and referral of patients to the hospital twice. When the patients admitted to hospital in 2 days, discharge, discharged from hospital 1 month later, and 3 months later. to evaluate the activities of daily living, neurological function, depression, family function and compliance and care compliance adherence, by using FMA, NIHSS, BI, BBS, HRSD, APGAR and Application of patient compliance Scale. Statistical analysis was accomplished with SPSS18. 0 soft package. Data is represented in x±s. The results were analyzed by t-test, chi-square test, analysis of variance.Results 1 The BI scores’ comparison of the two group before and after the intervention. The BI scores in the two groups had no significant difference before the intervention(P>0.05); At discharge, the scores of the intervention group were higher than the control group in toilet, moving and dressing three items, there is a significant difference in the two groups(P<0.05); While discharged from hospital 1 month later, the intervention group got higher BI scores than the control group and there is a significant difference in the two groups(P<0.05); While discharged from hospital 3 month later, the intervention group got higher BI scores at total and each item and there is a significant difference in the two groups(P<0.05). 2 The neurological function’s comparison of the two group before and after the intervention.(1)The NIHSS scores’ comparison between before and after the intervention in two groups. The NIHSS scores in the two groups had no significant difference before the intervention while admitted to hospital at the second day(P>0.05); While discharged from hospital the intervention group got lower scores than the control group, but the difference was not statistically significant(P>0.05); While discharged from hospital 1 month later the intervention group got lower scores than the control group, and the difference was statistically significant(P<0.05);While discharged from hospital 3 month later the intervention group got lower scores than the control groupsignificantly, and the difference was statistically significant(P<0.05);(2)The FMA scores’ comparison between before and after the intervention in two groups: The FMA scores and upper and lower limbs scores in the two groups had no significant difference before the intervention(P>0.05); While discharged from hospital 3 month later, the intervention group got higher FAM scores and upper and lower limbs scores than the control group, and there were significant difference in the two groups(P<0.05).(3)The BBS scores’ comparison between before and after the intervention in two groups: The Berg scores in the two groups had no significant difference before the intervention(P>0.05); While discharged from hospital 3 month later, the intervention group got higher Berg scores than the control group, and there was a significant difference in the two groups(P<0.05). 3 The HRSD scores’ comparison of the two group before and after the intervention. The HRSD scores in the two groups had no significant difference before the intervention(P>0.05); While discharged from hospital the intervention group got higher scores in retardation, sleep disturbances, hopelessness and total scores than the control group, and the difference was statistically significant(P<0.05);While discharged from hospital 1 month later the intervention group got higher scores in weight changes, cognitive disorders, retardation, sleep disturbances, hopelessness and total scores than the control group, and the difference was statistically significant(P<0.05);While discharged from hospital 3 month later the intervention group got higher scores at each items and total scores than the control group, and the difference was statistically significant(P<0.05). 4 The APGAR scores’ comparison of the two group before and after the intervention: The APGAR scores in the two groups had no significant difference at 5 dimension and total scores before the intervention(P>0.05); While discharged from hospital 3 month later the intervention group got higher scores at extend of growth, emotion and precision and total scores than the control group after the intervention, and the difference was statistically significant(P < 0.05); 5 The patient compliance’s comparison while discharged from hospital 3 month later in two groups. the intervention group got higher scores at rehabilitation exercises, balanced diet, daily schedule, prescribed medication emotion and precision and total scores than the control group, and the difference was statistically significant(P<0.05);Conclusion 1 The continuity of care intervention can effectively promote the recovery of activity of daily living and neurological function of stroke patients. 2 The continuity of care intervention can effectively deduce the level of depressed emotion. 3 The continuity of care intervention can effectively promote the family function and patient compliance.