| ObjectiveThrough self-designed "questionnaire of extended service demands of cerebral stroke patients after hospital discharge ", understand the service demands of cerebral stroke patients after hospital discharge, implement extend care service measures according to the situation of demand, and evaluate the effects of extension services, guide cerebral stroke patients’ late rehabilitation, provide the basis to save health care resources, optimize the distribution of medical resources, formulate feasible medical-recuperate policy. MethodsEvaluate self-designed "Questionnaire of extended nursing service demands of cerebral stroke patients" scientifically, through analyzing the discrimination, reliability, validity of the questionnaire, confirm the scientific nature of the questionnaire. Select 300 patients with cerebral stroke in six inpatient areas of neurology department of our hospital in July 2014-September 2014, conduct a demand questionnaire survey, understand the demand present situation of the continuous nursing service for patients with cerebral stroke. Select 300 patients with cerebral stroke in six inpatient areas and a familial ward of neurology department of our hospital in September 2014-November 2014 randomly, patients were randomly divided into experimental group and control group, 150 patients in each group, experimental group patients accept telephone follow-up and family visits after discharge from specialized medical team, cared control group with the neurology routine nursing, no after-discharge visits, observed the variation of data of blood biochemical indexes, blood pressure values, self-care ability score, satisfaction score, the number of hospital readmission, and so on, made evaluation respectively when discharged from hospital, 1 month after discharge, 6 months after discharge and 12 months after discharge, and conducted statistical processing with SPSS17.0 statistical software. ResultsThe Pearson correlation coefficient of each entry scores and total scores of questionnaire of nursing service demands of cerebral stroke patients after hospital discharge was 0.51 ~ 0.94(P < 0.01); Accumulative contribution rate of 7 common factors in exploratory factor analysis was 72.37%. Cronbach’s a coefficient values of seven dimensions of scale were all greater than 0.7, Cronbach’s a coefficient value of the total scale was 0.84. We can know that the score of extended nursing service of cerebral stroke patients after hospital discharge was(106.25±9.46) points, the demand was relatively intense.Evaluating the effect of continuous nursing service, the content differences of experimental group through intervention and the control group are statistically significant(P < 0.05) in blood biochemical indexes of low density lipoprotein cholesterol, high-density lipoprotein cholesterol, homocysteine content in different time points after discharge. The blood biochemical indexes are statistically significant(P < 0.05). There is interaction in blood biochemical indexes of low density lipoprotein cholesterol, high-density lipoprotein cholesterol, homocysteine content. Repetitive measure analysis of variance in the differences of changes in blood pressure, self-care ability(Barthel) score and satisfaction scores were statistically significant. Repeated measures analysis of variance contour figure shows that low density lipoprotein content, cholesterol, homocysteine, content elevated, high-density lipoprotein cholesterol, content decreased. And test group change is obviously than the control group. The blood pressure of two groups of patients after discharge decreased in different level. Systolic blood pressure decreased obviously than diastolic blood pressure. With the extension of discharge time, the Barthel score of patients increased, and test group is higher than control group; satisfaction of test group increased and satisfaction of control group decreased. The difference between the two groups of hospital readmission number 12 months after discharge was statistically significant(P < 0.05), the number of experimental group declined compared with control group. ConclusionThe survey of self-designed "questionnaire of continuous nursing service demands of cerebral stroke patients" shows that the level of extended demands of patients are intense. By extended nursing service measures after hospital discharge, blood biochemical index of experimental group patients was improved significantly than the control group, blood pressure dropped in different degrees, ability of self-care activities was elevated, cerebral stroke recurrence or complications were decreased. The improvement of patient satisfaction, made doctor-patient relationship harmonious. t The number of readmissions reduced, eased the economic burden of family and the society, and provide evidence for the allocation of medical resources. |
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