Application Study Of "Ineffective Health Maintain" Based On NNN-link In Hospitalized Stroke Patients With Hemiplegia

Objective: 1.According a survey to patients' demand for health nursing interventions linked from "ineffective health maintain" in NNN-links(organic links of Nursing diagnosis,nursing outcomes classification and nursing interventions classification),nursing care plan for stroke inpatients with hemiplegia should be formulated.2.Apply NNN-links of "ineffective health maintain" to stroke inpatients with hemiplegia.Compared with traditional nursing activity,the clinical application effect of NNN-link should be explored.3.Carry out qualitative interviews to intervention group patients and their main caregivers and sum up the experience to provide reference for NNN-links nursing mode.Methods: 1.Cross-sectional study: This study was conducted on 179 stroke inpatients who met the criteria of a level of the first hospital of Shanxi Medical University by convenience sampling with self-made nursing interventions demand questionnaire linked from ineffective health maintain to investigate and statistical analysis.2.Prospective study: A total of 78 cases of stroke inpatients with hemiplegia who were in accordance with the inclusive criteria were divided into intervention group(39 cases)and control group(39 cases).The control group accepted usual nursing intervention,while the intervention group accepted "ineffective health maintain" nursing model based on NNN-link and usual nursing intervention.According to nursing outcome scale(on the aspects of health knowledge and behavior,risk detection,health resources belief,self-care ability,therapeutic behavior,social support,decisions of participating in health care treatment,self-directed ability,personal health condition,etc.),their state of health maintenance were evaluated at base line,hospital admission,expectation and hospital discharge after the intervention.3.Semi-structured interview:carry out interviews for selected intervention group patients and their main caretakers before hospital discharge by self-made interview interviews outline to understand their experience and suggestions of the NNN-link nursing mode of " ineffective health maintain".Results: 1.According to the demand of nursing intervention research,Nursing interventions were divided into necessary interventions and selected interventions.Above 80% demanded interventions were selected into necessary nursing interventions and the rest were the selected intervention.The nuring intervention manual of stroke inpatients with hemiplegia was developed to ensure the feasibility of the scheme.2.General data comparison of the intervention group and control group inpatients was conducted and there was no statistically significant difference(P > 0.05).It said that the baseline data of two groups' s patients possessed a balance and comparability.3.Comparison for all nursing outcome dimensions of two groups' patients before interventions,there was no statistically significant difference(P > 0.05).It said that the nursing outcome of two groups' patients before interventions possessed a balance;Comparison for all nursing outcome dimensions of two groups' patients after interventions,there was no statistically significant difference(P < 0.05)and the intervention group scores were higher than the control group.It said that compared with traditional nursing mode,the NNN-link nursing mode of "ineffective health maintain" is better for nursing outcomes of stroke inpatients with hemiplegia on the aspects of health maintenance.4.Own comparison for all nursing outcome dimensions of intervention groups' patients,there was statistically significant difference(P < 0.05);Own comparison for all nursing outcome dimensions of control groups' patients,there was statistically significant difference(P < 0.05)in all nursing outcomes but personal health condition.It said that both the traditional nursing mode and NNN-link nursing mode of "ineffective health maintain" are better for nursing outcomes of stroke inpatients with hemiplegia on the aspects of health maintenance.5.Comparison to the number of reaching desired outcome of two groups' patients,the difference was statistically significant(P < 0.05)and the intervention group's reaching desired number of all dimensions after intervention were more than the control group.It said that NNN-link nursing mode of "ineffective health maintain" were more helpful to reaching their desired targets.6.Spearman correlation analysis was conducted between all dimensions of two groups and patients compliance behavior and they presented positively correlated relationship.It said that the better,patients compliance behavior,the higher all dimension outcome level.7.Statistic analysis on selected interventions in intervention group patients were conducted and the aspects of self-care assistance,family involvement promotion,anxiety reduction,exercise promotion,decision-making support ranked top five in selected nursing interventions.Besides self-care assistance,the rest four interventions were all belonging to behavior area.It said that the patients' high demand for behavior area interventions.8.According to the interview outline,semi-structured interview for intervention group patients and their main caretakers were conducted and analyzed.It prsented that the vast majority of patients were satistied with NNN-link nursing mode of "ineffective health maintain" and put forward some valuable opinions,especially on the selection of nursing interventions,the methed of application and applied range.Conclusion: 1.Nursing model of "ineffective health maintain" based on NNN-link effectively improved the patients' health knowledge and behavior,risk detection,health resources belief,self-care ability,therapeutic behavior,social support,decisions of participating in health care treatment,self-directed ability,personal health condition,etc and improved both health maintenance and behavior.Finally,the behaviors and habits and the quality of the patients' life were changed and improved.2.Among NNN-link,the nursing diagnosis clears existing and potential nursing problems;The nursing intervention classification provides the basis of regulations and standards for clinical nursing activity;Nursing outcome classification is measurement tool for patients' continuous nursing outcome state and of the effectiveness of nursing interventions.The nursing outcome classification provides a real and scientific nursing data and plays a vital role in the development of chinese nursing career.