| ObjectiveThe purpose of this study was to observe the effect of Montessori's cognitive function intervention on cognitive ability and life ability of patients of post-stroke cognitive impairment.And the second purpose was to explore the appropriate rehabilitation intervention methods for patients of PSCI.MethodsFrom January 2017 to July 2017,50 patients(28 males and 22 females,aged 35-65 years)with post-stroke cognitive impairment were recruited.The average age was 52 years.The MMSE scores were from 10 to 19.The intervention includes daily life training for 20 minutes,Montessori intervention for 40 minutes,60 minutes for each time,twice a day.MMSE,MoCA and Barthel index were scored before treatment,4 weeks after intervention and 8 weeks after intervention respectively.The data were processed by IBM SPSS Statistics 20.0 software,and the bilateral test level was 0.05.And repeated measurement analysis of variance was used to compare the difference pre-post intervention.The independent sample t-test was used to compare the influence of stratified factors such as sex,age and culture on MMSE score and Barthel index.ResultsAll the patients completed successfully 8 weeks of Montessori intervention.No cases were withdrawn,no adverse events occurred,and cognitive function and activities of daily living(ADL)were evaluated successfully.1.The score was 15.17 ±0.75 before intervention,and was 15.62 ±0.75 after 4 weeks of intervention,which was significantly higher than that of before(P<0.05).And after 8 weeks of intervention,the MMSE score was 16.02 ±1.08,which was more higher than that of before(P<0.01).2.The MoCA score was 14.74 ±1.05 before intervention,and was 14.94 ±1.28 after 4 weeks of intervention,there was no significant difference compared with that of before(P>0.05).As the training time extended,after 8 weeks of intervention,the MoCA scorewas 15.20 + 1.01,and the difference was statistically significant(P <0.05)compared with that of before intervention.The subitems of MoCA scale were further analyzed before and after 8 weeks of intervention.The results showed that the scores were increased in varying degrees,only the difference in naming,speech and orientation was statistically significant(P< 0.05),but there was no significant difference in visual space and executive function,attention,abstraction and delayed recall compared with before intervention(P>0.05).3.The score of Barthel index before treatment was 44.20 ±2.11,and was 45.76 ±4.49 after 4 weeks of intervention,which was significantly higher than that of before intervention(P<0.05);After 8 weeks of treatment,the score of Barthel index was 46.02 ±3.72,which was significantly different from that before(P<0.01).4.The possible effects of stratified factors such as age,sex and education on the outcome of treatment were further analyzed by independent sample t-test.The results showed that the effect of sex,stroke type,basic diseases on MMSE score and Barthel index score after 8 weeks intervention were not statistically significant than that of before(P>0.05).However,age,marital status and care had a significant effect on MMSE score and Barthel index score after 8 weeks of intervention(P<0.05).Marital stability(family harmony,family care and meticulous care)has a positive impact on cognitive function and activities of daily living improvement,vice versa.The level of education has an effect on cognitive function,the higher the level of education,the higher the score of MMSE(P<0.05),but not the score of Barthel index(P>0.05).Conclusion1.Based on Montessori education concept,the cognitive rehabilitation training centered on people can improve the cognitive ability and activities of daily living of patients with post-stroke cognitive impairment.2.Montessori method is helpful to arouse the enthusiasm and initiative of PSCI patients,which is easy for patients to accept,and is suitable for establishing the home care mode which based on family training.3.Age,marital status,care have great influence on cognitive function and activities of daily living of PSCI patients.That is,young,stable marriage(family harmony)and careful care has a positive effect on cognitive function and activities of daily living improvement,Vice versa.4.After Montessori cognitive function intervention,the cognitive function of PSCI patients is improved,which is helpful for patients to return to family and society as soon as possible,to solve the heavy mental and economic burden of patients and families. |
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