Investigation On Influencing Factors Of Early Rehabilitation Of Stroke And Establishment Of Rehabilitation Nursing Pathway

Stroke is the most common disease with the highest disability rate in the world.Early rehabilitation can significantly reduce the disability rate and degree of disability of patients.However,the current status of early rehabilitation nursing is not optimistic.There are many problems such as inadequate rehabilitation nursing system,lack of uniform guidelines,and low level of rehabilitation.In order to improve the rehabilitation nursing system,establish clinical rehabilitation nursing norms,and improve the effectiveness of rehabilitation,some experts proposed the management mode of clinical nursing pathway.But the existing stroke clinical nursing pathways are mainly aimed at the disease diagnosis and treatment process,and the nurses are only assisting the doctors in the diagnosis and treatment,and lack of evidence of nursing.This study investigates the current status of stroke rehabilitation and its influencing factors,analyzes the problems of early rehabilitation,and provides references for developing intervention measures to improve the level of rehabilitation.At the same time,throughthe literature to find rehabilitation-related evidence and nursing-related evidence,establish rehabilitation nursing pathway of stroke,to regulate the work of nurses in the early rehabilitation,provide early guidance for clinical nurses and improve the implementation of rehabilitation.The study was conducted in two parts:Part I: Investigation on the Current Status of Stroke Early Rehabilitation and Its Influencing Factors1.Method:Investigate nurses from provinces and citieswereinvestigated by self-designed questionnaire by convenience sampling.2.Results:1).Stroke rehabilitation is generally started later;the rehabilitation content is not comprehensive;rehabilitation nursing system is not perfect;the implementation of rehabilitation nursing lacks uniform guidelines;2).Among the nurses participating in the survey,38.38% of nurses were able to implement rehabilitation;Logistic regression analysis showed that academic qualifications,lack of relevant professional knowledge and skills,and responsible nurses were necessary to implement rehabilitation nursing;patients or their families considered that they did not need toimplement rehabilitation,and patients or their families with poor awareness of activecoordination,heavy workload,lack of rehabilitation guidelines,effect evaluation,and rehabilitation nursing pathway are the influencing factors for implementing rehabilitation nursing(P<0.01 or P<0.05).3.Conclusion:1).The establishment of stroke rehabilitation nursing guidance standards is an important measure to improve the implementation of rehabilitation nursing;2).The factors affecting nurses' rehabilitation nursing are various,and they should be controlled from the macro perspective according to the influencing factors to improve the effect of rehabilitation nursing.Part II: Establishment of Stroke Rehabilitation Nursing Pathway1.Methods:1).According to the components of the clinical pathway,establish the framework of the pathway,and through the review of stroke rehabilitation guidelines,extract relevant evidence and establish rehabilitation nursing pathway;2).Pre-experiment was performed using non-randomized concurrent controlled study.The control group was cared for according to conventional rehabilitation,and the observation group was cared for according to the rehabilitation nursingpathway.Barthel index rating scale,Putian drinking test,MMSE scale,Mo CA scale,HAMA anxiety scale,length of hospital stay and hospitalization cost were used to evaluate the implementation effect of the pathway.2.Results:1).Establishing stroke rehabilitation nursing pathway;2).Compared with the control group,the Barthel index score,swallowing function,MMSE score,in the observation group were significantly improved(P<0.05);but there was no statistically significant difference in the Mo CA score,HAMA score(P>0.05).3.Conclusions:1).Stroke rehabilitation nursing pathway is guided by the empirical evidence of nursing and regulates the content of rehabilitation nursing work;2).Rehabilitation nursing pathway can improve stroke patients' activities of daily living activities,improve swallowing function and cognitive ability.However,no unified conclusions have been formed on the patient's anxiety.In summary,this study investigated the current status of strokerehabilitation and its influencing factors,found problems,established rehabilitation nursing pathway,and through pre-experiment,basically achieved the purpose of pathway design.The study is an active exploration to improve the effect of stroke rehabilitation nursing.The results of the study provide new ideas and practical basis for the development of stroke rehabilitation nursing.