Construction And Application Of Self-management Scheme In Patients With Post-stroke Fatigue

ObjectivesTo construct a post stroke fatigue self-management intervention scheme for stroke patients and to explore its influence on post-stroke fatigue,self-efficacy and activities of daily living.Methods1.Construction of the intervention plan: Based on the analysis of the related literature at home and abroad,Social Learning Theory established by Albert Bandura,and influence factors of post-stroke fatigue,the post-stroke fatigue self-management intervention scheme was initially constructed.Through the expert consultation and combined with the preliminary test,the intervention plan was modified and improved,Finally a simple and easy post-stroke fatigue self-management scheme was formed.2.Implementation of the intervention plan:94 stroke patients admitted to someone 3A hospital in Henan Province were randomly divided into control group(47 cases)and study group(47 cases).In addition to routine treatment and nursing care,the control group received two telephone follow-up visits after discharge.On this basis,the intervention group was given a self-management program based on Social Learning Theory established by Albert Bandura,including four different subjects group activities during the hospitalization and two telephone follow-up visitsafter discharge.To evaluate the efficacy of self-management scheme on post-stroke fatigue,self-efficacy and activities of daily living,the scale of FSS,SECD6 and MBI were filled both before and after the intervention.The statistical methods included descriptive statistical analysis,two independent samples t test,pair t test,chi-square test,Fisher's exact probability method and Wilcoxon rank sum test.ResultsDuring the intervention,4 cases were missed,the rate of missing was 4.3 %,90 cases were completed,44 cases were in intervention group and 46 cases in control group.1.After intervention,the score of FSS in intervention group was reduced from(45.68±6.30)to(40.05±6.78),the score of SECD6 increased from(38.75±7.80)to(50.93±4.72)and that of MBI from(56.00±6.37)to(78.34±6.11).2.Comparison of the outcomes in two groups after intervention: the two independent samples t test showed that the scores of FSS in intervention group was significantly lower than that in control group,the scores of SECD6 and MBI was significantly higher than those in control group.The differences were all statistically significant(P?0.001).3.Comparison of the outcomes in intervention groups before and after intervention: the paired t test showed that the scores of FSS after intervention was significantly lower than that before intervention,the scores of SECD6 and MBI was significantly higher than those before intervention.The differences were all statistically significant(P?0.001).ConclusionThe self-management scheme based on the Social Learning Theory and related research at home and abroad is simple and easy,and can be easily accepted by the stroke,It can effectively reduce the patient's fatigue after stroke,enhance theirself-efficacy and activities of daily living.