Effect Of Out-of-hospital Follow-up Education On Rehabilitation Of Patients With Ischemic Stroke

Objective: This study aims to evaluate the impact of out-of-hospital follow-up education on the rehabilitation of patients with ischemic stroke by providing regular systematic outpatient follow-up education for patients with ischemic stroke,and provide a reliable basis for health education and secondary prevention of stroke patients in the future.Method: Randomized controlled study was conducted to select all hospitalized patients with neurological ischemic stroke in the Department of Cardiovascular and Cerebrovascular Specialized Hospital of Yan'an University Hospital from October 1,2017 to December 31,2017,and collected in strict accordance with the inclusion criteria and exclusion criteria.200 patients with ischemic stroke were randomly divided into the outpatient follow-up education group and the control group.The control group(n=100 cases)received routine treatment,health education,and discharge guidance and NIHSS scores at the time of admission.On the basis of this,the outpatient follow-up education group(n=100 cases)applied a self-made out-of-hospital follow-up education form(see Appendix 1),using a simple and easy-to-understand language,through face-to-face interviews or telephone interviews for ischemic stroke.The patients were discharged from the hospital in January,March,June and 1 year for out-of-hospital follow-up,health education,rehabilitation guidance,psychological counseling,and targeted questions and answers for patients and their families.The time was controlled at about 30 minutes each time.After 1 year of intervention,the modified Rankin score,HAMD score,and daily living ability(ADL)scores were performed on the two groups.The lifestyle and compliance of the two groups of patients were investigated according to the outpatientfollow-up record.The statistics were also calculated within 1 year.The recurrence rate,complication rate,rehospitalization rate and mortality of ischemic stroke.Thus,the impact of out-of-hospital follow-up education on the rehabilitation of stroke patients 1 year later was statistically analyzed.Result: 1.Follow-up to 1 year after statistical analysis,4 outpatients in the outpatient follow-up education group,8 were lost to follow-up,a total of 88 patients completed the fourth follow-up education and assessment of each scale.In the control group,5 patients died and 4 patients were lost to follow-up.A total of 91 patients completed the assessment of each scale.2.There were no significant differences in the age,gender,education level,occupation,medical insurance payment method,severity of disease(NIHSS score),hypertension,diabetes,lipid metabolism abnormality and heart disease between the outpatient follow-up education group and the control group.(P>0.05).3.The out-of-hospital follow-up education group was better than the control group in smoking cessation,alcohol restriction,reasonable diet,moderate exercise,and weight control.The difference was statistically significant(P<0.05).4.In the out-of-hospital follow-up education group,drug compliance,compliance with medical practice,rehabilitation training,regular review,etc.were all better than the control group,and the difference was statistically significant(P<0.01).5.According to the modified Rankin score,the neurological recovery of the two groups was compared.It was found that 68 patients(77.3%)in the outpatient follow-up education group had a good prognosis,compared with 56 patients(61.5%)in the control group.The neurological function of the group was better than that of the control group,and the difference was statistically significant(P<0.05).6.According to the HAMD scores,the incidence of post-stroke depression in the two groups was compared.It was found that 35(39.8%)patients in the outpatient follow-up education group had post-stroke depression,compared with 51 patients(56.0%)in the control group combined with post-stroke depression.The prevalence of post-stroke depression in the outpatient follow-up education group was lower than that in the control group,and the difference was statistically significant(P<0.05).Further statistical analysis found that the degree of depression after stroke in the outpatient follow-up education group was lighter than that in the control group,and the difference was statistically significant(P<0.05).7.According to the Barthle index results,the self-care ability of the two groups of patients was compared.It was found that the self-care ability of the outpatient follow-up education group was higher than that of the control group,and the difference was statistically significant(P<0.05).8.After 1 year of intervention,the clinical outcomes of the two groups were analyzed and compared.It was found that the recurrence rate,complication rate and rehospitalization rate of ischemic stroke in the outpatient follow-up education group were lower than those in the control group,and the difference was statistically significant(P< 0.05).Conclusion: 1.Out-of-hospital follow-up education can help patients with ischemic stroke to re-establish a healthy lifestyle and improve adherence to medication.2.Out-of-hospital follow-up education can promote the recovery of neurological function and improve self-care ability in patients with ischemic stroke.3.Out-of-hospital follow-up education can reduce the incidence of post-stroke depression and reduce the degree of post-stroke depression.4.Out-of-hospital follow-up education can reduce the recurrence rate,complication rate,and readmission rate of patients with ischemic stroke.