Study On The Application Of Self-management Intervention Based On The Patient-report Outcomes With First-episode Ischemic Stroke

Research Purpose: In this study,a randomized controlled trial was conducted to explore the development and implementation of exercise self-management intervention programs for patients with first ischemic stroke based on patient-reported outcomes,to test the application feasibility of the intervention methods,and to provide suggestions for improving the nursing effect of patients with first ischemic stroke in the future.Research Methods: 74 patients with first-episode ischemic stroke received by our hospital from June 2018 to June 2019 were randomly selected for clinical analysis.The study subjects were divided into control group and observation group by random number arrangement table method,with 37 cases in each group.The observation group was followed up by routine health education and exercise self-management intervention,while the control group was followed up by routine health education.The results,motor function score,Berg Balance score,stand walk and 10 meter walk time,GSEs score and intervention satisfaction were observed before and after the intervention,and the statistical data were processed by spss25.0.Research Results:(1)The degree of spasmodic hemiplegia and the ability of daily living activities(ADL),the MBI scores of spasmodic hemiplegia at different time after intervention between the two groups were compared,and the difference was statistically significant(p<0.05);the spastic hemiplegia scores and MBI scores of the two groups at the 4th,8th and 12 th weekends after the intervention were compared with those before the intervention,and the difference was statistically significant(p<0.05).Pairwise comparison of time points between the two groups showed that the difference was statistically significant(p<0.001).(2)FMA motor function.The motor function scores of the two groups at different time after intervention were compared,and the difference was statistically significant(p<0.05);there was a statistically significant difference in FMA score between the two groups at the end of 4 weeks,end of 8 weeks and end of 12 weeks after the intervention and before the intervention(p<0.05). Pairwise comparison of time points between the two groups showed that the difference was statistically significant(p<0.001).(3)Balance ability,Berg balance score after intervention between the two groups,the difference was statistically significant(p<0.05)there was a statistically significant difference in Berg balance score between the two groups at the end of 4 weeks,end of 8 weeks and end of 12 weeks after the intervention and before the intervention(P<0.05).Pairwise comparison of time points between the two groups showed that the difference was statistically significant(p<0.001).(4)Stand up and walk test(TUG)and 10-meter walk test.The difference between stand up and walk time and 10-meter walk at different time after intervention between the two groups was statistically significant(P<0.05).compared with the TUG and 10-meter walking before the intervention,there was a statistically significant difference between the two groups at the end of 4 weeks,end of 8 weeks and end of 12 weeks after the intervention(P<0.05).Pairwise comparison of time points between the two groups showed that the difference was statistically significant(p<0.001).(5)General self-efficacy(GSES)scores were compared between the two groups at different time after intervention,and the difference was statistically significant(P<0.05);there was a statistically significant difference in GSES scores between the two groups at the end of 4 weeks,end of 8 weeks and end of 12 weeks after the intervention and before the intervention(P<0.05).Pairwise comparison of time points between the two groups showed that the difference was statistically significant(p<0.001).Research Conclusion: Motor self-management intervention based on patient reported outcome was applied to patients with first ischemic stroke.After 12 weeks of intervention,patients in the observation group could effectively improve their degree of spasmodic hemiplegia and quality of life,improve their motor function score and balance ability,and significantly improve their walking ability.The general self-efficacy of the patients was also better than that of the control group.The exercise self-management model based on patient reported outcome is effective and can be widely used in the exercise management of patients with first ischemic stroke.