Construction And Application Of Nursing Program For The Elderly Patients With Cerebral Infarction Based On 5E Rehabilitation Model

BackgroundWith the aging of the population and the prevalence of unhealthy lifestyle in China,the number of patients with cerebrovascular disease is increasing.Cerebral infarction is the most common cerebrovascular disease.It has the characteristics of high incidence rate,high disability rate,high recurrence rate,high mortality rate and heavy economic burden.Sequela of cerebral infarction not only seriously affects the patient’s self-care ability,motor function and psychological state,but also brings heavy burden to family and society.5E rehabilitation model includes five parts:encouragement,education,exercise,employment and evaluation.It is widely used in patients with diabetes,dialysis and chronic obstructive pulmonary disease.Based on the framework of 5E rehabilitation model,this study constructs a nursing program for elderly patients with cerebral infarction,in order to promote the rehabilitation of patients and improve their quality of life.ObjectiveConstructing the nursing program for elderly patients with cerebral infarction,and evaluate the application effect of the program,in order to improve the muscle strength,motor function,activities of daily living and anxiety and depression of patients,so as to improve their quality of life.Methods1.Construction of Nursing Program The nursing program for elderly patients with cerebral infarction includes 5 first level indicators of encouragement,education,exercise,employment and evaluation,and 20 second level indicators.The content includes psychological nursing,health education,exercise guidance,activities of daily living training and effect evaluation.2.Application of Nursing Program 84 elderly patients with cerebral infarction were selected as the research objects,and they were randomly divided into control group and intervention group with 42 cases in each group.The control group was treated with routine nursing,and the intervention group was treated with the constructed nursing scheme after the vital signs and neurological symptoms were stable.The muscle strength,motor function,activities of daily living,anxiety and depression of the two groups were evaluated and compared before intervention,4 weeks and 8 weeks after intervention.SPSS 22.0 was used to analyze the data by Chi square test,t test and repeated measurement ANOVA,P<0.05 as the difference was statistically significant.Results1.Construction program Based on the framework of 5E rehabilitation model,combined with literature research and expert consultation,this study finally constructed a rehabilitation nursing program for elderly patients with cerebral infarction,including five primary indicators of encouragement,education,exercise,employment and evaluation,and 20 secondary indicators.The content includes psychological nursing,health education,exercise guidance,activities of daily living training and effect evaluation.2.Comparison of muscle strength grades between the two groups After 4 and 8weeks of intervention,there were statistically significant differences in upper limb muscle strength(t_4w=4.283,t_8w=6.447)and lower limb muscle strength grading(t_4w=2.762,t_8w=4.018)between the intervention group and the control group（P<0.05）;The time effect,grouping effect and interaction effect of upper limb muscle strength(F_time=107.855,F_{between-group}=21.667,F_{time*between-group}=14.777)and lower limb muscle strength grading(F_time=186.339,F_{between-group}=8.930,F_{time*between-group}=6.956)in the two groups were statistically significant（P<0.05）.3.Comparison of motor function grades between the two groups After 4 and 8weeks of intervention,there were significant differences in upper limb motor function(t_4w=3.257,t_8w=3.814),hand motor function(t_4w=2.139,t_8w=3.061)and lower limb motor function grading(t_4w=2.606,t_8w=4.950)between the intervention group and the control group（P<0.05）;The time effect,grouping effect and interaction effect of upper limb motor function(F_time=73.224,F_{between-group}=7.986,F_{time*between-group}=5.688),hand motor function(F_time=119.894,F_{between-group}=4.280,F_{time*between-group}=4.348)and lower limb motor function grading(F_time=172.729,F_{between-group}=8.629,F_{time*between-group}=8.425)in the two groups were statistically significant（P<0.05）.4.Comparison of activities of daily living scores between the two groups After 4weeks and 8 weeks of intervention,the scores of daily life activity ability of the intervention group(t_4w=3.402,t_8w=5.383)were statistically significant compared with the control group（P<0.05）;The time effect,processing effect and interaction effect of the scores of daily life activity ability in the two groups were statistically significant,F_time=135.239,F_{between-group}=11.667,F_{time*between-group}=9.910（P<0.05）.5.Comparison of anxiety and depression scores between the two groups After 4and 8 weeks of intervention,the scores of anxiety(t_4w=-3.116,t_4w=-4.724)and depression(t_4w=-3.359,t_8w=-5.302)in the intervention group were significantly higher than those in the control group（P<0.05）;The time effect,treatment effect and interaction effect of anxiety(F_time=56.315,F_{between-group}=5.958,F_{time*between-group}=9.529)and depression(F_time=66.299,F_{between-group}=4.559,F_{time*between-group}=16.965)in the two groups were statistically significant（P<0.05）.ConclusionsThe nursing program of elderly patients with cerebral infarction based on 5E rehabilitation model was constructed.The program can enhance the patient’s muscle strength,improve the patient’s motor function,improve the patient’s activities of daily living,anxiety and depression effectively.