| ObjectiveThrough evidence-based methods,the evidence of self-management of patients with post-stroke fatigue was summarized,and based on the theory of goal setting,combined with evidence summary and literature review,an intervention program for young and middle-aged patients with post-stroke fatigue was constructed,and the clinical application effect of the intervention plan was verified.Method1.Evidence synthesisFrom January 1,2010 to January 31,2022,the Chinese Bio Medical Literature Database(CBM),CNKI,VIP,Wanfang Database,Pub Med,Web of science,Cochrane Library,Up To Date,CINAHL,Joanna Briggs Institute Center for Evidence-Based Health Care(JBI),BMJ Best Clinical Practice,American Heart/Stroke Association(AHA/ASA),Scottish Intercollegiate Guidelines Network(SIGN),the UK National Institute for Health and Care Excellence(NICE),the Australian Stroke Foundation,Yimaitong and other websites,on the self-management of patients with post-stroke fatigue guidelines,clinical decisions,expert consensus,best practices,systematic review,by two investigators independently conducted literature quality evaluation and data extraction,and finally formed the best evidence summary for self-management of patients with post-stroke fatigue.2.Intervention plan constructionBased on the goal-setting theory,the first draft of the intervention protocol for post-stroke fatigue in young and middle-aged patients was constructed by combining an evidence summary and relevant literature,and the final draft of the intervention protocol was formed by expert correspondence and pre-experimentation.3.Empirical researchA total of 74 patients who met the inclusion criteria in a comprehensive tertiary hospital in Zhengzhou City,Henan Province,were selected as the study subjects;37 patients in the control group were treated with usual care,and 37 patients in the intervention group were clinically intervened using the post-stroke fatigue intervention program for young and middle-aged patients based on goal setting theory,and the scores of fatigue severity,self-efficacy,sleep quality,and daily living ability of the two groups at admission and after intervention were compared.Results1.Evidence synthesis resultsThe literature on self-management of patients with post-stroke fatigue was searched,screened,and analyzed,and finally,15 articles were included,including 5 guidelines,1 best practice,and 9 systematic reviews.Finally,from the aspects of multidisciplinary teamwork,familiar with PSF related knowledge,drug management,lifestyle,diet and nutrition,exercise management,psychological adjustment,assistive technology treatment,health education,medical treatment and follow-up,31 recommendations were finally extracted,including 23 recommendations for grade A and 8 recommendations for level B.2.Solution construction resultsThe intervention program for young and middle-aged stroke fatigue patients includes goal setting,decomposition goals,action plans,follow-up and feedback,and effect evaluation.The intervention content mainly includes patient setting,setting with medical staff,disease cognition,preventive measures,today’s goals,dietary guidance,psychological intervention,sleep management,exercise intervention,interpersonal relationship management,and health education.3.Empirical research results(1)Study object sheddingAmong the 37 patients selected in the intervention group,2 cases were dropped,and 1 case was transferred to the ICU due to exacerbation.One case lost contact after discharge;among the 37 patients selected in the control group,1 patient withdrew from the study due to personal reasons after discharge,so a total of 71 patients were finally included in the study: 35 patients in the intervention group and 36 patients in the control group.(2)Before interventionThe comparison of general information,severity of fatigue,self-efficacy,sleep quality,and ability to perform activities of daily living between the two groups showed that the differences between the two groups were not statistically significant(P > 0.05)and were comparable.(3)After intervention(1)The fatigue severity score of the intervention group after the intervention was lower than that of the control group,and the difference was statistically significant(P<0.001).The post-intervention fatigue severity score of the intervention group was lower than that before the intervention(P<0.001),while the post-intervention fatigue severity score of the control group was lower than that before the intervention(P=0.270).(2)The self-efficacy score of the intervention group after the intervention was higher than that of the control group,and the difference was statistically significant(P<0.001).The post-intervention self-efficacy score of the intervention group was higher than that before the intervention,and the difference was statistically significant(P<0.001),and the self-efficacy score of the control group after the intervention was slightly higher than that before the intervention,but the difference was not statistically significant(P=0.304).(3)The sleep quality score of the intervention group after the intervention was higher than that of the control group,and the difference was statistically significant(P<0.001).The post-intervention sleep quality score of the intervention group was lower than that before the intervention,and the difference was statistically significant(P<0.001),and the sleep quality score of the control group after the intervention was slightly lower than that before the intervention,but the difference was not statistically significant(P=0.055).(4)The activity ability score of the intervention group after the intervention was higher than that of the control group,and the difference was statistically significant(P<0.001).The post-intervention activity ability score of the intervention group was higher than that before the intervention,and the difference was statistically significant(P<0.001),and the post-intervention activity ability score of the control group was slightly higher than that before the intervention,but the difference was not statistically significant(P=0.555).ConclusionBased on the goal-setting theory,the intervention program for young and middle-aged patients with post-stroke fatigue can effectively reduce the fatigue level of patients,improve their self-efficacy,sleep quality,and daily living ability,and improve the quality of their lives. |
