| Objective:1.To investigate the status quo of rehabilitation self-efficacy of patients with post-stroke cognitive impairment,and analyze the influencing factors of rehabilitation self-efficacy of patients with post-stroke cognitive impairment,so as to provide a basic basis for implementing intervention.2.To evaluate the effects of Montessori sensory education,resistance training and their combination on cognitive function(visuospatial and executive ability,naming,attention and calculation,language,abstract ability,delayed recall,orientation)and daily living ability of patients with post-stroke cognitive impairment,so as to provide scientific guidance for the rehabilitation and nursing intervention of patients with post-stroke cognitive impairment.Methods:1.Using simple random sampling method,192 patients with post-stroke cognitive impairment in the department of encephalopathy and rehabilitation of a grade A tertiary hospital from January to June,2022 were selected as the research objects.The general information questionnaire,social support rating scale,ADL scale of daily living(Barthel index)and stroke rehabilitation self-efficacy scale were used to investigate,and the influencing factors of rehabilitation self-efficacy of patients with post-stroke cognitive impairment were analyzed by multiple linear regression.2.120 patients with post-stroke cognitive impairment in the rehabilitation department of a grade A tertiary hospital from January to December,2022 were selected as the research object.Randomly divided into control group,Montessori sensory education group,resistance training group,Montessori sensory education combined with resistance training group(hereinafter referred to as the combined group)with 30 cases each.All the patients in the four groups received routine treatment and nursing.On this basis,the Montessori sensory education group was given Montessori sensory education training,and the intervention time was once a day,30min/time,5 times a week for 4 weeks.The resistance training group was given elastic belt resistance training,and the intervention time was once a day,30min/time,5times a week for 4 weeks.The combined group was given Montessori sensory education combined with elastic belt resistance training.The specific implementation steps and methods were the same as those of the above two groups.Montessori sensory education training in the morning,resistance training in the afternoon,each training 30 minutes/day,5 times/week,a total of 4 weeks.Montreal Cognitive Assessment Scale(Mo CA),Mini-Mental State Checklist(MMSE)and ADL Scale of Daily Living(Barthel Index)were used to evaluate the intervention effect.Results:1.The score of rehabilitation self-efficacy of patients with cognitive impairment after stroke is(69.92±7.71),the score of social support scale is(38.90±6.27),and the score of daily living ability is(63.91±9.57).Multiple linear regression analysis showed that patients’ education level,monthly income,disease course,disease recurrence,receiving related health education,daily living ability and social support were the main influencing factors of rehabilitation self-efficacy of patients with cognitive impairment after stroke(P<0.05),which could explain 52.3% of the total variation.2.Comparison of cognitive function of patients in 4 groups: The cognitive function of patients in 4 groups was analyzed,and the results showed that: In the control group,MMSE score was 22.00(22.00,23.00)points before intervention,23.50(22.00,24.00)points after intervention,Mo CA score was(20.15±1.54)points before intervention and(21.69±1.91)points after intervention,and the difference was not statistically significant(P>0.05).In the Montessori sensory education group,MMSE score was 22.00(22.00,23.00)before intervention,24.00(24.00,24.75)after intervention,Mo CA score was 20.00(19.00,21.00)before intervention and(22.89±1.97)after intervention.The differences were statistically significant(P<0.05).In the resistance training group,MMSE score was 22.00(22.00,23.00)before intervention,24.00(24.00,24.00)after intervention,Mo CA score was 20.00(19.00,21.00)before intervention,and(22.75±1.51)after intervention.The differences were statistically significant(P<0.05).In combination group,MMSE score was 22.00(22.00,24.00)points before intervention,24.50(24.00,26.00)points after intervention,Mo CA score was(20.41±1.60)points before intervention and(23.96±1.51)points after intervention,the differences were statistically significant(P<0.05).After 4 weeks of intervention,there were statistically significant differences in MMSE scores among the 4 groups(H=17.064,P=0.001),and there were statistically significant differences in Mo CA scores among the 4 groups(F=7.588,P<0.001).Pairwise comparison and LSD analysis showed that,The intervention effect of the combination group was better than that of other single interventions.3.Comparison of daily living ability of 4 groups: ADL scores of 4 groups of patients were analyzed.The results showed as follows: the ADL score of the control group was 57.50(53.75,70.00)points before intervention,and(63.27±6.77)points after intervention,the difference was not statistically significant(P>0.05).The ADL score of the Montessori sensory education group was 57.50(50.00,68.75)points before intervention and(68.39±8.50)points after intervention,and the difference was statistically significant(P<0.05).The ADL score of resistance training group was 60.00(50.00,65.00)points before intervention and(68.04±9.46)points after intervention,and the difference was statistically significant(P<0.05).The ADL score of the combined group was(61.67±7.60)points before intervention and(69.81±8.26)points after intervention,and the difference was statistically significant(P<0.05).After 4 weeks of intervention,there was a statistically significant difference in ADL scores among the 4 groups(F=3.072,P=0.031).After LSD analysis,it was found that the ADL score of the Montessori sensory education group was higher than that of the control group(P=0.026),and the ADL score of the resistance training group was higher than that of the control group.The difference was statistically significant(P=0.038),and the ADL score of the combined group was higher than that of the control group(P=0.005).There was no statistically significant difference in ADL score between the Montessori sensory education group and the resistance training group(P=0.873).The ADL score of the combined group was significantly higher than that of the Montessori sensory education group.The difference was not statistically significant(P=0.528),and the ADL score of the combined group was not statistically significant compared with that of the resistance training group(P=0.430).Conclusion:1.The level of rehabilitation self-efficacy of patients with cognitive impairment after stroke is low,and it is affected by the educational level of patients,monthly income,course of disease,disease recurrence,receiving relevant health education,daily living ability,social support and other factors.Medical staff should develop targeted intervention measures for patients with cognitive impairment after stroke to improve the level of rehabilitation self-efficacy.2.Both Montessori sensory education and resistance training can improve the cognitive function and daily living ability of PSCI patients to a certain extent.In the combination of the two methods to improve the cognitive function of PSCI patients,the differences of visuospatial and executive function,naming,language,delayed recall and orientation in the combination group were statistically significant compared with those before intervention.The effect of combined intervention is better than that of single intervention,which is suitable for clinical promotion.In the improvement of PSCI patients’ daily living ability by the combination of the two methods,it is still not clear that the effect of combined intervention is better than that of single intervention,and further exploration is still needed. |
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