| Objective: In this study,we conducted community rehabilitation for stroke sequelae under the family contract system and used FMA,MBI,SAS,SDS,and other scales to evaluate the patients’ limb motor function,self-care ability,and psychological status before and after the intervention,to reveal the impact of community rehabilitation on stroke patients,improve the level of stroke rehabilitation in our community,improve the service quality of community hospitals,and improve the quality of life of patients,It improved patient satisfaction and provided clinical evidence for the Health Commission to incorporate stroke into chronic disease management.Methods: According to a certain criteria,200 stroke patients who visited a health service center in a village in Wuhu and a central South health service center from January2022 to July 2022 were selected and divided into two groups: the control group and the experimental group.The control group received only routine drug treatment and health education,while the experimental group was given exercise therapy,self-care ability training,and psychological rehabilitation on the control group.Six months later,the indexes of FMA,MBI,SAS,SDS,recurrence rate,mortality,etc.before and after the intervention were compared between the two groups,and the patients’ limb motor function,self-care ability,depression and anxiety,stroke recurrence,stroke death,etc.were analyzed to find out whether there was any difference between the two groups.The database was built and the software SPSS26.0 was used for statistical data processing.The data were analyzed using t-Test,ANOVA and other statistical methods to analyze the changes and clinical significance of the above related indicators.Results:(1)From May 2022 to November 2022,200 patients with stroke sequelae admitted to two health service centers in Wuhu were selected,who had a history of seeing a doctor in secondary and tertiary hospitals.Patients and their families agreed to the intervention experiment.There were 200 cases,including 136 men and 64 females.The age of the patients was 45-85 years,the course of disease was 1 month to 16 years,138 cases of ischemic stroke and 62 cases of hemorrhagic stroke.According to the method of random number table,they were divided into two groups,100 cases in the experimental group and 100 cases in the control group.There were 70 males and 30 females in the control group,ranging from 42 to 78 years old,with an average age of 60.554 ± 10.215 years.67 cases of ischemic stroke and 33 can see of hemorrhagic stroke,the course of the disease is half a year to 8 years,and the average course of the disease is(3.25 ± 1.49)years;There were 66 men and 34 females in the observation group,ranging from 45 to 81 years old,with an average age of 61.148 ± 10.985 years.There were 71 cases of ischemic stroke and 29 cases of hemorrhagic stroke.The course of the disease was from half a year to 7.5 years,with an average course of(3.40 ± 1.55)years.There were no obvious differences between the two groups in sex,age,education,stroke type,course of disease course,and other data(P>0.05),which was comparable.(2)Before the intervention,the Fugl Meyer score for the control group was 31.50 ±5.26 points and the observation group’s score was 30.96 ± 5.38 points.There was no obvious difference between the two groups.(P>0.05).After the intervention,the FMA scores of the control group and the observation group were higher than before,but the observation group changed more than the control group and the difference was statistically significant(P<0.05).(3)Before the intervention,the MBI score of the control group was 49.68 ± 9.51 points,while that of the experimental group was 49.71 ± 9.39 points.There was no significant difference between the two groups(P>0.05).After the intervention,the MBI scores of the experimental group and the control group were higher than those before the intervention(P≤0.05),and the level of improvement of the test group was better than that of the control group,with a statistically significant difference.(P<0.05).(4)Before the intervention,there was no difference in SAS and SDS scores between the experimental group and control group(P>0.05).After 6 months of intervention,the anxiety and depression in both groups decreased,and the SAS and SDS scores in the observation group were lower than those in control group(P<0.05).(5)After 6 months of intervention,compared to the observation group,the recurrence rate of the observation group was obviously lower than that of the control group and the case fatality rate was also lower.The differences were statistically significant(P<0.05).Conclusion: The results of the controlled experimental research found that the effect of community rehabilitation of stroke patients under the family doctor signing system was better than that of the conventional group,which not only improved the athlete’s ability of patients,but enhanced their ability to take care of themselves,improved their psychological state,reduced the rate of recurrence and the rate of mortality,but also further improved the qualities of the life of patients,providing clinical evidence for the Health Commission to include stroke in the management of chronic diseases. |
PDF Full Text Request