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目的探讨契约学习法在脑卒中患者康复训练中的应用效果。方法将120例脑卒中患者按随机数字表法随机分为对照组和观察组,每组各60例。对照组患者住院期间给予神经内科常规护理,出院后予以健康指导及出院随访;观察组患者在住院及出院期间按照契约学习进行康复训练。6个月后比较两组患者干预前、出院时、出院后1个月、出院后6个月生存质量状况。结果经过6个月的干预,随着时间的推移,除记忆思维度外,干预后不同时间点观察组患者生存质量在日常生活能力、手功能、移动能力、力气、情绪、交流和社会参与7个维度评分逐渐增高(均P<0.001),并明显高于对照组,组间比较,差异具有统计学意义(均P<0.001);随着时间的推移,除社会参与、记忆思维维度外,干预后不同时间点对照组患者生存质量在日常生活能力、手功能、移动能力、力气、情绪、交流6个维度评分逐渐增高(均P<0.001),差异具有统计学意义。结论对康复期脑卒中患者在康复训练过程采用契约学习法,可提高患者康复训练效果,从而提高脑卒中患者生存质量,改善其预后。
Objective To explore the application of contract learning in rehabilitation training of patients with stroke. Methods A total of 120 stroke patients were randomly divided into control group and observation group according to random number table method, 60 cases in each group. Patients in the control group were given routine neurological nursing during hospitalization, followed by health guidance and discharge from the hospital after discharge. The patients in the observation group were trained according to the contract during hospitalization and discharge. Six months later, the quality of life of the two groups was compared before intervention, at discharge, 1 month after discharge and 6 months after discharge. Results After 6 months of intervention, with the passage of time, in addition to the memory of thinking, the quality of life of observation group patients at different time points after intervention were significantly different from those of daily life, hand function, mobility, strength, emotion, communication and social participation (All P <0.001), which were significantly higher than those in the control group (P <0.001, P <0.001, respectively). With the exception of social participation and memory thinking, After intervention, the quality of life of patients in control group increased gradually (P <0.001) in six dimensions of daily living ability, hand function, mobility, strength, emotion and communication at different time points after intervention, the difference was statistically significant. Conclusions The contract learning method can be used to improve the rehabilitation training effect of patients with stroke during rehabilitation, so as to improve the quality of life and improve the prognosis of patients with stroke.