CAJ | 학술논문

目的：探讨延续性自我管理教育在缺血性脑卒中患者康复过程中的作用。方法选缺血性脑卒中患者162例，随机分为干预组和对照组。两组均接受常规健康教育，干预组患者在此基础上接受综合自我管理教育，包括4期康复训练和缺血性脑卒中危险因素控制。观察出院6、12、24个月时，两组缺血性脑卒中康复知识知晓情况及二级预防行为、缺血性脑卒中危险因素达标率及卒中事件发生情况。结果缺血性脑卒中康复知识及二级预防行为得分：干预组6、12、24个月明显高于对照组(P＜0.01)。缺血性脑卒中危险因素达标率比较：6个月时干预组低密度脂蛋白（LDL-C）、运动达标率好于对照组（P＜0.05）；12和24个月时缺血性脑卒中危险因素达标率均好于对照组（P＜0.05）；与入院时比较，干预组6、12、24个月戒烟和运动达标率均显著增高（P＜0.05），而对照组仅6个月时戒烟达标率增加明显（P＜0.05）。随访2年，干预组卒中再发率少于对照组（P＜0.05）。结论延续性自我管理教育有助于提高缺血性卒中患者健康知识和疾病自我管理能力，从而防止和减少卒中事件的发生，是一种安全、有效、依从性高的卒中康复模式。
목적：탐토연속성자아관리교육재결혈성뇌졸중환자강복과정중적작용。방법선결혈성뇌졸중환자162례，수궤분위간예조화대조조。량조균접수상규건강교육，간예조환자재차기출상접수종합자아관리교육，포괄4기강복훈련화결혈성뇌졸중위험인소공제。관찰출원6、12、24개월시，량조결혈성뇌졸중강복지식지효정황급이급예방행위、결혈성뇌졸중위험인소체표솔급졸중사건발생정황。결과결혈성뇌졸중강복지식급이급예방행위득분：간예조6、12、24개월명현고우대조조(P＜0.01)。결혈성뇌졸중위험인소체표솔비교：6개월시간예조저밀도지단백（LDL-C）、운동체표솔호우대조조（P＜0.05）；12화24개월시결혈성뇌졸중위험인소체표솔균호우대조조（P＜0.05）；여입원시비교，간예조6、12、24개월계연화운동체표솔균현저증고（P＜0.05），이대조조부6개월시계연체표솔증가명현（P＜0.05）。수방2년，간예조졸중재발솔소우대조조（P＜0.05）。결론연속성자아관리교육유조우제고결혈성졸중환자건강지식화질병자아관리능력，종이방지화감소졸중사건적발생，시일충안전、유효、의종성고적졸중강복모식。
Objective To evaluate the effects of a continued self-management education program the ischemic stroke patients. Methods Totally 162 ischemic stroke patients into the experimental group and the control group. All patients received routine health education. In addition, the patients in the experimental group received a continued self-management education program including four-stage rehabilitation and risk factors control of coronary heat diseasers. The patients’ knowledge about ischemic stroke rehabilitation and behavior of secondary prevention, the qualiifed rate of risk factors control of ischemic stroke and the incidence stroke accident events were compared at 6 months, 12 months and 24 months after discharge between the two groups. Results The knowledge about ischemic stroke rehabilitation and behavior of secondary prevention at 6 months, 12 months and 24 months after discharge were signiifcantly better in the experimental group than that of the control group (P<0.01). At six months after discharge, the qualiifed rates of lowdensity lipoprotein (LDL) and exercise were signiifcantly higher in the experimental group than those of the control group (P<0.05). At 12 mouths and 24 mouths after discharge, the qualiifed rates in each index of risk factors of coronary heart diseases were signiifcantly higher in the experimental group than in the control group (P<0.05). In the experimental group, the qualiifed rates of smoking cessation and exercise were signiifcantly improved at 6 months, 12 months and 24 months after discharge (P<0.05). While in the control group, the qualiifed rate of smoking cessation only increased at 6 months after discharge (P<0.05). Two years later, the incidence of stroke was signiifcantly lower in the experimental group than that of the control group (P<0.05). Conclusions The continued self-management education program can improve the health knowledge level and the disease self-management ability, and thereby to prevent and reduce the incidence of stroke accident events. It is a safe,effective and feasible heart rehabilitation model for ischemic stroke patients .