CAJ | 학술논문

目的：探讨家庭跟进照料模式对老年卧床患者家庭康复效果的影响。方法选择2012年10月—2013年7月在广东省人民医院出院的老年卧床患者120例，按照患者的出院时间顺序编号，奇数号为试验组，偶数号为对照组，每组各60例。试验组在出院时由医生、营养师、康复治疗师和康复专科护士根据患者的病情制定家庭康复计划，并通过家庭跟进照料来保证家庭康复计划的实施，指导照顾者减少老年卧床患者卧床时间及预防并发症的发生；对照组给予口头指导并告知患者家庭康复注意事项，定期电话随访。比较两组患者出院时及出院后3、6、9、12个月时Barthel指数评分与并发症发生情况。结果重复测量结果显示，干预措施与时间对Barthel指数评分的影响不存在交互作用（F＝0.139，P＝0.710）；干预措施对Barthel指数评分的影响有统计学意义（F＝10.272，P＝0.002）；时间对Barthel指数评分的影响有统计学意义（ F＝14.515，P﹤0.01）。干预12个月内压疮、尿路感染、肺炎、肌肉萎缩、便秘、尿失禁的发生率间差异均有统计学意义（ P﹤0.01）。结论对老年卧床患者由医生、护士、康复治疗师和营养师进行评估，由经过康复专科培训的护士进行家庭跟进照料，能提高老年卧床患者的日常生活能力，减少压疮、尿路感染、肺炎、肌肉萎缩、便秘、尿失禁并发症的发生。
목적：탐토가정근진조료모식대노년와상환자가정강복효과적영향。방법선택2012년10월—2013년7월재광동성인민의원출원적노년와상환자120례，안조환자적출원시간순서편호，기수호위시험조，우수호위대조조，매조각60례。시험조재출원시유의생、영양사、강복치료사화강복전과호사근거환자적병정제정가정강복계화，병통과가정근진조료래보증가정강복계화적실시，지도조고자감소노년와상환자와상시간급예방병발증적발생；대조조급여구두지도병고지환자가정강복주의사항，정기전화수방。비교량조환자출원시급출원후3、6、9、12개월시Barthel지수평분여병발증발생정황。결과중복측량결과현시，간예조시여시간대Barthel지수평분적영향불존재교호작용（F＝0.139，P＝0.710）；간예조시대Barthel지수평분적영향유통계학의의（F＝10.272，P＝0.002）；시간대Barthel지수평분적영향유통계학의의（ F＝14.515，P﹤0.01）。간예12개월내압창、뇨로감염、폐염、기육위축、편비、뇨실금적발생솔간차이균유통계학의의（ P﹤0.01）。결론대노년와상환자유의생、호사、강복치료사화영양사진행평고，유경과강복전과배훈적호사진행가정근진조료，능제고노년와상환자적일상생활능력，감소압창、뇨로감염、폐염、기육위축、편비、뇨실금병발증적발생。
Objective To investigate the effect of family follow-up care model on the family rehabilitation of elderly bedridden patients. Methods We enrolled 120 elderly bedridden patients who discharged from the Guangdong General Hospital from October 2012 to July 2013. According to the sequence number of discharge,we assigned the patients with odd sequence numbers into trial group and the patients with even sequence numbers into control group,with 60 patients in each group. For trial group,a family rehabilitation plan was made at discharge based on the state of illness by doctors,nutritionists,rehabilitation therapists and specialist nurses of rehabilitation,family follow-up care model was undertaken to ensure the plans being carried out,and guidance was provided to caregivers in order to reduce the bedridden time of the patients and prevent the occurrence of complications;for control group,verbal instruction about family rehabilitation was given and the matters that need attention were told to the family members of the patients,and regular telephone follow-up was conducted. Comparison was made between the two groups in Barthel score and the incidence rates of complications at discharge,and 3,6,9,12 months after discharge. Results The results of repeated measurements showed the follow results:there was no interaction effect between intervention measure and time in terms of their influence on Barthel score(F =0. 139,P =0. 710);intervention measure had significant influence on Barthel score(F=10. 272,P=0. 002);time had significant influence on Barthel score(F=14. 515,P﹤0. 01). Within 12 months after intervention, the two groups were significantly different in pressure sores, urinary tract infection, pneumonia,muscle atrophy,constipation and urinary incontinence( P ﹤0. 01 ). Conclusion The evaluation of bedridden elderly patients by doctors,nurses,therapists and nutritionists and the family follow -up care model provided by nurses who have received specialist rehabilitation training can improve the activities of daily living of bedridden elderly patients and reduce the incidence rates of pressure sores,urinary tract infection,pneumonia,muscle atrophy,constipation and urinary incontinence.