The impact of integration of doctors-nurses-therapists continuous nursing management on rehabilitation of patients with spinal cord injury_West China Medical Journal

Authors：

YANG Jie ^1,2 , ZHANG Jianmei ^1,2 , JIANG Hongying ^1,2 , QU Yun ^1,2 ,  NING Ning ³

1. Department of Rehabilitation Medicine, West China Hospital, Sichuan University / West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
3. Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

NING Ning, Email: gknningning@126.com

Keywords：

Integration of doctors-nurses-therapists; Continuous nursing; Spinal cord injury; Activity of daily living; Quality of life

DOI：

10.7507/1002-0179.201911267

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Objective To explore the application and effect of integration of doctors-nurses-therapists continuous nursing management in patients with spinal cord injury.Methods The patients with spinal cord injury from June to December 2018 in the Department of Rehabilitation Medicine of West China Hospital of Sichuan University were selected. A set of numbers was generated by a computer. And the patients were randomly divided into the trial group and the control group. Patients in the control group were given routine discharge continuous nursing management, and patients in the trial group adopted the integration of doctors-nurses-therapists continuous nursing management to implement post-discharge guidance. The activity of daily living (ADL), quality of life or psychological status of the two groups were compared at discharge and 3 months after discharge. The compliance, satisfaction and readmission rates between the two groups were also compared 3 months after discharge.Results A total of 60 patients were included, with 30 cases in each group. There was no significant difference in the scores of ADL, quality of life or Huaxi Xinqing index between the two groups (P>0.05). Three months after discharge, the score of ADL (71.65±1.87 vs. 62.70±2.29), quality of life (302.90±2.71 vs. 292.95±3.39), compliance rate of medication on time (86.67% vs. 63.33%), compliance rate of exercise on time (86.67% vs. 60.00%), compliance rate of follow-up visit on time (90.00% vs. 63.33%), compliance rate of reasonable diet (83.33% vs. 60.00%), and satisfaction (90.45±1.82 vs. 79.55±1.39) of patients in the trial group were higher than those in the control group (P<0.05). There was significant difference in Huaxi Xinqing index between the trial group and the control group (14.57±1.36 vs. 21.60±1.88, P<0.001). The readmission rate of the trial group was lower than that of the control group (6.67% vs. 26.67%), but the difference was not statistically significant (P>0.05). Three months after discharge, the ADL and quality of life in both groups were significantly different from those at discharge (P<0.001); the score of Huaxi Xinqing index in the control group was higher than that at discharge (t=-17.971, P<0.001), which in the trial group was also higher than that at discharge, but the difference was not statistically significant (t=-1.352, P=0.187).Conclusion The integration of doctors-nurses-therapists continuous nursing management can effectively improve the ADL, quality of life and compliance of discharged patients with spinal cord injury, improve the mental state of patients, and improve patient satisfaction, which is helpful for the rehabilitation of patients with spinal cord injury outside the hospital.

Citation： YANG Jie, ZHANG Jianmei, JIANG Hongying, QU Yun, NING Ning. The impact of integration of doctors-nurses-therapists continuous nursing management on rehabilitation of patients with spinal cord injury. West China Medical Journal, 2021, 36(5): 656-660. doi: 10.7507/1002-0179.201911267 Copy

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13.	賴海靜, 李津, 肖厚安, 等. 同伴教育對重度燒傷患者康復效果的影響. 中國美容醫學, 2021, 30(1): 153-156.
14.	朱小華. 電話隨訪聯合以患者為中心的護理模式在慢性乙型肝炎患者護理中的應用價值. 河南醫學研究, 2021, 30(1): 177-179.
15.	吳肖梅, 韋英成, 黃珍, 等. 醫護一體化管理模式對神經根型頸椎病患者依從性和療效的影響. 中西醫結合護理(中英文), 2016, 2(4): 24-27.
16.	朱英娥, 俞靜嫻, 裔馨穎, 等. 肝癌介入治療術后延續性護理的實施效果. 國際護理學雜志, 2021, 40(3): 549-553.
17.	Aase K, Laugaland KA, Dyrstad DN, et al. Quality and safety in transitional care of the elderly: the study protocol of a case study research design (phase 1). BMJ Open, 2013, 3(8): e003506.
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1. 楊云, 許光旭. 脊髓損傷的臨床康復進展. 華西醫學, 2018, 33(10): 1303-1310.
2. 陳紅娟, 王麗芳, 方良妹. 對脊髓損傷患者實施心理康復護理的臨床效果觀察. 健康研究, 2014, 34(4): 414-415, 418.
3. 孫學明, 劉冰, 姬棟巖. 國內外延續性護理研究進展. 世界最新醫學信息文摘, 2017, 17(34): 36-37.
4. 美國脊柱損傷協會, 國際脊髓學會. 脊髓損傷神經學分類國際標準(第6版, 2006). 李建軍, 周紅俊, 孫迎春, 等, 譯. 中國康復理論與實踐, 2008, 14(7): 693-698.
5. 李萍, 錢微琳. 延續性護理干預對新生兒ICU極低出生體質量兒母親心理狀態和照護能力的影響. 中國實用護理雜志, 2020, 36(3): 225-229.
6. 王曉平, 鄒紅. 延續性護理管理干預對老年骨質疏松患者遵醫行為及生活質量的影響. 川北醫學院學報, 2021, 36(3): 390-393.
7. Oveisgharan S, Shirani S, Ghorbani A, et al. Barthel index in a Middle-East country: translation, validity and reliability. Cerebrovasc Dis, 2006, 22(5-6): 350-354.
8. 方積乾, 郝元濤, 李彩霞. 世界衛生組織生活質量量表中文版的信度與效度. 中國心理衛生雜志, 1999, 13(4): 203-205.
9. 劉珊珊, 鄭儒君, 李俊英, 等. 華西心晴指數在腫瘤科護士心理狀況測定中的應用. 四川醫學, 2017, 38(11): 1330-1335.
10. 王巍, 牛素英, 董慈, 等. 老年腦卒中住院患者心理健康狀況及與社會支持和治療的依從性. 中國老年學雜志, 2013, 33(7): 1528-1529.
11. 南登昆, 繆鴻石. 康復醫學. 北京: 人民衛生出版社, 2001: 54-55.
12. 薛春麗, 葉菁, 王燕. 個體化康復訓練聯合視頻教育對老年骨質疏松性股骨粗隆間骨折患者術后恢復的影響. 臨床心身疾病雜志, 2021, 27(1): 140-142.
13. 賴海靜, 李津, 肖厚安, 等. 同伴教育對重度燒傷患者康復效果的影響. 中國美容醫學, 2021, 30(1): 153-156.
14. 朱小華. 電話隨訪聯合以患者為中心的護理模式在慢性乙型肝炎患者護理中的應用價值. 河南醫學研究, 2021, 30(1): 177-179.
15. 吳肖梅, 韋英成, 黃珍, 等. 醫護一體化管理模式對神經根型頸椎病患者依從性和療效的影響. 中西醫結合護理(中英文), 2016, 2(4): 24-27.
16. 朱英娥, 俞靜嫻, 裔馨穎, 等. 肝癌介入治療術后延續性護理的實施效果. 國際護理學雜志, 2021, 40(3): 549-553.
17. Aase K, Laugaland KA, Dyrstad DN, et al. Quality and safety in transitional care of the elderly: the study protocol of a case study research design (phase 1). BMJ Open, 2013, 3(8): e003506.
18. 張揚, 李國宏, 劉敏. 我國外科出院患者延續護理實施現狀及建議. 中華護理雜志, 2016, 51(4): 409-412.

West China Medical Journal

The impact of integration of doctors-nurses-therapists continuous nursing management on rehabilitation of patients with spinal cord injury

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