Home-visit nursing techniques for preventing relapse and restructuring lifestyles among patients with cerebrovascular disorder and verification of their effects

对脑血管疾病患者实施家访护理技术，并对其效果进行验证。研究结果如下：1。共有32.7%的脑血管疾病患者（神奈川县）在出院后一年内使用了家访护理服务2。在使用家访护理服务的患者中，38%的护理要求等级为5级，约68%的日常生活标准为B或C级，约48%的老年痴呆患者的日常生活标准为II至IV3级。家访护理以预防复发、挛缩和并发症为目的，包括观察、评估、调整、教育指导、心理支持和康复。这些护理服务的频率因护理水平而异。护理重点是护理要求等级为3和4的患者的日常生活自理能力维持和培训，以及护理要求等级为5.4的患者的如厕协助、卫生和家庭支持。在此基础上，制定了脑血管疾病患者家访护理方案。该方案包括与脑血管疾病患者相关的11个领域，与家庭照顾者相关的4个领域和与社会资源应用相关的1个领域。选择以下指标评价家庭护理状况：1)生命体征、体重、营养状况、口腔和吞咽功能；2) JSS-DE（抑郁与情绪障碍量表）；3)鳍;4)欧洲生活质量；5)照顾者疲劳（CSFI）。对传统家访护理组（对照组）和家访护理方案组（干预组）进行对比研究。结果：19个护理站虽有配合，但出院后1个月内使用家访护理服务的患者极少，满足条件的患者只有6例。对照组3例患者6个月的观察显示，脑血管病严重后遗症患者3个月后废用综合征进展。FIM和抑郁量表未见变化。3个月后欧洲生活质量提高，护理负担减轻。干预组仍处于早期阶段。我们将继续观察一年，比较两组。少

We implemented home-visit nursing techniques for patients with cerebrovascular disorder and verified their effects. The following findings were obtained:1. A total of 32.7% of patients with cerebrovascular disorder (in Kanagawa Prefecture) used home-visit nursing services within a year of discharge from hospitals or facilities2. Among patients who used home-visit nursing services, 38% had a care requirement level of 5, approximately 68% had a daily living criteria of B or C, and approximately 48% had a daily living criteria for elderly dementia patients of II to IV3. Home-visit nursing was conducted with the objectives of preventing relapse, contracture, and complications, and consisted of observation, evaluation, adjustment, education and guidance, mental support, and rehabilitation. The frequency of these nursing services varied depending on care level. Care focused on ADL maintenance and training for patients with care requirement levels of 3 and 4, and on toileting assistance, hygi … More ene care, and family support for those with a care requirement level of 5.4. A home-visit nursing program for patients with cerebrovascular disorder was created based on the above results. The program comprised 11 areas related to patients with cerebrovascular disorders, four areas related to family caregivers, and one area related to the application of social resources.5. The following indicators were selected for evaluating the condition of homecare: 1) vital signs, body weight, nutritional status, oral and swallowing functions; 2) JSS-DE(a scale for depression and emotional disorders); 3) FIM; 4) Euro QOL; and 5) caregiver fatigue (CSFI).6. A comparative study was initiated for the conventional home-visit nursing group(control group) and the home-visit nursing program group (intervention group).Results: Although cooperation was obtained from 19 nursing stations, only six patients satisfied the conditions as very few patients used home-visit nursing services within one month of discharge from hospitals or facilities. Observation of three patients in the control group for six months showed that disuse syndrome progressed after three months in patients with severe sequelae secondary to cerebrovascular disorder. No changes were observed for FIM or the depression scale. Euro QOL increased after three months, and care burden was reduced. The intervention group is still in its early stages. We will continue observation for one year and compare the two groups. Less