医务人员对急性缺血性脑卒中患者早期活动知识和态度现状调查
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摘要
目的 :调查医务人员对急性缺血性脑卒中患者早期活动知识和态度现状,并分析其影响因素。方法 :采用便利抽样法,选择来自江苏省4个城市的6所三级医院和3所二级医院的253名医务人员进行问卷调查。结果:医务人员对急性缺血性脑卒中患者早期活动知识和态度得分的中位数分别为68(62,74)分和68(63,73)分。有序多分类Logistic回归分析结果显示,专科工作年限、医院等级、接受早期活动培训经历是医务人员对急性缺血性脑卒中患者早期活动知识和态度的影响因素。结论 :医务人员对急性缺血性脑卒中患者早期活动知识的水平需要进一步提升,对早期活动态度不够积极,能够意识到早期活动的益处,但过分担忧早期活动的潜在风险,需要通过加强相关知识培训,提升知识与态度水平,促进早期活动的实施。
Objective: To investigate the knowledge and attitude of medical staff in various specialties on early mobilization in Acute Ischemic Stroke patients and to explore its influential factors. Methods: It was a cross-sectional study. A total of 253 medical workers from 6 tertiary hospitals, 3 secondary hospitals from 4 cities in Jiangsu province were recruited by convenience sampling and surveyed with self-designed questionnaires. Results: The median scores of knowledge and attitude of medical staff were 68(62, 74) and 68(63, 73). Logistic regression analysis showed that level of hospitals, time of specialty, whether received training or not were influential factors for medical staff's knowledge and attitude of early mobilization in patients with Acute Ischemic Stroke. Conclusion: The knowledge and attitude of medical staff on early mobilization in Acute Ischemic Stroke patients should be improved. Most medical staff have realized the benefits of early mobilization, but they worried about the risk of early mobilization too much. Thus training should be enhanced and resources should be shared to improve their knowledge and attitude.
Objective: To investigate the knowledge and attitude of medical staff in various specialties on early mobilization in Acute Ischemic Stroke patients and to explore its influential factors. Methods: It was a cross-sectional study. A total of 253 medical workers from 6 tertiary hospitals, 3 secondary hospitals from 4 cities in Jiangsu province were recruited by convenience sampling and surveyed with self-designed questionnaires. Results: The median scores of knowledge and attitude of medical staff were 68(62, 74) and 68(63, 73). Logistic regression analysis showed that level of hospitals, time of specialty, whether received training or not were influential factors for medical staff's knowledge and attitude of early mobilization in patients with Acute Ischemic Stroke. Conclusion: The knowledge and attitude of medical staff on early mobilization in Acute Ischemic Stroke patients should be improved. Most medical staff have realized the benefits of early mobilization, but they worried about the risk of early mobilization too much. Thus training should be enhanced and resources should be shared to improve their knowledge and attitude.
引文
[1]Gittler M,Davis AM.Guidelines for adult stroke rehabilitation and recovery.JAMA,2018,319(8):820-821.
[2]中华医学会神经病学分会.中国脑卒中早期康复治疗指南.中华神经科杂志,2017,50(6):405-412.Chinese Society of Neurology.Guidelines for early rehabilitation of stroke patients in China.Chinese Journal of Neurology,2017,50(6):405-412.
[3]中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2018.中华神经科杂志,2018,51(9):666-682.Chinese Society of Neurology,Chinese Stroke Society.Chinese guidelines for diagnosis and treatment of acute ischemic stroke 2018.Chinese Journal of Neurology,2018,51(9):666-682.
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[5]Forster A.Very early mobilization within24 hours of stroke results in a less favourable outcome at 3 months[commentary 1].Journal of Physiotherapy,2015,61(4):219.
[6]Diserens K,Moreira T,Hirt L,et al.Early mobilization out of bed after ischaemic stroke reduces severe complications but not cerebral blood flow:a randomized controlled pilot trial.Clin Rehabil,2012,26(5):451-459.
[7]Sj?holm A,Skarin M,Linden T,et al.Does evidence really matter?Professionals'opinions on the practice of early mobilization after stroke.Journal of Multidisciplinary Healthcare,2011,4(4):367-376.
[8]Wellwood I,Langhorne P,Mckevitt C,et al.An observational study of acute stroke care in four countries:the European registers of stroke study.Cerebrovasc Dis,2009,28(2):171-176.
[9]Bernhardt J,Godecke E,Johnson L,et al.Early rehabilitation after stroke.Curr Opin Neurol,2017,30(1):48-54.
[10]Lynch EA,Cumming T,Janssen H,et al.Early mobilization after stroke:changes in clinical opinion despite an unchanging evidence base.JStroke Cerebrovasc Dis,2017,26(1):1-6.
[11]王清,史慧玲,薛俐俐,等.早期活动对急性脑卒中患者预后影响的Meta分析.中华护理杂志,2016,51(12):1443-1450.Wang Q,Shi HL,Xue LL,et al.The effect of early mobilization on prognosis for acute stroke patients:a meta-analysis.Chinese Journal of Nursing,2016,51(12):1443-1450.
[12]李红丽,王清.急性缺血性脑卒中患者家属参与早期活动方案的研究.护理学杂志,2016,31(21):31-34.Li HL,Wang Q.Development of a family-involved early mobilization regimen for ischemic stroke.Journal of Nursing Science,2016,31(21):31-34.
[13]李佳倩,曹晶,焦静,等.护士对卧床患者常见并发症护理知识和态度的多中心调查.中华护理杂志,2017,52(3):327-331.Li JQ,Cao J,Jiao J,et al.Multicenter survey on nurses'knowledge and attitude on common complications among bedridden patients in Chinese hospitals.Chinese Journal of Nursing,2017,52(3):327-331.
[14]李映兰,贺连香,钟平.国家临床重点专科护理区域辐射作用的发挥.中华护理杂志,2015,50(2):152-154.Li YL,He LX,Zhong P.Regional influence of an advancing national clinical priority specialty in nursing.Chinese Journal of Nursing,2015,50(2):152-154.
[15]刘晓涵,吴燕燕,卢根娣.上海市三级甲等综合性医院外科护士预防患者静脉血栓栓塞症的知信行现状调查.解放军护理杂志,2014,31(12):1-5.Liu XH,Wu YY,Lu GD.Status investigation of knowledge-attitude-practice of surgical nurses in Shanghai 3A-level general hospitals in preventing venous thromboembolism.Nurs J Chin PLA,2014,31(12):1-5.
[16]杨晶,郑晓娜.ICU护士对患者早期活动的信念和态度现状调查.护理管理杂志,2017,17(10):720-722.Yang J,Zheng XN.A survey of nurse'beliefs and attitudes on ICU patients'early activities.Journal of Nursing Administration,2017,17(10):720-722.
[2]中华医学会神经病学分会.中国脑卒中早期康复治疗指南.中华神经科杂志,2017,50(6):405-412.Chinese Society of Neurology.Guidelines for early rehabilitation of stroke patients in China.Chinese Journal of Neurology,2017,50(6):405-412.
[3]中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2018.中华神经科杂志,2018,51(9):666-682.Chinese Society of Neurology,Chinese Stroke Society.Chinese guidelines for diagnosis and treatment of acute ischemic stroke 2018.Chinese Journal of Neurology,2018,51(9):666-682.
[4]Bernhardt J,Langhorne P,Lindley RI,et al.Efficacy and safety of very early mobilization within 24 h of stroke onset(AVERT):a randomised controlled trial.Lancet,2015,386(9988):46-55.
[5]Forster A.Very early mobilization within24 hours of stroke results in a less favourable outcome at 3 months[commentary 1].Journal of Physiotherapy,2015,61(4):219.
[6]Diserens K,Moreira T,Hirt L,et al.Early mobilization out of bed after ischaemic stroke reduces severe complications but not cerebral blood flow:a randomized controlled pilot trial.Clin Rehabil,2012,26(5):451-459.
[7]Sj?holm A,Skarin M,Linden T,et al.Does evidence really matter?Professionals'opinions on the practice of early mobilization after stroke.Journal of Multidisciplinary Healthcare,2011,4(4):367-376.
[8]Wellwood I,Langhorne P,Mckevitt C,et al.An observational study of acute stroke care in four countries:the European registers of stroke study.Cerebrovasc Dis,2009,28(2):171-176.
[9]Bernhardt J,Godecke E,Johnson L,et al.Early rehabilitation after stroke.Curr Opin Neurol,2017,30(1):48-54.
[10]Lynch EA,Cumming T,Janssen H,et al.Early mobilization after stroke:changes in clinical opinion despite an unchanging evidence base.JStroke Cerebrovasc Dis,2017,26(1):1-6.
[11]王清,史慧玲,薛俐俐,等.早期活动对急性脑卒中患者预后影响的Meta分析.中华护理杂志,2016,51(12):1443-1450.Wang Q,Shi HL,Xue LL,et al.The effect of early mobilization on prognosis for acute stroke patients:a meta-analysis.Chinese Journal of Nursing,2016,51(12):1443-1450.
[12]李红丽,王清.急性缺血性脑卒中患者家属参与早期活动方案的研究.护理学杂志,2016,31(21):31-34.Li HL,Wang Q.Development of a family-involved early mobilization regimen for ischemic stroke.Journal of Nursing Science,2016,31(21):31-34.
[13]李佳倩,曹晶,焦静,等.护士对卧床患者常见并发症护理知识和态度的多中心调查.中华护理杂志,2017,52(3):327-331.Li JQ,Cao J,Jiao J,et al.Multicenter survey on nurses'knowledge and attitude on common complications among bedridden patients in Chinese hospitals.Chinese Journal of Nursing,2017,52(3):327-331.
[14]李映兰,贺连香,钟平.国家临床重点专科护理区域辐射作用的发挥.中华护理杂志,2015,50(2):152-154.Li YL,He LX,Zhong P.Regional influence of an advancing national clinical priority specialty in nursing.Chinese Journal of Nursing,2015,50(2):152-154.
[15]刘晓涵,吴燕燕,卢根娣.上海市三级甲等综合性医院外科护士预防患者静脉血栓栓塞症的知信行现状调查.解放军护理杂志,2014,31(12):1-5.Liu XH,Wu YY,Lu GD.Status investigation of knowledge-attitude-practice of surgical nurses in Shanghai 3A-level general hospitals in preventing venous thromboembolism.Nurs J Chin PLA,2014,31(12):1-5.
[16]杨晶,郑晓娜.ICU护士对患者早期活动的信念和态度现状调查.护理管理杂志,2017,17(10):720-722.Yang J,Zheng XN.A survey of nurse'beliefs and attitudes on ICU patients'early activities.Journal of Nursing Administration,2017,17(10):720-722.