国际功能、残疾和健康分类理念下的作业训练对脑卒中患者认知功能、心理状态和生活质量的影响

目的:探讨国际功能、残疾和健康分类(ICF)理念下的作业训练对脑卒中患者认知功能、心理状态和生活质量的影响。方法:选取我院2018年1月~2020年1月收治的脑卒中患者140例,根据随机数字表法,分成观察组(n=70)、对照组(n=70)。对照组行常规作业训练,观察组采用基于ICF理念下的作业训练。两组均观察3个月,分别在干预前、干预3个月后,经蒙特利尔认知评估量表(MOCA)评价两组认知功能的变化。经抑郁自评量表(SDS)、焦虑自评量表(SAS)分析患者的焦虑、抑郁情况。经Fugl-Meyer运动功能评定量表(FMA)、功能综合评定量表(FCA)评估患者运动功能、综合功能。利用健康状态调查量表(SF-36)评估两组生活质量。结果:两组干预后MOCA评分高于干预前,且观察组高于对照组(P<0.05)。两组干预后SDS、SAS评分低于干预前,且观察组低于对照组(P<0.05)。两组干预后FMA、FCA评分高于干预前,且观察组高于对照组(P<0.05)。两组干预后SF-36各维度评分均高于干预前,且观察组高于对照组(P<0.05)。结论:基于ICF理念下的作业训练能进一步改善脑卒中患者的认知功能以及心理状态,且有利于提升运动功能与综合功能,改善生活质量。

The Effect of Operation Training under the Concept of International Functioning, Disability and Health Classification on Cognitive Function, Mental State and Quality of Life of Stroke Patients

Objective: To explore the effects of operation training under the concept of international functioning, disability and health classification(ICF) on cognitive function, mental state and quality of life of stroke patients. Methods: 140 stroke patients admitted to our hospital from January 2018 to January 2020 were selected. According to the random number table method, patients were randomly divided into observation group(n=70), control group(n=70). The control group received routine rehabilitation training, and the observation group used operation training based on the ICF concept. Both groups were observed for 3 months. Before intervention and 3 months after intervention, the changes of cognitive function were evaluated by the Montreal cognitive assessment scale(MOCA) scale.The patients’ anxiety and depression were analyzed by self rating depression scale(SDS), self rating anxiety scale(SAS) scale.Fugl-meyer assessment scale(FMA) and functional comprehensive assessment scale(FCA) were used to evaluate the motor function and comprehensive function of patients. Medical outcomes study 36-item short-form health survey(SF-36) scale was used to evaluate the quality of life of the two groups. Results: The MOCA score of the two groups after intervention was higher than that before intervention,and the observation group was higher than the control group(P<0.05). The SDS and SAS scores of the two groups after intervention were lower than before intervention, and the observation group was lower than the control group(P<0.05). The FMA, FCA score of the two groups after intervention were higher than those before intervention, and the observation group was higher than the control group(P<0.05). The scores of SF-36 in all dimensions of both groups after intervention were higher than those before intervention, and the observation group was higher than the control group(P<0.05). Conclusion: Operation training based on the ICF concept can further improve the cognitive function and mental state of patients with stroke, and is conducive to improve motor function and comprehensive function, and improve the quality of life.