【摘要】 目的 探讨基于叙事医学模式的健康管理对围绝经期女性脑卒中患者自我管理、认知功能及肢体功能的影响。方法 选取2020年1月—2023年4月在绍兴市上虞人民医院就诊的围绝经期女性脑卒中患者100例为研究对象，随机将其分常规健康管理(HM)组和基于叙事医学模式的健康管理(NH)组，每组各50例，观察两组患者自我管理、认知功能及肢体功能等情况。结果 干预前，两组自我健康管理量表评分比较差异无统计学意义(P>0.05);干预后，NH组自我健康管理量表评分[(3.66±0.88)分]高于HM组[(2.34±0.71)分],差异有统计学意义(t=8.255,P<0.05)。干预前，两组MoCA评分比较差异无统计学意义(P>0.05);干预后，NH组MoCA评分[(27.15±2.59)分]高于HM组[(24.63±2.03)分],差异有统计学意义(t=5.415,P<0.05)。干预前，两组总FMA评分比较差异无统计学意义(P>0.05);干预后，NH组总FMA评分[(71.94±7.43)分]高于HM组[(60.33±6.67)分],差异有统计学意义(t=8.222,P<0.05)。与HM组对比，NH组撞伤、窒息、再出血及舌咬伤人数明显降低，NH组不良事件总发生率(6.00%)明显低于HM组(24.00%),组间比较差异有统计学意义(χ~2=6.353,P<0.05)。结论 采用基于叙事医学模式的健康管理对围绝经期女性脑卒中患者进行干预的效果更佳，可显著提高患者自我管理能力、认知功能及肢体功能。更多还原

【Abstract】 Objective To explore the effects of health management based on narrative medicine model on self-management, cognitive function and limb function of perimenopausal female stroke patients.Methods A total of 100 perimenopausal female stroke patients treated in Shangyu People’s Hospital of Shaoxing City from January 2020 to April 2023 were selected as the study objects, and randomly divided into routine health management(HM) group and health management(NH) group based on narrative medicine model, with 50 cases in each group. The self-management, cognitive function and limb function of the two groups were observed. Results Before intervention, there was no significant difference in self-health management scale scores between the two groups(P>0.05). After the intervention, the score of self-health management scale in NH group [(3.66±0.88) points] was higher than that in HM group [(2.34±0.71) points], and the difference was statistically significant(t=8.255,P<0.05). Before intervention, there was no significant difference in MoCA score between the two groups(P>0.05). After intervention, MoCA score in NH group [(27.15±2.59) points] was higher than that in HM group [(24.63±2.03) points], and the difference was statistically significant(t=5.415,P<0.05). Before intervention, there was no significant difference in FMA scores between the two groups(P>0.05). After intervention, FMA score in NH group [(71.94±7.43) points] was higher than that in HM group [(60.33±6.67) points], and the difference was statistically significant(t=8.222,P<0.05).Compared with HM group, the number of collisions, asphyxia, rebleeding and tongue bite in NH group was significantly reduced, and the overall incidence of adverse events in NH group(6.00%) was significantly lower than that in HM group(24.00%), with statistical significance(χ~2=6.353,P<0.05). Conclusion Health management based on narrative medicine model has a better effect on the intervention of perimenopausal female stroke patients, which can significantly improve patients’ self-management ability, cognitive function and limb function.更多还原