基于老年综合评估的护理干预对老年帕金森病患者生活质量的影响

夏雪芬; 杨碎丽; 刘炯炯; 张扬; 徐惠琴

doi:10.16766/j.cnki.issn.1674-4152.003355

基于老年综合评估的护理干预对老年帕金森病患者生活质量的影响

doi: 10.16766/j.cnki.issn.1674-4152.003355

1.
温州医科大学附属第一医院神经内科，浙江温州 325000
2.
安徽医科大学附属阜阳医院全科医学科，安徽阜阳 236000

基金项目:

浙江省自然科学基金项目 LGD22H090011

温州市科研项目 Y20220548

详细信息

通讯作者:
徐恵琴，E-mail：xuhuiqin@wmu.edu.cn

中图分类号: R742.5 R473.74
计量
- 文章访问数: 107
- HTML全文浏览量: 39
- PDF下载量: 12
- 被引次数: 0
出版历程
- 收稿日期: 2023-09-18
- 网络出版日期: 2024-03-09

Effect of nursing intervention based on geriatric comprehensive assessment on quality of life in elderly patients with Parkinson's disease

1.
Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China

摘要

摘要: 目的老年帕金森病(PD)患者的生活质量不容乐观，也是临床护理研究的热点。本研究探讨基于老年综合评估(CGA)的护理对其生活质量的干预效果。方法选取2021年8月—2022年8月温州医科大学附属第一医院神经内科收治的120例老年PD患者，采用随机数字表法分为对照组和观察组各60例。因2组研究期间各失访2例，予以剔除，每组均按58例进行统计和数据分析。对照组进行常规护理，观察组进行基于CGA的护理干预，均持续干预和观察至出院6个月。比较2组日常生活能力(ADL)和帕金森病生活质量量表(PDQ-39)评分情况。结果观察组入院时、出院时和出院1、6个月的ADL评分均呈明显升高趋势(P＜0.05)，且出院1、6个月的ADL评分[(90.17±13.95)分、(91.18±13.05)分]均明显高于对照组[(82.16±18.69)分、(79.57±22.19)分]，差异有统计学意义(P＜0.05)；2组出院6个月PDQ-39评分均较入院时明显下降，且观察组出院6个月的PDQ-39评分[(29.71±8.97)分]明显低于对照组[(45.33±10.84)分]，差异有统计学意义(P＜0.05)。结论基于CGA的护理干预可有效提高老年PD患者的日常生活能力及生活质量，值得临床使用。
- 老年综合评估 /
- 护理 /
- 帕金森病 /
- 老年人 /
- 生活质量
Abstract: Objective The quality of life of older people with Parkinson's disease (PD) is not optimistic and is the focus of clinical nursing research. This study investigated the effect of a nursing intervention based on a nursing intervention based on a comprehensive geriatric assessment (CGA) on their quality of life. Methods A total of 120 elderly PD patients admitted to the Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University from August 2021 to August 2022 were selected and divided into control group and observation group, with 60 cases in each group by random number table method. As 2 cases were lost to follow-up in each of the two groups during the study period, statistics and data analysis were performed on 58 cases in each group. The control group received routine care, the observation group received the CGA-based care intervention, and the intervention and observation continued until 6 months after discharge. Activities of daily living (ADL) and the 39-item Parkinson disease questionnaire (PDQ-39) scores were compared between the two groups. Results The ADL scores of the observation group were significantly increased at admission, discharge, 1 month and 6 months after discharge (P < 0.05). The ADL scores [(90.17±13.95) points, (91.18±13.05) points] at 1 and 6 months after discharge were significantly higher than those of the control group [(82.16±18.69) points, (79.57±22.19) points] and the difference was statistically significant (P < 0.05). The PDQ-39 scores of both groups at 6 months after discharge were significantly lower than those at admission, and the PDQ-39 scores of the observation group at 6 months after discharge [(29.71±23.97) points] were significantly lower than those of the control group [(45.33±21.84) points], with statistical significance (P < 0.05). Conclusion A nursing intervention based on CGA can effectively improve activities of daily living and quality of life in older people with PD, which is worthy of clinical application.
- Comprehensive geriatric assessment of the elderly /
- Nursing /
- Parkinson's disease /
- The elderly /
- Quality of life

HTML全文

表 1 2组老年PD患者一般资料比较

Table 1. Comparison of general data of elderly PD patients between the two groups

项目	观察组 (n=58)	对照组 (n=58)	统计量	P值
性别(例)			0.035^a	0.852
男性	27	28
女性	31	30
年龄(x±s, 岁)	70.36±6.51	68.71±6.58	-1.362^b	0.176
住院时间(x±s，d)	5.97±1.35	5.91±1.40	-0.242^b	0.809
学历(例)				0.906^c
大专及以上	1	1
初中或高中	10	12
小学及以下	47	45
医保类别(例)				0.714^c
医疗保险	20	17
合作医疗	35	39
自费	3	2
婚姻(例)				0.558^c
已婚	50	53
离异或丧偶	7	5
未婚	1	0
宗教(例)			1.477^a	0.478
佛教	22	23
基督教	6	10
其他	30	25
注：^a为χ²值，^b为t值，^c为采用Fisher精确检验。

下载: 导出CSV

表 2 2组老年PD患者干预前后ADL评分比较(x±s，分)

Table 2. Comparison of ADL scores between the two groups of elderly PD patients before and after intervention (x±s, score)

组别	例数	入院时	出院时	出院个1月	出院6个月
观察组	58	78.19±18.89	84.91±15.66^a	90.17±13.95^a	91.18±13.05^a
对照组	58	77.12±17.94	83.76±16.95^a	82.16±18.69	79.57±22.19
F值		0.313	-0.380	-2.616	-3.435
P值		0.755	0.705	0.011	0.001
注：与同组入院时比较，^aP＜0.05。

下载: 导出CSV

表 3 2组老年PD患者生活质量评分比较(x±s，分)

Table 3. Comparison of quality of life scores of elderly PD patients between the two groups (x±s, score)

组别	例数	干预前 (入院时)	干预后 (出院6个月)	t值	P值
观察组	58	50.00±13.57	29.71±8.97	9.499	＜0.001
对照组	58	50.91±14.63	45.33±10.84	2.334	0.021
t值		-0.347	8.455
P值		0.729	＜0.001

下载: 导出CSV

参考文献(24)

[1]	ZHU B, YIN D, ZHAO H, et al. The immunology of Parkinson's disease[J]. Semin Immunopathol, 2022, 44(5): 659-672. doi: 10.1007/s00281-022-00947-3
[2]	TYSNES O B, STORSTEIN A. Epidemiology of Parkinson's disease[J]. J Neural Transm (Vienna), 2017, 124(8): 901-905. doi: 10.1007/s00702-017-1686-y
[3]	SIMON D K, TANNER C M, BRUNDIN P. Parkinson's disease epidemiology, pathology, genetics, and pathophysiology[J]. Clin Geriatr Med, 2020, 36(1): 1-12. doi: 10.1016/j.cger.2019.08.002
[4]	王伟, 曹庆华, 孙光玲, 等. 脑白质病变与帕金森病患者运动症状及非运动症状的相关性分析[J]. 中华全科医学, 2022, 20(2): 237-239. doi: 10.16766/j.cnki.issn.1674-4152.002321 WANG W, CAO Q H, SUN G L, et al. Correlation analysis of white matter lesions and motor symptoms and non-motor symptoms in Parkinson's patients[J]. Chinese Journal of General Practice, 2022, 20(2): 237-239. doi: 10.16766/j.cnki.issn.1674-4152.002321
[5]	PARKER S G, MCCUE P, PHELPS K, et al. What is comprehensive geriatric assessment (CGA)? An umbrella review[J]. Age Ageing, 2018, 47(1): 149-155. doi: 10.1093/ageing/afx166
[6]	江志远, 钟世彪, 唐莉, 等. 老年综合评估在老年Ⅲ~Ⅳ度混合痔手术患者健康管理中的应用效果[J]. 结直肠肛门外科, 2022, 28(6): 583-587. https://www.cnki.com.cn/Article/CJFDTOTAL-DCGM202206012.htm JIANG Z Y, ZHONG S B, TANG L, et al. Application of comprehensive geriatric assessment in health management of older patients with grade Ⅲ to Ⅳ mixed hemorrhoids undergoing surgery[J]. Colorectal and anal surgery, 2022, 28(6): 583-587. https://www.cnki.com.cn/Article/CJFDTOTAL-DCGM202206012.htm
[7]	王丽娜, 张炜, 李媛媛, 等. 基于老年综合评估的干预方案在老年2型糖尿病患者中的应用[J]. 河北医药, 2023, 45(16): 2457-2460. https://www.cnki.com.cn/Article/CJFDTOTAL-HBYZ202316012.htm WANG L N, ZHANG W, LI Y Y, et al. Application of interventions based on comprehensive geriatric assessment in elderly patients with type 2 diabetes mellitus[J]. Hebei Med J, 2023, 45(16): 2457-2460. https://www.cnki.com.cn/Article/CJFDTOTAL-HBYZ202316012.htm
[8]	刘颖, 杨继红. 老年综合评估干预在慢性肾脏病患者中的应用[J]. 中华老年医学杂志, 2020, 39(11): 1365-1368. doi: 10.3760/cma.j.issn.0254-9026.2020.11.028 LIU Y, YANG J H. Comprehensive geriatric assessment and intervention in elderly patients with chronic kidney disease[J]. Chinese Journal of Geriatrics, 2020, 39(11): 1365-1368. doi: 10.3760/cma.j.issn.0254-9026.2020.11.028
[9]	张冰, 王靖茹. 基于老年综合评估的护理干预对脑卒中患者的影响[J]. 护理实践与研究, 2022, 19(19): 2910-2915. doi: 10.3969/j.issn.1672-9676.2022.19.014 ZHANG B, WANG J R. Effect of nursing intervention based on comprehensive geriatric assessment in stroke patients[J]. Nursing Practice and Research, 2022, 19(19): 2910-2915. doi: 10.3969/j.issn.1672-9676.2022.19.014
[10]	刘军. 中国帕金森病的诊断标准(2016版)[J]. 中华神经科杂志, 2016, 49(4): 268-271. doi: 10.3760/cma.j.issn.1006-7876.2016.04.002 LIU J. Diagnostic criteria for Parkinson's disease in China (2016 edition)[J]. Chinese Journal of Neurology, 2016, 49(4): 268-271. doi: 10.3760/cma.j.issn.1006-7876.2016.04.002
[11]	宋鲁平, 王强. 帕金森病康复中国专家共识[J]. 中国康复理论与实践, 2018, 24(7): 745-752. https://www.cnki.com.cn/Article/CJFDTOTAL-ZKLS201807002.htm SONG L P, WANG Q. Rehabilitation for Parkinson's Disease: Chinese Expert Consensus[J]. Chinese Journal of Rehabilitation Theory and Practice, 2018, 24(7): 745-752. https://www.cnki.com.cn/Article/CJFDTOTAL-ZKLS201807002.htm
[12]	童卫东, 姚宏伟, 张忠涛. 《中国成人慢性便秘评估与外科处理临床实践指南(2022版)》解读: 一些值得关注的问题[J]. 结直肠肛门外科, 2022, 28(2): 115-118. https://www.cnki.com.cn/Article/CJFDTOTAL-DCGM202202003.htm TONG W D, YAO H W, ZHANG Z T. Clinical practice guideline on the evaluation and management of chronic constipation for Chinese adults (2022 edition)[J]. Colorectal and anal surgery, 2022, 28(2): 115-118. https://www.cnki.com.cn/Article/CJFDTOTAL-DCGM202202003.htm
[13]	O'MALLEY N, CLIFFORD A M, CONNEELY M, et al. Effectiveness of interventions to prevent falls for people with multiple sclerosis, Parkinson's disease and stroke: an umbrella review[J]. BMC Neurol, 2021, 21(1): 378. doi: 10.1186/s12883-021-02402-6
[14]	吴延, 王广玲, 聂作婷, 等. 2022年版《世界指南: 老年人跌倒的预防与管理》解读[J]. 中国全科医学, 2023, 26(10): 1159-1163, 1171. https://www.cnki.com.cn/Article/CJFDTOTAL-QKYX202310001.htm WU Y, WANG G L, NIE Z T, et al. Interpretation of the 2022 World Guidelines for Falls Prevention and Management for Older Adults: a Global Initiative[J]. Chinese General Practice, 2023, 26(10): 1159-1163, 1171. https://www.cnki.com.cn/Article/CJFDTOTAL-QKYX202310001.htm
[15]	张伟伟, 黄墩兵, 尹梦, 等. LSVT-BIG联合重复经颅磁刺激对帕金森病患者平衡及步行功能的影响[J]. 浙江医学, 2022, 44(20): 2194-2199. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJYE202220012.htm ZHANG W W, HUANG D B, YIN M, et al. Efficacy of Lee Silverman voice treatment-BIG combined with repetitive transcranial magnetic stimulation for balance and walking function in patients with Parkinson's disease[J]. Zhejiang Medical Journal, 2022, 44(20): 2194-2199. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJYE202220012.htm
[16]	WROBLEWSKA A, GAJOS A, SMYCZYNSKA U, et al. The therapeutic effect of nordic walking on freezing of gait in Parkinson's disease: a pilot study[J]. Parkinsons Dis, 2019, 2(10): 3846279. DOI: 10.1155/2019/3846279.
[17]	DEUEL L M, SEEBERGER L C. Complementary therapies in Parkinson' disease: a review of acupuncture, Tai Chi, Qi Gong, Yoga, and Cannabis[J]. Neurotherapeutics, 2020, 17(4): 1434-1455. doi: 10.1007/s13311-020-00900-y
[18]	FAN B, JABEEN R, BO B, et al. What and how can physical activity prevention function on Parkinson's disease?[J]. Oxid Med Cell Longev, 2020, 12(1): 4293071. DOI: 10.1155/2020/4293071.
[19]	BEARSS K A, DESOUZA J F X. Parkinson's disease motor symptom progression slowed with multisensory dance learning over 3-years: a preliminary longitudinal investigation[J]. Brain Sciences, 2021, 11(7): 895. doi: 10.3390/brainsci11070895
[20]	GALEOTO G, COLALELLI F, MASSAI P, et al. Quality of life in Parkinson's disease: Italian validation of the Parkinson's disease questionnaire (PDQ-39-IT)[J]. Neurol Sci, 2018, 39(11): 1903-1909. doi: 10.1007/s10072-018-3524-x
[21]	ZHAO N, YANG Y, ZHANG L, et al. Quality of life in Parkinson's disease: a systematic review and meta-analysis of comparative studies[J]. CNS Neurosci Ther, 2021, 27(3): 270-279. doi: 10.1111/cns.13549
[22]	张建华, 张洁, 李虹. 老年综合评估技术在老年护理工作中的应用进展[J]. 中华现代护理杂志, 2019, 25(13): 1585-1590. ZHANG J H, ZHANG J, LI H. Application progress of comprehensive geriatric assessment in geriatric nursing[J]. Chinese Journal of Modern Nursing, 2019, 25(13): 1585-1590.
[23]	VERONESE N, CUSTODERO C, DEMURTAS J, et al. Comprehensive geriatric assessment in older people: an umbrella review of health outcomes[J]. Age Ageing, 2022, 51(5): 35524746. DOI: 10.1093/ageing/afac104.
[24]	黄梅, 陈华玉, 季晶, 等. 老年帕金森病病人焦虑和抑郁情绪与生活质量的相关性研究[J]. 实用老年医学, 2023, 37(1): 96-99. https://www.cnki.com.cn/Article/CJFDTOTAL-SYLA202301024.htm HUANG M, CHEN H Y, JI J, et al. Comprehensive geriatric assessment and intervention in elderly patients with chronic kidney disease[J]. Chinese Journal of Geriatrics, 2023, 37(1): 96-99. https://www.cnki.com.cn/Article/CJFDTOTAL-SYLA202301024.htm