Orem部分补偿的团体作业治疗在脑卒中上肢运动障碍患者中的应用

卞立; 董万利; 张丽; 鲍丹

文章摘要

卞立,董万利,张丽,鲍丹.Orem部分补偿的团体作业治疗在脑卒中上肢运动障碍患者中的应用[J].中国康复,2022,37(3):136-139

Orem部分补偿的团体作业治疗在脑卒中上肢运动障碍患者中的应用

Application of group therapy based on Orem’s part of the compensation in stroke patients with upper limb motor dysfunction

DOI：

中文关键词: 脑卒中 Orem自理理论团体治疗上肢运动功能

英文关键词: stroke Orem self-care theory group therapy upper limb motor function

基金项目:南京医科大学面上项目（No.2017NJMU178）；无锡市卫健委重大课题（Z202013）

作者	单位
卞立	1.苏州大学附属独墅湖医院（苏州大学医学中心）神经内科，江苏苏州 215124；2.无锡市同仁康复医院康复治疗科，江苏无锡 214151
董万利	苏州大学附属独墅湖医院（苏州大学医学中心）神经内科，江苏苏州 215124
张丽	无锡市同仁康复医院康复治疗科，江苏无锡 214151
鲍丹	无锡市同仁康复医院康复治疗科，江苏无锡 214151

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中文摘要:

目的：探讨以Orem自理理论-部分补偿系统为框架的团体作业疗法在脑卒中上肢运动功能障碍患者中的应用效果。方法：将脑卒中患者42例随机分为对照组和观察组各21例。对照组进行一对一作业治疗，40min/次，1次/d，5天/周，共4周；观察组实施一周3次的团体作业治疗和2次一对一的作业治疗，40min/次，1次/d，5d/周，共4周。干预前后采用Fugl-Meyer运动功能评定上肢部分（FMA-UE）、改良Barthel指数（MBI）、焦虑（SAS）和抑郁自评量表（SDS）进行评估。结果：与干预前相比，干预后2组的FMA-UE、MBI得分均明显提高（P<0.05），SAS和SDS得分均明显降低（P<0.05）。组间比较显示，干预前后FMA-UE、MBI、SAS及SDS得分的差值比较，观察组均高于对照组（P<0.05）。结论：对脑卒中患者实施以Orem部分补偿系统为框架的团体作业治疗，不但可以促进上肢运动功能和日常生活活动能力恢复，同时有助于改善焦虑、抑郁症状。

英文摘要:

Objective: To explore the application effect of group occupational therapy based on Orem’s self-care theory in stroke patients with upper limb motor dysfunction. Methods: According to the random number table method, 42 hospitalized stroke patients were randomly divided into control group and the experimental group, with 21 cases in each group. The control group received routine one-to-one occupational therapy, 40 min/time, 1 time/day, 5 days/week, for a total of 4 weeks. The experimental group received 3 times of group occupational therapy and 2 times of one-to-one occupational therapy every week, 40 min/time, once a day, 5 days a week for 4 weeks. The score of Fugl-meyer assessment upper extremity (FMA-UE), modified Barthel index (MBI), self-rating anxiety scale (SAS), and self-rating depression scale (SDS) were evaluated before and after the intervention. Results: Compared with those before the intervention, the FMA-UE and MBI scores were increased (P<0.05), SAS and SDS scores were decreased (P<0.05) in both groups after the intervention. Comparing the difference scores of FMA-UE, MBI, SAS and SDS before and after intervention, those in the experimental group were all higher than in the control group (P<0.05). Conclusion: The implementation of group occupational therapy based on Orem’s theory of self-care for stroke patients can promote patients’ upper limb motor function and activities of daily living, as well as help to improve anxiety and depression symptoms.

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