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目的 基于IMCHB运动干预策略探究对老年女性脑卒中后疲劳(PSF)患者医院-家庭过渡期康复进程中的影响。方法 前瞻性选取2024年7—12月温州市中心医院收治的老年PSF女性患者98例，采用随机数字方法分为对照组与观察组，均49例。对照组采用常规干预，观察组采用IMCHB运动干预策略。比较两组患者入院时、干预1周、出院时、干预1个月及干预3个月进行疲劳严重度量表(Fatigue Severity Scale, FSS)评分、日常生活活动能力(activities of daily living, ADL)、疲劳影响量表(Fatigue Impact Scale, FIS)评分、锻炼依从性、同型半胱氨酸(Hcy)水平及C-反应蛋白(CRP)水平。结果 干预1个月及干预3个月时观察组的FSS评分分别为(35.10±4.80)分及(31.00±4.08)分，均低于对照组的(38.71±5.11)分及(34.12±4.80)分，差异均有统计学意义(t=3.604及3.467,均P<0.05);干预1个月及干预3个月时观察组的ADL评分分别为(60.03±7.14)分及(72.26±7.55)分，均高于对照组的(44.90±5.23)分及(58.90±6.88)分，差异均有统计学意义(t=11.970及9.156,均P<0.05);干预1个月及干预3个月时观察组的FIS评分分别为(93.56±8.08)分及(84.50±6.70)分，均低于对照组的(103.40±10.27)分及(91.44±8.50)分，差异均有统计学意义(t=5.271及4.489,均P<0.05);干预1个月及干预3个月时观察组的身体锻炼、锻炼效果监测评分高于对照组，差异有统计学意义(t身体锻炼=3.743、5.849;t锻炼效果=3.006及3.004,均P<0.05);干预1周、干预1个月及干预3个月时观察组的主动寻求建议评分高于对照组(t=2.800、2.132及2.895,均P<0.05);干预1周、干预1个月及干预3个月时观察组的CRP水平低于对照组(t=2.907、2.345及2.955,均P<0.05),观察组干预1个月及干预3个月时的Hcy低于对照组，差异均有统计学意义(t=2.644及2.078,均P<0.05)。结论 IMCHB运动干预策略可减少老年女性卒中后疲劳患者医院-家庭过渡期康复进程中的疲劳感，并可提高活动能力及依从性的同时降低Hcy、CRP水平，利于康复。
Abstract：Objective To explore the effect of exercise intervention strategy based on the Interactive Model of Client Health Behavior(IMCHB) on the rehabilitation process of elderly female patients with post-stroke fatigue(PSF) during the hospital-home transition period. Methods A total of 98 elderly female PSF patients admitted to Wenzhou Central Hospital from July to December 2024 were prospectively selected and randomly divided into a control group and an observation group, with 49 cases in each group. The control group received routine intervention, while the observation group adopted the IMCHB-based exercise intervention strategy. The Fatigue Severity Scale(FSS) score, activities of daily living(ADL) score, Fatigue Impact Scale(FIS) score, exercise compliance, homocysteine(Hcy) level, and C-reactive protein(CRP) level were compared between the two groups at admission, 1 week after intervention, at discharge, 1 month after intervention, and 3 months after intervention. Results At 1 month and 3 months after intervention, the FSS scores of the observation group were(35.10±4.80) points and(31.00±4.08) points, respectively, which were significantly lower than those of the control group [(38.71±5.11) points and(34.12±4.80) points], with statistically significant differences(t=3.604 and 3.467, both P<0.05). At 1 month and 3 months after intervention, the ADL scores of the observation group were(60.03±7.14) points and(72.26±7.55) points, respectively, which were significantly higher than those of the control group [(44.90±5.23) points and(58.90±6.88) points], with statistically significant differences(t=11.970 and 9.156, both P<0.05). At 1 month and 3 months after intervention, the FIS scores of the observation group were(93.56±8.08) points and(84.50±6.70) points, respectively, which were significantly lower than those of the control group [(103.40±10.27) points and(91.44±8.50) points], with statistically significant differences(t=5.271 and 4.489, both P<0.05). At 1 month and 3 months after intervention, the scores of physical exercise and exercise effect monitoring in the observation group were higher than those in the control group, with statistically significant differences(tphysical exercise=3.743, 5.849; texercise effect=3.006 and 3.004, both P<0.05). At 1 week, 1 month, and 3 months after intervention, the score of active advice-seeking in the observation group was higher than that in the control group(t=2.800, 2.132, and 2.895, all P<0.05). At 1 week, 1 month, and 3 months after intervention, the CRP level of the observation group was lower than that of the control group(t=2.907, 2.345, and 2.955, all P<0.05). At 1 month and 3 months after intervention, the Hcy level of the observation group was lower than that of the control group, with statistically significant differences(t=2.644 and 2.078, both P<0.05). Conclusion The IMCHB-based exercise intervention strategy can reduce fatigue in elderly female patients with post-stroke fatigue during the hospital-home transition rehabilitation period, improve their activity ability and compliance, and decrease Hcy and CRP levels, which is conducive to rehabilitation.
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基本信息:
DOI：10.19829/j.zgfybj.issn.1001-4411.2026.02.002
中图分类号:R743.3
引用信息:
[1]陈凌英,方佩琼.基于IMCHB运动干预策略在老年女性脑卒中后疲劳患者医院-家庭过渡期康复进程中的应用研究[J].中国妇幼保健,2026,41(02):198-203.DOI:10.19829/j.zgfybj.issn.1001-4411.2026.02.002.
基金信息:
浙江省温州市基础性公益科研项目(Y20240519)