Abstract:

Objective To use the cognitive reinforcement comprehensive intervention program constructed by our team to intervene in patients with spinal cord injury and evaluate its clinical application effect. Methods A non-randomized trial design was adopted to select 97 patients with spinal cord injury from November 2021 to September 2022. Forty-four patients from March to September 2022 in a Grade A hospital in Hefei City were included in the experimental group，and 53 patients from November 2021 to February 2022 were included in the control group. The cognitive reinforcement comprehensive intervention program was used to intervene in the experimental group，and the conventional rehabilitation nursing was used to intervene in the control group.The intervention lasted for 12 weeks in both groups. The Changsha Montreal Scale，Social Support Rating Scale，Rehabilitation Exercise Self-efficacy Scale，Spinal Cord Injury Independence Rating Scale and Hamilton Anxiety Scale were used to measure the two groups before intervention，1 month after intervention and 3 months after intervention. Results 40 cases in the experimental group and 48 cases in the control group completed the study.Repeated measurement ANOVA showed that the temporal，interactive and intergroup effects of cognitive function scores and anxiety scores were statistically significant（P<0.05）. The time effect and interaction effect of the subjective support dimension score，coping self-efficacy dimension score of the two groups were statistically significant（P<0.05）. One month after the intervention，the cognitive function scores of test group were higher than before intervention and control group，and the anxiety scores were lower than before intervention and control group（P<0.05）. Three months after the intervention，the scores of cognitive function，subjective support dimension and coping self-efficacy dimension of experimental group were higher than those before intervention and control group，and the scores of anxiety level were lower than those before intervention and control group（P<0.05）. Conclusion Comprehensive intervention of cognitive reinforcement can improve the cognitive function of patients with spinal cord injury，delay the process of cognitive impairment，enhance self-confidence，relieve anxiety，and promote physical and mental rehabilitation of patients.

Key words: Spinal Cord Injury, Cognitive Dysfunction, Comprehensive Cognitive Reinforcement Intervention, Rehabilitation Nursing

摘要：

目的 运用前期构建的认知强化综合干预方案对脊髓损伤患者开展干预并评价其临床应用效果。 方法 采用非随机分组的类实验研究设计，通过便利抽样将2022年3月—9月在合肥市某三级甲等医院就诊的44例脊髓损伤患者纳入试验组，2021年11月—2022年2月就诊的53例脊髓损伤患者纳入对照组。使用认知强化综合干预方案对试验组进行干预，对对照组进行常规康复护理，两组干预均持续12周。分别于干预前、干预后1、3个月用长沙版蒙特利尔认知评估量表、社会支持评定量表、康复锻炼自我效能量表、脊髓损伤独立性评定量表、汉密尔顿焦虑量表对两组进行测评。结果 试验组40例、对照组48例完成研究。重复测量方差分析显示，两组认知功能评分、焦虑水平评分的时间效应、交互效应、组间效应具有统计学意义（P<0.05）；两组主观支持维度得分、应对自我效能维度得分的时间效应、交互效应具有统计学意义（P<0.05）。干预后1个月，试验组认知功能评分高于干预前和对照组、焦虑水平得分低于干预前和对照组，差异具有统计学意义（P<0.05）；干预后3个月，试验组的认知功能评分、主观支持维度得分、应对自我效能维度得分高于干预前和对照组，焦虑水平评分低于干预前和对照组，差异具有统计学意义（P<0.05）。结论 认知强化综合干预可改善脊髓损伤患者的认知功能，延缓患者认知障碍进程，提升自我信心，缓解焦虑，促进患者身心康复。

关键词: 脊髓损伤, 认知功能障碍, 认知强化综合干预, 康复护理