关键词: 吞咽障碍, 脑卒中, 居家管理, Triangle分层分级管理, 康复护理

Abstract: Objective: To develop a Triangle hierarchical management scheme for patients with Post-Stroke Dysphagia (PSD) and to evaluate the effects of this scheme in home-bound patients, aiming to provide a basis for clinical intervention. Methods: A total of 86 PSD patients from a tertiary grade A hospital in Taiyuan from August 2023 to April 2024 were selected by the convenience sampling method. These patients were assigned into the control group (43 patients) and the intervention group (43 patients) through random number table. Patients in the control group received routine care, while patients in the intervention group received the measures based on the Triangle hierarchical management scheme. The levels of swallowing function, nutritional status, compliance with swallowing functional exercise, and quality of life of the two groups of patients were compared before the intervention and 1 month and 3 months after the intervention. Results: Totally 40 patients in the intervention group and 39 patients in the control group completed the study. The results of repeated measures analysis of variance showed that there were statistically significant time effects, group effects, and time-by-group interaction effects when comparing the levels of swallowing function, nutritional status, compliance with swallowing function exercise, and quality of life levels of the two groups of patients at different time points (all P<0.05). The results of simple effect analysis showed that at 1 month and 3 months after the intervention, the levels of swallowing function, nutritional status, compliance with swallowing function exercise, and quality of life levels in the intervention group were higher than those in the control group (all P<0.05). Conclusion: The Triangle hierarchical management scheme can effectively improve the swallowing function and nutritional status of of home-bound patients with PSD, and improve their compliance with swallowing functional exercise and quality of life. It is worthy of clinical promotion.

Key words: dysphagia, stroke, home management, Triangle hierarchical management, rehabilitation nursing