关键词: 家庭医生；签约式服务；脑卒中；心理状态；自我感受负担；康复效果

Abstract: Objective: To explore the effects of contracted services of family physicians on self-perceived burden and psychological status of stroke patients in a community. Methods: A total of 116 patients with stroke were randomly divided into the observational group and the control group. 52 patients in the observational group received individualized behavior intervention by contracted services of family physicians. Another 64 patients in the control group received routine care. A series of questionnaires including Modified Rankin Scale (mRS), Barthel Index (BI), Self-Perceived Burden Scale (SPBS), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS) were used to evaluate the effects of the intervention on self-perceived burden and psychological status of the patients. Results: Six months after the intervention, the scores of SPBS (24.43±4.04) and each dimension in the observational group were significantly lower than those in the pre-intervention (39.12±4.46) and the control group (31.48±4.21) (F=179.82, t=9.1326, P<0.05). Six months after the intervention, the scores of SAS (26.57±6.81), SDS (28.74±6.87) and mRS (1.93±0.45) in the observational group were lower than those in the pre-intervention [(53.14±7.26), (52.25±9.53), (3.81±0.65)] and the control group [(34.33±7.75), (35.55±8.38), (2.44±0.53)], and the BI scores (68.99±8.43) were higher than those in the pre-intervention (36.26±8.83) and the control group (60.38±7.72), and all the differences were statistically significant (P<0.05). Conclusion: The worse the family function is, the heavier the self-perceived burden of patients with stroke have. The community-based contract services of family physicians has good effects on rehabilitation of patients with stroke. It can reduce the self-perceived burden of patients, improve their limb function and psychological status, and increase their daily living ability. The contacted services of family physicians can be promoted.

Key words: family physician; contracted service; stroke; psychological status; self-perceived burden; rehabilitation effect