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Article(id=1322929548001686303, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322929547464815391, articleNumber=null, orderNo=null, doi=10.12102/j.issn.1009-6493.2026.14.017, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1757088000000, receivedDateStr=2025-09-06, revisedDate=1776614400000, revisedDateStr=2026-04-20, acceptedDate=null, acceptedDateStr=null, onlineDate=1793340583085, onlineDateStr=2026-10-30, pubDate=1784908800000, pubDateStr=2026-07-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793340583085, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793340583085, creator=13701087609, updateTime=1793340583085, updator=13701087609, issue=Issue{id=1322929547464815391, tenantId=1146029695717560320, journalId=1220038315760373764, year='2026', volume='40', issue='14', pageStart='2385', pageEnd='2576', issueExtLink='null', onlineDate='null', pubDate='1784908800000', pubDateStr='2026-07-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793340582958, creator='13701087609', updateTime=1793343111003, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322940150912790807, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322929547464815391, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322940150912790808, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322929547464815391, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=2510, endPage=2515, ext={EN=ArticleExt(id=1322929548219790112, articleId=1322929548001686303, tenantId=1146029695717560320, journalId=1220038315760373764, language=EN, title=Application of rehabilitation nursing with occupational therapy based on a healing garden in stroke patients, columnId=1220689488284668633, journalTitle=Chinese Nursing Research, columnName=Comprehensive Study, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the application effect of rehabilitation nursing with occupational therapy based on a healing garden in stroke patients.

Methods

A total of 111 stroke patients admitted to our hospital from July 2024 to May 2025 were selected as the study subjects.The 56 stroke patients admitted from July to December 2024 were included in the control group,and 55 stroke patients admitted from January to May 2025 were included in the experimental group.The control group received conventional nursing care,while the experimental group received rehabilitation nursing with occupational therapy based on a healing garden.The results in two groups were compared in terms of cognitive function,ability of daily living,limb motor function,rehabilitation self-efficacy,and quality of life.

Results

After 4 weeks of intervention,the scores of the Montreal Cognitive Assessment(MoCA),Ability of Daily Living(ADL) scale,Fugl-Meyer Assessment(FMA),Self-Efficacy for Rehabilitation(SER) scale,and the World Health Organization Quality of Life-BREF(WHOQOL-BREF) in the experimental group were higher than those in the control group(all P<0.05).

Conclusions

Rehabilitation nursing with occupational therapy based on a healing garden could effectively improve patients' cognitive function,ability of daily living,and limb motor function,enhance their rehabilitation self-efficacy and quality of life.

, authors=Jinlin LIU, Guilan CAI, Jingjing WANG, Yong ZHEN, authorsList=Jinlin LIU, Guilan CAI, Jingjing WANG, Yong ZHEN, authorCompany=null, correspAuthors=Yong ZHEN, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322929548937016098, articleId=1322929548001686303, tenantId=1146029695717560320, journalId=1220038315760373764, language=CN, title=基于康复花园的作业疗法康复护理在脑卒中病人中的应用, columnId=1220689488938980091, journalTitle=护理研究, columnName=综合研究, runingTitle=null, highlight=null, articleAbstract=
目的

探讨基于康复花园的作业疗法康复护理在脑卒中病人中的应用效果。

方法

选取2024年7月—2025年5月于我院收治的111例脑卒中病人为研究对象，将2024年7月—12月收治的56例脑卒中病人作为对照组，将2025年1月—5月收治的55例脑卒中病人作为试验组。对照组采用常规护理模式，试验组采用基于康复花园的作业疗法康复护理。比较两组病人认知功能、日常生活能力、肢体运动功能、康复自我效能感以及生活质量。

结果

干预4周后试验组蒙特利尔认知评估量表（MoCA）得分、日常生活活动能力量表（ADL）得分、Fugl-Meyer运动功能评分法（FMA）得分、康复自我效能感量表（SER）得分、世界卫生组织生活质量测定量表简表（WHOQOL-BREF）得分均高于对照组（均P<0.05）。

结论

基于康复花园的作业疗法康复护理能够有效改善病人认知功能、日常生活能力、肢体运动功能，增强病人康复自我效能感，提高病人生活质量。

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刘金林，主管护师，本科

, correspAuthorsNote=
甄勇，E-mail:
ZHEN Yong, E-mail:
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companyList=[AuthorCompany(id=1322929549155119907, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322929548001686303, xref=1, ext=[AuthorCompanyExt(id=1322929549167702820, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322929548001686303, companyId=1322929549155119907, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1Northern Jiangsu People's Hospital, Jiangsu 225001 China), AuthorCompanyExt(id=1322929549176091429, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322929548001686303, companyId=1322929549155119907, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1苏北人民医院，江苏 225001)])], figs=[ArticleFig(id=1322929553357812554, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322929548001686303, language=EN, label=Table 1, caption=

Rehabilitation nursing plan with occupational therapy based on a healing garden

, figureFileSmall=null, figureFileBig=null, tableContent=
活动名称活动目的活动内容
园艺种植与养护提高病人肢体运动功能锄草：通过锄草活动，锻炼病人的上肢力量和手部精细动作
翻地：使用小铲子或耙子翻地，可以增强病人的上肢和肩部肌肉力量
施肥：学习如何正确施肥，促进病人的手眼协调能力和对精细动作的控制
播种：亲自播种植物种子，培养病人的耐心和责任感
浇水：定期为植物浇水，有利于改善病人的肢体协调性和平衡能力
植物认知与记忆提高病人认知功能辨认植物：引导病人辨认花园中的不同植物，包括它们的名称、特征和生长习性，以锻炼病人的视觉认知能力和记忆力
记忆游戏：设计一些与植物相关的记忆游戏，如记忆植物的位置、名称或特征等，以提高病人的记忆力和注意力
园艺疗法小组活动改善病人心理状态集体园艺：组织病人一起参与园艺活动，如共同种植一片花海或蔬菜园，通过团队合作和互相支持增强病人的社交能力和归属感
分享与交流：在园艺活动过程中或结束后，鼓励病人分享自己的感受、经验和成果，以促进彼此之间的情感交流和心理健康，增强康复自我效能感
花园中的日常生活模拟提高病人日常生活能力日常生活：病人可以在康复师的指导下进行穿衣、进食、洗碗等日常生活活动的模拟练习，以提高生活自理能力
搬运花盆：模拟搬运日常物品的动作，锻炼病人的上肢力量和平衡能力
布置花园：参与花园的布置和美化工作，如摆放座椅、装饰物等，以锻炼病人的空间感知能力和审美能力
休闲与娱乐活动改善病人生活质量绿色疗愈：在康复花园中划分出小块区域供病人种植花草或蔬菜，在康复师指导下进行播种、浇水、施肥、修剪等园艺活动，以锻炼病人的上肢和手功能，并通过接触自然、观察植物生长变化，带来心灵上的慰藉和满足感
悠然时光：在康复花园中设置休闲区域，如阅读角、音乐角等，病人可以在这里阅读书籍、听音乐、与他人交流等，享受悠闲的时光，提高生活质量
), ArticleFig(id=1322929553492030283, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322929548001686303, language=CN, label=表1, caption=

基于康复花园的作业疗法康复护理方案

, figureFileSmall=null, figureFileBig=null, tableContent=
活动名称活动目的活动内容
园艺种植与养护提高病人肢体运动功能锄草：通过锄草活动，锻炼病人的上肢力量和手部精细动作
翻地：使用小铲子或耙子翻地，可以增强病人的上肢和肩部肌肉力量
施肥：学习如何正确施肥，促进病人的手眼协调能力和对精细动作的控制
播种：亲自播种植物种子，培养病人的耐心和责任感
浇水：定期为植物浇水，有利于改善病人的肢体协调性和平衡能力
植物认知与记忆提高病人认知功能辨认植物：引导病人辨认花园中的不同植物，包括它们的名称、特征和生长习性，以锻炼病人的视觉认知能力和记忆力
记忆游戏：设计一些与植物相关的记忆游戏，如记忆植物的位置、名称或特征等，以提高病人的记忆力和注意力
园艺疗法小组活动改善病人心理状态集体园艺：组织病人一起参与园艺活动，如共同种植一片花海或蔬菜园，通过团队合作和互相支持增强病人的社交能力和归属感
分享与交流：在园艺活动过程中或结束后，鼓励病人分享自己的感受、经验和成果，以促进彼此之间的情感交流和心理健康，增强康复自我效能感
花园中的日常生活模拟提高病人日常生活能力日常生活：病人可以在康复师的指导下进行穿衣、进食、洗碗等日常生活活动的模拟练习，以提高生活自理能力
搬运花盆：模拟搬运日常物品的动作，锻炼病人的上肢力量和平衡能力
布置花园：参与花园的布置和美化工作，如摆放座椅、装饰物等，以锻炼病人的空间感知能力和审美能力
休闲与娱乐活动改善病人生活质量绿色疗愈：在康复花园中划分出小块区域供病人种植花草或蔬菜，在康复师指导下进行播种、浇水、施肥、修剪等园艺活动，以锻炼病人的上肢和手功能，并通过接触自然、观察植物生长变化，带来心灵上的慰藉和满足感
悠然时光：在康复花园中设置休闲区域，如阅读角、音乐角等，病人可以在这里阅读书籍、听音乐、与他人交流等，享受悠闲的时光，提高生活质量
), ArticleFig(id=1322929553584304972, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322929548001686303, language=EN, label=Table 2, caption=

Comparison of general information between the two groups of patients

, figureFileSmall=null, figureFileBig=null, tableContent=
项目分组试验组（n=55）对照组（n=56）统计值P
性别[例（%）]男34（61.82）39（69.64）χ2=0.7550.385
女21（38.18）17（30.36）
年龄（x±s，岁）63.64±7.1262.89±7.25t=0.5490.584
文化程度[例（%）]小学及以下26（47.27）24（42.86）
初中12（21.82）14（25.00）χ2=0.2680.966
高中11（20.00）12（21.43）
专科及以上6（10.91）6（10.71）
脑卒中类型[例（%）]出血型19（34.55）22（39.29）
缺血型28（50.91）27（48.21）χ2=0.2950.863
混合型8（14.55）7（12.50）
脑卒中病程[例（%）]≤1个月31（56.36）33（58.93）
>1~3个月12（21.82）14（25.00）χ2=0.6980.874
>3~6个月6（10.91）4（7.14）
>6个月6（10.91）5（8.93）
), ArticleFig(id=1322929553676579661, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322929548001686303, language=CN, label=表2, caption=

两组病人一般资料比较

, figureFileSmall=null, figureFileBig=null, tableContent=
项目分组试验组（n=55）对照组（n=56）统计值P
性别[例（%）]男34（61.82）39（69.64）χ2=0.7550.385
女21（38.18）17（30.36）
年龄（x±s，岁）63.64±7.1262.89±7.25t=0.5490.584
文化程度[例（%）]小学及以下26（47.27）24（42.86）
初中12（21.82）14（25.00）χ2=0.2680.966
高中11（20.00）12（21.43）
专科及以上6（10.91）6（10.71）
脑卒中类型[例（%）]出血型19（34.55）22（39.29）
缺血型28（50.91）27（48.21）χ2=0.2950.863
混合型8（14.55）7（12.50）
脑卒中病程[例（%）]≤1个月31（56.36）33（58.93）
>1~3个月12（21.82）14（25.00）χ2=0.6980.874
>3~6个月6（10.91）4（7.14）
>6个月6（10.91）5（8.93）
), ArticleFig(id=1322929553747882830, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322929548001686303, language=EN, label=Table 3, caption=

Comparison of MoCA scores and ADL scores between the two groups of patients before and after nursing（x±s）

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组别例数MoCA得分ADL得分
入院后24 h干预4周后入院后24 h干预4周后
试验组5512.44±1.3922.87±3.5154.21±4.8475.54±5.52
对照组5612.95±1.5218.12±2.5952.89±4.5769.13±4.15
t值-1.8448.1231.4786.923
P0.068<0.0010.142<0.001
), ArticleFig(id=1322929553856934735, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322929548001686303, language=CN, label=表3, caption=

两组病人护理前后MoCA得分和ADL得分比较（x±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数MoCA得分ADL得分
入院后24 h干预4周后入院后24 h干预4周后
试验组5512.44±1.3922.87±3.5154.21±4.8475.54±5.52
对照组5612.95±1.5218.12±2.5952.89±4.5769.13±4.15
t值-1.8448.1231.4786.923
P0.068<0.0010.142<0.001
), ArticleFig(id=1322929553949209424, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322929548001686303, language=EN, label=Table 4, caption=

Comparison of FMA scores between the two groups of patients before and after nursing（x±s）

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组别例数上肢运动下肢运动
入院后24 h干预4周后入院后24 h干预4周后
试验组5522.37±0.6556.92±2.4711.83±1.7931.59±1.52
对照组5622.46±0.5446.58±1.6511.52±1.4826.46±1.87
t值-0.79425.9770.99515.844
P0.429<0.0010.322<0.001
), ArticleFig(id=1322929554062455633, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322929548001686303, language=CN, label=表4, caption=

两组病人护理前后FMA得分比较（x±s）

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组别例数上肢运动下肢运动
入院后24 h干预4周后入院后24 h干预4周后
试验组5522.37±0.6556.92±2.4711.83±1.7931.59±1.52
对照组5622.46±0.5446.58±1.6511.52±1.4826.46±1.87
t值-0.79425.9770.99515.844
P0.429<0.0010.322<0.001
), ArticleFig(id=1322929554171507538, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322929548001686303, language=EN, label=Table 5, caption=

Comparison of SER scores between the two groups of patients before and after nursing（x±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数身体锻炼自我效能应对自我效能总分
入院后24 h干预4周后入院后24 h干预4周后入院后24 h干预4周后
试验组5525.37±2.8133.51±2.2336.83±1.8143.59±2.5263.48±4.7675.26±6.14
对照组5624.78±2.4530.22±1.6436.58±1.5739.89±1.9662.35±3.8470.12±5.53
t值1.1798.8660.7788.6441.3784.636
P0.241<0.0010.438<0.0010.171<0.001
), ArticleFig(id=1322929554267976531, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322929548001686303, language=CN, label=表5, caption=

两组病人护理前后SER得分比较（x±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数身体锻炼自我效能应对自我效能总分
入院后24 h干预4周后入院后24 h干预4周后入院后24 h干预4周后
试验组5525.37±2.8133.51±2.2336.83±1.8143.59±2.5263.48±4.7675.26±6.14
对照组5624.78±2.4530.22±1.6436.58±1.5739.89±1.9662.35±3.8470.12±5.53
t值1.1798.8660.7788.6441.3784.636
P0.241<0.0010.438<0.0010.171<0.001
), ArticleFig(id=1322929555949892437, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322929548001686303, language=EN, label=Table 6, caption=

Comparison of WHOQOL-BREF scores between the two groups of patients before and after nursing（x±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数生理心理环境社会关系
入院后24 h干预4周后入院后24 h干预4周后入院后24 h干预4周后入院后24 h干预4周后
试验组5565.26±5.5381.25±1.4862.68±5.2482.32±2.8168.75±4.5785.87±2.3264.87±4.1284.87±2.01
对照组5666.13±5.6476.42±1.8463.15±5.1778.63±2.5467.98±4.3978.72±2.5965.13±4.2877.72±2.28
t值-0.82015.223-0.4767.2610.90515.311-0.32617.514
P0.414<0.0010.635<0.0010.367<0.0010.745<0.001
), ArticleFig(id=1322929556021195606, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322929548001686303, language=CN, label=表6, caption=

两组病人护理前后WHOQOL-BREF得分比较（x±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数生理心理环境社会关系
入院后24 h干预4周后入院后24 h干预4周后入院后24 h干预4周后入院后24 h干预4周后
试验组5565.26±5.5381.25±1.4862.68±5.2482.32±2.8168.75±4.5785.87±2.3264.87±4.1284.87±2.01
对照组5666.13±5.6476.42±1.8463.15±5.1778.63±2.5467.98±4.3978.72±2.5965.13±4.2877.72±2.28
t值-0.82015.223-0.4767.2610.90515.311-0.32617.514
P0.414<0.0010.635<0.0010.367<0.0010.745<0.001
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基于康复花园的作业疗法康复护理在脑卒中病人中的应用
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刘金林 , 蔡桂兰 , 王菁菁 , 甄勇 *, *
护理研究 | 综合研究 2026,40(14): 2510-2515
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护理研究 |综合研究 2026 , 40 (14) : 2510 -2515
基于康复花园的作业疗法康复护理在脑卒中病人中的应用
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刘金林，主管护师，本科

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刘金林, 蔡桂兰, 王菁菁, 甄勇*, *
作者信息
  • 1苏北人民医院，江苏 225001
通讯作者:
甄勇，E-mail:
ZHEN Yong, E-mail:
作者简介:

刘金林，主管护师，本科

Application of rehabilitation nursing with occupational therapy based on a healing garden in stroke patients
Jinlin LIU, Guilan CAI, Jingjing WANG, Yong ZHEN
Affiliations
  • 1Northern Jiangsu People's Hospital, Jiangsu 225001 China
出版时间: 2026-07-25 doi: 10.12102/j.issn.1009-6493.2026.14.017
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摘要
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目的

探讨基于康复花园的作业疗法康复护理在脑卒中病人中的应用效果。

方法

选取2024年7月—2025年5月于我院收治的111例脑卒中病人为研究对象，将2024年7月—12月收治的56例脑卒中病人作为对照组，将2025年1月—5月收治的55例脑卒中病人作为试验组。对照组采用常规护理模式，试验组采用基于康复花园的作业疗法康复护理。比较两组病人认知功能、日常生活能力、肢体运动功能、康复自我效能感以及生活质量。

结果

干预4周后试验组蒙特利尔认知评估量表（MoCA）得分、日常生活活动能力量表（ADL）得分、Fugl-Meyer运动功能评分法（FMA）得分、康复自我效能感量表（SER）得分、世界卫生组织生活质量测定量表简表（WHOQOL-BREF）得分均高于对照组（均P<0.05）。

结论

基于康复花园的作业疗法康复护理能够有效改善病人认知功能、日常生活能力、肢体运动功能，增强病人康复自我效能感，提高病人生活质量。

康复花园  /  作业疗法  /  脑卒中  /  认知功能  /  日常生活能力  /  肢体运动功能  /  自我效能  /  生活质量
Objective

To investigate the application effect of rehabilitation nursing with occupational therapy based on a healing garden in stroke patients.

Methods

A total of 111 stroke patients admitted to our hospital from July 2024 to May 2025 were selected as the study subjects.The 56 stroke patients admitted from July to December 2024 were included in the control group,and 55 stroke patients admitted from January to May 2025 were included in the experimental group.The control group received conventional nursing care,while the experimental group received rehabilitation nursing with occupational therapy based on a healing garden.The results in two groups were compared in terms of cognitive function,ability of daily living,limb motor function,rehabilitation self-efficacy,and quality of life.

Results

After 4 weeks of intervention,the scores of the Montreal Cognitive Assessment(MoCA),Ability of Daily Living(ADL) scale,Fugl-Meyer Assessment(FMA),Self-Efficacy for Rehabilitation(SER) scale,and the World Health Organization Quality of Life-BREF(WHOQOL-BREF) in the experimental group were higher than those in the control group(all P<0.05).

Conclusions

Rehabilitation nursing with occupational therapy based on a healing garden could effectively improve patients' cognitive function,ability of daily living,and limb motor function,enhance their rehabilitation self-efficacy and quality of life.

healing garden  /  occupational therapy  /  stroke  /  cognitive function  /  ability of daily living  /  limb motor function  /  self-efficacy  /  quality of life
刘金林, 蔡桂兰, 王菁菁, 甄勇. 基于康复花园的作业疗法康复护理在脑卒中病人中的应用. 护理研究, 2026 , 40 (14) : 2510 -2515 . DOI: 10.12102/j.issn.1009-6493.2026.14.017
Jinlin LIU, Guilan CAI, Jingjing WANG, Yong ZHEN. Application of rehabilitation nursing with occupational therapy based on a healing garden in stroke patients[J]. Chinese Nursing Research, 2026 , 40 (14) : 2510 -2515 . DOI: 10.12102/j.issn.1009-6493.2026.14.017
正文
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脑卒中是一种由于脑血管突然破裂或阻塞导致血液不能流入大脑而引起脑组织损伤的疾病，具有高发病率、高致残率、高死亡率、高复发率、高经济负担等特点，尤其在中低收入国家，增长速度较快[1]。世界卫生组织统计数据显示，每年约有1 500万人因脑卒中死亡，脑卒中已成为全球第二大死因[2]。随着医疗技术的不断进步，脑卒中死亡率下降，但病人残疾率仍较高。大多数脑卒中病人存在不同程度的肢体运动障碍，给其日常生活带来极大不便，同时也给家庭和社会带来沉重负担。康复护理作为脑卒中病人治疗过程中的重要环节，对于促进病人功能恢复、提高生活质量具有重要意义。在传统护理模式下，护士通常是遵照医嘱执行护理措施，缺乏整体规划和前瞻性，对病人心理、社会等多维度需求关注较少，护理方案不够周全和细致[3]。作业疗法（occupational therapy，OT）作为一种以脑卒中病人日常生活活动能力为核心的康复治疗方法，正逐渐受到关注，而康复花园以其整合性、可控性、兼容性和自然性等特点，为脑卒中病人提供了一个集心理、生理及精神康复于一体的综合环境[4]。本研究将基于康复花园的作业疗法应用于脑卒中病人，旨在为脑卒中病人的康复护理干预提供参考。
1　对象与方法
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1.1　研究对象
选取2024年7月—2025年5月我院收治的111例脑卒中病人为研究对象。纳入标准：1）符合《脑血管病防治指南（2024年版）》中的脑卒中诊断标准；2）首次发生脑卒中，无继发或多次发作；3）自愿入组并在护士解读知情同意书后同意并签署。排除标准：1）存在肝、肾等重要器官衰竭；2）因各种原因无法配合实施医嘱；3）合并其他严重并发症；4）存在意识障碍，沟通不畅；5）生活不能自理；6）资料不完整；7）中途退出研究。将2024年7月—12月收治的56例脑卒中病人作为对照组，将2025年1月—5月收治的55例脑卒中病人作为试验组，所有病人及家属均被提前告知研究内容和目的，研究经过我院医学伦理委员会的审查和批准（编号：2023ky059）。
1.2　干预方法
1.2.1　对照组
采用常规护理模式，病人入院后护理团队对病人的身体功能、语言能力、认知能力等进行全面评估，根据评估结果制订常规康复护理计划，主要包括物理治疗与运动康复、语言与认知康复以及心理康复与社会支持等，提高病人舒适度，实时观察病人的病情变化，对病人需求及时响应。
1.2.2　试验组
采用基于康复花园的作业疗法康复护理，即综合运用康复医学、园艺疗法以及作业治疗的理论与实践，通过自然环境和有针对性的活动，促进病人身体、心理和社会功能的全面恢复。
1.2.2.1　建立基于康复花园的作业疗法康复护理团队
康复护理团队共12名医护人员，其中，神经内科主治医生2名，主要负责对病人病情进行动态评估，并结合临床实际制订基于康复花园的作业疗法康复护理方案；神经内科主任护师2名，主要负责统筹、协调和指导培训；护士4名，主要负责监督规划的实施，对工作中出现的潜在问题进行反馈，并共同讨论制定改进措施，接待病人，建立病历档案，进行健康教育，对病人进行全方位的护理支持；康复师1名，主要负责根据病人具体情况指导病人进行具体的康复训练；心理咨询师1名，主要负责对病人进行心理支持干预，缓解病人因疾病带来的不健康情绪；园艺师1名，主要负责协助基于康复花园作业疗法制定康复护理方案；护理研究生1名，主要负责资料收集及统计分析。团队成员均接受护理方法和评估程序的培训。
1.2.2.2　制订基于康复花园的作业疗法康复护理方案
护理团队在常规护理模式的基础上结合相关指南、专家共识、以往研究结果制订干预方案。康复花园设计：在医院开辟一处园艺区，用于进行特定园艺操作和实践活动，并设置功能分区，包括日常生活活动训练区、植物疗养区、艺术活动疗养区，其中，日常生活活动训练区为结合脑卒中病人日常生活需求设置的模拟家庭环境的训练区域，内有床椅转移、穿衣、进食等训练设施；植物疗养区种植颜色鲜明、形态别致的植物以及可以发出声响和散发有益气味的植物，旨在营造出一个视觉、听觉、嗅觉全方位刺激的康复环境，病人可以在园艺治疗师指导下进行植物种植、养护等活动；艺术活动疗养区设置休闲活动广场、景观水池等，通过营造流水声等自然声音辅助康复，同时建设阳光玻璃房等供园艺治疗师带领病人进行艺术插花、果实加工等园艺康复治疗。康复花园中的道路设计应满足病人可达、安全和消防需求，主要道路宽度应保证至少有2辆轮椅可以并排通过，地面铺装以防滑耐磨材料为主，同时兼具美观性，避免使用大理石、纹理复杂的砖石铺装。
1.2.2.3　实施基于康复花园的作业疗法康复护理方案
干预时间为4周，每周活动2次，每次45~60 min。活动开始前，向病人详细介绍活动内容及相关要求，并向病人阐述参与园艺活动的好处，以此激发其参与热情。活动期间，积极鼓励病人亲自动手操作、病人之间相互帮助与合作。责任护士细心收集病人反馈意见，并根据实际情况及时调整活动细节，方案具体内容见表1。
1.3　评价指标
1）认知功能：采用蒙特利尔认知评估量表（MoCA）评估，该量表根据临床经验并参考简明精神状态检查（MMSE）的认知项目和评分制定[5]，涵盖8个认知领域，共11个项目，满分为30分，得分越高表明认知功能越好。2）日常生活能力：采用日常生活活动能力量表（ADL）评估，该量表由Lawton和Brody制定，包括基础生活技能和工具使用能力等方面，采用Likert 4级评分法，满分为100分，得分越高表示日常生活能力越好[6]。3）肢体运动功能：采用Fugl-Meyer运动功能评分法（FMA）[7-8]评估，上肢运动包含33个评估项目，每个项目根据完成情况依次计0~2分，满分66分；下肢运动包含17个评估项目，每个项目根据完成情况依次计0~2分，满分34分，得分越高表示肢体运动功能恢复程度越好。4）康复自我效能感：采用康复自我效能感量表（SER）评估，该量表由王海燕等[9]汉化，涵盖2个维度，共12个条目，病人根据自己的实际情况对每个问题进行回答，满分120分，得分越高表示自我效能感水平越高。5）生活质量：采用世界卫生组织生活质量测定量表简表（WHOQOL-BREF）[10]评估，该量表由世界卫生组织领导，由来自不同经济发展水平、不同文化背景下的国家研究中心共同研制，涵盖生理、心理、社会关系和环境4个维度，每个维度满分100分，得分越高表示生活质量越好。
1.4　资料收集方法
于入院后24 h和干预4周后采用问卷星或纸质问卷的形式进行资料收集。问卷主要由病人自行填写，如病人不能自行完成问卷填写或需医护人员进行专业评估，由经过培训的护士予以协助，指导过程中避免言语暗示或客观性误导。问卷填写完毕后由专人核查，将合格问卷统一收回。
1.5　质量控制方法
严格按照纳入和排除标准选择研究对象，数据收集过程中对病人有疑问的地方给予统一指导和解释，以保证收集资料的准确性与完整性。对问卷设置最短作答时间以避免不认真读题快速作答的情况。采用双人核对方式录入数据以保证数据资料录入准确，使用计算机进行校对，及时发现并纠正错误。
1.6　统计学方法
采用Excel软件对数据进行系统整理，并采用SPSS 26.0软件进行统计分析。符合正态分布的定量资料以均数±标准差（x±s）表示，组间比较采用t检验；定性资料以频数及百分比（%）表示，组间比较采用χ2检验。以P<0.05为差异有统计学意义。
2　结果
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2.1　两组病人一般资料比较（见表2）
2.2　两组病人护理前后MoCA得分和ADL得分比较（见表3）
2.3　两组病人护理前后FMA得分比较（见表4）
2.4　两组病人护理前后SER得分比较（见表5）
2.5　两组病人护理前后WHOQOL-BREF得分比较（见表6）
3　讨论
收起
3.1　基于康复花园的作业疗法康复护理能够有效改善病人认知功能和日常生活能力
本研究结果显示，干预4周后试验组MoCA得分和ADL得分均高于对照组（均P<0.05）。原因可能为康复花园为病人提供了一个接近自然、轻松愉悦的治疗环境，有利于减轻病人的紧张和焦虑情绪，提高其对环境的适应能力和应对挑战的能力。此外，在康复花园中，通过设计记忆植物名称、观察植物生长变化等认知训练活动，并以游戏和作业形式进行，能够增加训练的趣味性和实用性，从而更有效地提高病人认知功能。刘塔娜[11]研究表明，对脑卒中病人实施作业疗法结合认知康复训练有利于改善病人认知功能及日常生活能力。康复花园可以为病人模拟真实生活场景环境，同时指导其进行穿衣、洗漱、进食等基本生活技能训练，有利于使日常生活能力提高[12]。因此，在脑卒中病人的康复治疗中，应充分考虑基于康复花园的作业疗法的应用。
3.2　基于康复花园的作业疗法康复护理能够有效改善病人肢体运动功能
本研究结果显示，干预4周后试验组FMA得分高于对照组（均P<0.05）。原因可能为作业疗法鼓励病人进行自主活动关节，上肢屈伸、旋转等主动运动可以增强肌肉力量和关节灵活性。对于无法主动活动的肢体，通过医护人员或者设备辅助进行被动活动可以防止肌肉萎缩和关节僵硬，从而加速肢体运动功能恢复。同时，在康复花园中，作业疗法通过有目的的作业活动，使病人重复学习后在脑中形成运动程序，有利于改善和恢复病人躯体功能，对于脑卒中后遗留的功能障碍，尤其是肢体运动功能障碍的病人而言，具有极其重要的作用[13]。多项研究表明，基于康复花园的作业疗法将自然环境与有目的的作业活动相结合，既可以发挥作业疗法在改善肢体运动功能和生活自理能力方面的优势，又可以利用康复花园促进病人身心愉悦和放松，从而增强整体康复效果[14-15]。
3.3　基于康复花园的作业疗法康复护理能够有效增强病人康复自我效能感
本研究结果显示，干预4周后试验组SER得分高于对照组（均P<0.05），与相关研究结果[16]相似。自我效能感作为连接病人心理与行为的桥梁，不仅影响着病人对康复治疗的接受度和参与度，还直接关系到康复效果的优劣。在康复治疗背景下，自我效能感意味着病人对自己能够克服康复过程中的困难、坚持康复训练并最终达到康复目标有坚定信念[17]。本研究中，病人在参与作业疗法的过程中，通过不断努力和尝试，逐渐取得进步和成就，这些成功的经验会提高病人自我效能感，使其更加相信自己有能力完成康复任务。此外，病人在康复花园中观察到其他病人的康复成果和进步，也会受到激励，提高自我效能感。由此可见，基于康复花园的作业疗法能够通过多种机制有效增强脑卒中病人的康复自我效能感，促进其更好地完成康复任务并回归家庭和社会。
3.4　基于康复花园的作业疗法康复护理能够有效提高病人生活质量
本研究结果显示，干预4周后试验组WHOQOL-BREF得分高于对照组（均P<0.05）。原因可能为康复花园中的自然环境和社交互动有利于缓解病人紧张情绪，减轻压力，改善其心理状态。同时，参与作业疗法并取得进步和成就，也可以增强病人的自信心和自尊心，有利于病人在多个维度上得到支持和帮助，进而提高生活质量。病人生活质量提升意味着其独立生活能力增强，将减轻家庭照顾者负担[18]。此外，生活质量是对病人生理、心理及社会关系等整体状态的全面评价，随着医疗技术的不断进步和病人需求的日益多样化，护理也面临新机遇和挑战，故实施科学、有效的康复护理措施对于脑卒中病人疾病康复至关重要[19]。本研究通过在康复花园中进行作业疗法，病人可以在自然环境中进行各种康复活动，有利于提高其参与康复训练的积极性和主动性，从而提高生活质量。
4　小结
收起
本研究结果显示，实施基于康复花园的作业疗法康复护理对于改善病人认知功能、日常生活能力，促进肢体运动功能康复，提高康复自我效能感，以及提高生活质量具有积极作用，充分利用康复花园的自然环境和多样化资源，并实施有针对性的作业活动，可以有效提高病人躯体、心理和社会功能，促进其全面康复。随着康复医学和园林景观设计的不断发展，基于康复花园的作业疗法将在脑卒中病人的康复中发挥越来越重要的作用，可在已有研究基础上，开展多中心、大样本的临床研究，以进一步丰富护理方案内容，为临床护理干预提供参考。

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doi: 10.12102/j.issn.1009-6493.2026.14.017
  • 接收时间：2025-09-06
  • 首发时间：2026-10-30
  • 出版时间：2026-07-25
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  • 收稿日期：2025-09-06
  • 修回日期：2026-04-20
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    1苏北人民医院，江苏 225001

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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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