Abstract: Objective  To explore the effect of programmed nursing based on Roy adaptation model in self-management and negative emotion of stroke patients with hemiplegia. 
Methods  In this prospective study, 90 stroke patients with hemiplegia were consecutively enrolled from June 2020 to July 2022 in Beijing Tiantan Hospital, Capital Medical University, and were divided into a control group (June 2020—December 2021) and an observation group (January—July 2022) according to the different admission times. The control group received routine nursing. The observation group received programmed nursing based on Roy adaptation model. The total duration of the intervention was 3 months in both groups. Patients were assessed before and after the intervention using the stroke self-efficacy questionnaire (SSEQ), the self-management behavior rating scale and the symptom checklist 90 (SCL-90). 
Results  A total of 90 stroke patients with hemiplegia were included in this study, 48 of whom were male, aged 45-82 years, with a mean age of (67.66±6.53) years. Both the observation and control groups consisted of 45 patients. There was no significant difference in SSEQ score between the two groups before intervention. After intervention, the SSEQ score in the observation group was significantly higher than that in the control group [(95.32±11.60) points vs. (79.54±8.79) points, P=0.001]. There was no statistically significant difference in the score of the self-management behavior rating scale before intervention between the two groups. After intervention, the self-management behavior rating scale score of the observation group was significantly higher than that of the control group [(182.13±14.09) points vs. (157.05±11.75) points, P<0.001]. There was no statistically significant difference in SCL-90 score between the two groups before intervention. After intervention, the SCL-90 score of the observation group was significantly lower than that of the control group [(111.89±4.51) points vs. (174.58±7.49) points, P<0.001].
Conclusions  The programmed nursing guided by Roy adaptation model for stroke patients with hemiplegia can effectively stimulate the patients’ self-efficacy of rehabilitation, improve their self-management ability, overcome negative emotions, and actively participate in rehabilitation.

Key words: Stroke; Hemiplegia; Roy adaptation model; Programmed nursing; Self-management; Negative emotion

摘要： 目的 探讨基于Roy适应模式的程序式护理对卒中偏瘫患者自我管理、负面情绪的影响效果。
方法 本研究为前瞻性研究，连续入组2020年6月—2022年7月首都医科大学附属北京天坛医院的卒中偏瘫患者，按不同入院时间将研究对象分为对照组（2020年6月—2021年12月）和观察组（2022年
1—7月）。其中，对照组接受常规护理，观察组接受Roy适应模式引导的程序式护理。两组患者总干预时间均为3个月。干预前后采用卒中康复自我效能量表（stroke sellf-efficacy questionnaire，SSEQ）、自我管理行为评定量表、症状自评量表（symptom checklist 90，SCL-90）对患者进行评估。 
结果 本研究共纳入卒中偏瘫患者90例，其中男性48例，年龄45～82岁，平均（67.66±6.53）岁。观察组与对照组均为45例，观察组与对照组干预前SSEQ评分差异无统计学意义；干预后观察组SSEQ评分显著高于对照组[（95.32±11.60）分 vs.（79.54±8.79）分，P=0.001]。观察组与对照组干预前自我管理行为评定量表评分差异无统计学意义；干预后观察组自我管理行为评定量表评分显著高于对照组[（182.13±14.09）分 vs.（157.05±11.75）分，P<0.001]。观察组和对照组干预前SCL-90评分差异无统计学意义；干预后观察组SCL-90评分显著低于对照组[（111.89±4.51）分 vs.（174.58±7.49）分，P<0.001]。
结论 对卒中偏瘫患者开展Roy适应模式引导的程序式护理，可有效激发患者的康复自我效能感，提高自我管理能力，克服负面情绪，从而积极参与到康复中来。

关键词: 卒中; 偏瘫; Roy适应模式; 程序式护理; 自我管理; 负面情绪