社区空巢老年脑卒中患者自我效能状况及对策分析

The status of community-dwelling empty nest elderly stroke survivors' self-efficacy and countermeasure analysis

目的 分析社区空巢老年脑卒中患者自我效能水平,探求影响自我效能的因素,并提出相应护理对策。方法 于2011年3 ～11月抽取郑州市某三个社区的99例社区空巢老年脑卒中患者,采用一般资料问卷、慢性病患者自我效能量表及社会支持评定量表调查及其自我效能水平并分析影响因素。全部数据采用SPSS 13.0统计学软件进行统计学分析。不同经济收入、诊断类型及自理程度组间自我效能得分差异比较采用秩和检验Mann-Whitney或Kruskal-WallisH检验；不同年龄、性别、文化程度、合并类型组间自我效能得分比较采用独立样本t检验；对有统计学差异的指标再进行非条件logistic回归检验分析影响因素,并计算优势比(OR)。结果 社区空巢老年脑卒中患者的自我效能水平处于低中等水平,得分为0.6 ～6.0(3.54±1.72)分；自我效能和社会支持呈中度正相关性(r=0.509,P=0.000)；不同诊断类型、自理水平、合并症状数量之间自我效能水平差异均具有统计学意义(Z/H=17.430、13.081、19.520,P＜0.05)；Logistic回归结果显示主观支持、自理水平及合并症状是自我效能的影响因素。结论 社区空巢老年脑卒中患者的自我效能水平普遍较低；自理能力差和遗留症状多为危险因素,主观支持高为保护因素。

Objective To explore the status of community-dwelling empty nest elderly stroke survivors' self-efficacy and analyze its influential factors. Methods A cross sectional study of 99 community-dwelling stroke survivors was carried out in Zhengzhou city,and the self-efficacy and social support of these stroke survivors were acquired by interviews using self-efficacy scale for chronic( SESC),social support scale( SSS).Socio-demographic and disease-related information were collected from their family health records in community health service centers. Non-conditional logistic regression analysis was performed to determine the influencing factors. All data were analyzed by SPSS 13. 0 statistical software. Self-efficacy scores between groups of different economic income,diagnosis type,degree of self-care were compared by Mann-Whitney test,or Kruskal-Wallis H test. Self-efficacy scores in group of different age,sex,culture degree,combined type were compared with the independent samples of t-test,factors of statistically significant were tested by non conditional logistic regression analysis,and odds ratio( OR) were calculated. Results The mean score of self-efficacy was 0. 6-6. 0( 3. 54 ± 1. 72). There was a positive correlation between self-efficacy and social support( r= 0. 509,P = 0. 000). There was significant difference of self-efficacy level between different diagnosis,selfcare level and numbers of sequela symptoms( Z / H = 17. 430,13. 081,19. 520,P < 0. 05). Regression model contained three variables including subjective support,self-care level and numbers of sequela symptoms. Conclusions The self-efficacy of community-dwelling stroke survivors was generally low. Higher subjective support was a protective factor. Lower self-care level and more combined symptoms were dangerous factors.