青年和老年脑卒中后患者心理特征的不同变化及护理对策

Clinical Observation of Mental Disorder and Nursing Measures for Youth and the Elderly Post-stroke Patients in Acute Stage

目的探讨青年和老年脑卒中患者急性期心理特征的变化及相关因素。方法对符合脑卒中诊断标准的38例青年脑卒中患者和76例老年脑卒中患者,应用SCL-90量表及汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)进行调查、评估和诊断,并比较分析青年和老年脑卒中急性期心理特征变化的相关因素。结果青年及老年脑卒中患者的阳性项目数、总分与全国常模的差异有非常显著性意义(P均<0.05),且青年患者组的人际关系、抑郁、焦虑因子分与老年组比较增加更为明显(P均<0.05)。青年脑卒中患者抑郁、焦虑发生率分别为68.42%和73.68%,而老年脑卒中患者抑郁、焦虑发生率分别为52.63%和47.37%,与老年患者相比,青年卒中患者的抑郁、焦虑程度更为明显,且差异有统计学意义(P均<0.01)。结论无论是青年脑卒中患者或是老年脑卒中患者均存在明显的情感障碍,故对脑卒中患者进行常规治疗的同时,应针对其伴发的心理问题和情感障碍进行早期心理干预。

Objective To investigate the changes in psychological characteristics and related factors of youth and elderly stroke patients in acute phase. Methods 38 young patients and 76 elderly patients with stroke were evaluated with Symptom Checklist290 （SCL290）, Hamilton Depression Scale（HAMD） and Hamilton Anxiety Scale（HAMA）. The mental disorder and related factors of these patients in acute stage were analyzed. Results The scores of interpersonal sensitivity, depression and anxiety factor with young patients increased more significantly compared with the elderly patients. The depression, anxiety incidence rates of young stroke patients were 68. 42% and 73.68%, and the degree was more significant compared with the elderly patients（P all〈0.01）. Conclusion There are obvious affective disorder in stroke patients, whether young or elderly patients. Early psychological intervention should he taken to cure psychological problems and emotional obstacles.