社区脑卒中患者主动参与功能锻炼依从性现状及对策分析

Analysis of the status of stroke survivors＇ adherence to functional exercise in the community and countermeasures

目的分析社区脑卒中患者主动参与功能锻炼依从性现状，探讨其影响因素，并提出相应对策。方法采用便利抽样法选择10个社区，随机抽取脑卒中患者208例，采用一般资料问卷、脑卒中患者功能锻炼依从性量表、慢性病自我效能量表及社会支持评定量表调查社区脑卒中患者主动参与锻炼依从性现状并分析影响因素。结果调查显示，社区脑卒中患者的依从性为（34．71±8．45）分，平均依从率达61．98％；根据依从率高低对三个维度的依从程度进行排序，依次为身体锻炼依从、主动寻求建议依从和锻炼监测依从；自我效能、社会支持均与依从性呈正相关（r=0．699、0．569，P〈0．05）。多重线性回归分析显示，患者的自理程度、自我效能、社会支持及高龄是功能锻炼依从性的影响因素。结论社区脑卒中患者参与功能锻炼的依从性整体处于中等水平，值得关注；自理程度越好、自我效能越高、社会支持水平越高的患者主动参与锻炼的依从性越好。

Objective To analyse the adherence of community-dwelling stroke survivors to functional exercise regimens and explore the influencing factors. Then to establish measures to improve the situation. Methods A total of 208 stroke survivors from 10 communities were randomly recruited. Four questionnaires-a general information questionnaire, an exercise adherence questionnaire, a self-efficacy perceptions scale and a perceived social support scale-were administered. Results The mean adherence score was 34.71 ±8.45 and the mean adherence rate was 61.98%. The compliance to physical exercise, seeking advice positively and exercise effectiveness monitoring scores ranged from highest to lowest in order. Self-efficacy perceptions and perceived social support were both positively correlated with the adherence rate. Multiple linear regression showed that the influencing factors included self efficacy perceptions, social support perceptions, self-care ability and age. Conclusions The community stroke survivors＇ exercise adherence was moderate in general, but it could be improved by increasing their self-efficacy and social support perceptions and their self-care ability.