社区老年脑卒中患者社会参与水平及其影响因素分析

Status and Influencing Factors of Social Participation among Elderly Community Patients with Stroke

目的探讨社区老年脑卒中患者社会参与水平及其影响因素。方法采用分层随机抽样方法,于2015年7月至2016年7月对上海市5个社区546例老年脑卒中患者进行问卷调查,包括一般资料调查表、自主参与问卷、Barthel指数量表、简易精神状态检查量表、抑郁自评表、社会支持评定量表。对社区老年脑卒中患者社会参与水平的影响因素采用多元线性回归分析。结果 546例老年脑卒中患者的社会参与水平得分为(61.79±19.150)分;各维度得分为:家庭角色自主参与(21.26±6.629)分、室外自主参与(14.75±2.766)分、室内自主参与(16.11±6.203)分、社会生活自主参与(9.68±6.165)分。546例患者的婚姻状况为有配偶,文化程度为小学及以下、初中、高中,家庭月收入为<6000元,脑卒中类型为缺血性脑卒中,发作次数为1次,有高血压、有糖尿病社会参与水平得分与无配偶、大专及以上、≥6000元、出血性脑卒中、2次及以上、无高血压、无糖尿病比较差异均有统计学意义(P<0.05或P<0.01)。年龄、婚姻状况、脑卒中类型、认知功能障碍、抑郁状态、社会支持均是社区老年脑卒中患者社会参与水平的影响因素。结论社区老年脑卒中患者社会参与水平较低,影响因素是多方面的,社区医护人员应根据其影响因素制定针对性的干预措施,以促进患者参与社会,提高其生活质量。

Objective To explore the status and influencing factors of social participation among elderly community patients with stroke.Methods Totally 546 elderly stroke patients sampled from 5 communities in Shanghai were surveyed by using general information questionnaire,Impact on Participation and Autonomy(IPA)questionnaire,Barthel Index(BI),Mini-Mental State Examination(MMSE),Self-Rating Depression Scale(SDS),and Social Support Rating Scale(SSRS).Multiple linear regression analysis was used to study the factors influencing social participation among elderly community patients with stroke.Results IPA score was(61.79±19.150)in the 546 elderly community patients with stroke.The scores for each dimension were as follows:family role(21.26±6.629),outdoor autonomy(14.75±2.766),indoor autonomy(16.11±6.203),social life(9.68±6.165).Social participation scores in married patients,patients with educational level of senior high school and below,patients with monthly family income<6000 yuan,patients with ischemic stroke,patients with 1 attack,patients with hypertension and patients with diabetes were significantly different from those in unmarried patients,patients with educational level of college or above,patients with monthly family income≥6000 yuan,patients with hemorrhagic stroke,patients with 2 or more attacks,patients without hypertension and patients without diabetes,respectively(P<0.05 or P<0.01).The age,marital status,stroke type,cognitive impairment,depression and social support were the factors influencing social participation among elderly community patients with stroke.Conclusion The social participation level is low and its influencing factors are multiple among elderly community patients with stroke.Therefore,community staff should develop the targeted intervention measures according to the influencing factors to improve the social participation and quality of life in elderly patients with stroke.