脑出血偏瘫患者病耻感现状与伤残接受度的相关性研究

Correlation between stigma and disability acceptance in patients with hemiplegia due to cerebral hemorrhage

目的:调查脑出血偏瘫患者病耻感现状并分析其与伤残接受度的相关性。方法:采用方便抽样法,选取2018年9月至2019年5月于华北理工大学附属医院神经外科住院的脑出血偏瘫患者为调查对象进行调查,患者一般资料采用自行设计的一般资料调查表进行调查,脑出血偏瘫患者病耻感现状采用慢性疾病病耻感量表进行评估,伤残接受度采用伤残接受度量表进行调查。结果:文化程度、性别、职业类型、医疗支付方式、合并功能障碍器官个数、脑出血部位、生活依赖程度、神经功能分级、偏瘫部位、肢体麻木对脑出血偏瘫患者病耻感有影响,差异均有统计学意义(P<0.05);脑出血偏瘫患者病耻感得分为(80.52±8.32)分,伤残接受度得分为(70.62±14.10)分;相关性分析结果显示,病耻感总分与伤残接受度总分呈负相关(r总=-0.748,P<0.001),伤残接受度中扩大维度、从属维度、包容维度及转变维度分别与病耻感呈负相关(r1=-0.657,r2=-0.653,r3=-0.484,r4=-0.384,P<0.001)。结论:脑出血偏瘫患者的病耻感为中等偏高水平,与伤残接受度呈负相关,医护人员应及时对患者实施心理干预,减轻其病耻感,提升其伤残接受能力。

Objective:To investigate the relationship between the status of stigma and the acceptance of disability in patients with hemiplegia due to cerebral hemorrhage.Methods:Following convenient sampling,hemiplegic patients with cerebral hemorrhage admitted to the neurosurgery department of the affiliated hospital of North China University of Science and Technology,between September 2018 and May 2019,were enrolled in the current study.Patients’socio-demographic information were collected using a self-designed general data questionnaire,patients’stigma due to cerebral hemorrhage hemiplegia was evaluated by the Stigma Scale for Chronic Disease,and disability acceptance were assessed using the Acceptance of Disability Scale-Revised.Results:Patients’education level,gender,occupation type,medical expenses,number of functional disorders,cerebral hemorrhage site,degree of dependence,neurological function classification,hemiplegic site and limb numbness had significant impact on patients’stigma due to cerebral hemorrhage hemiplegia(P<0.05).The mean scores of stigma in patients with cerebral hemorrhage,and disability acceptance were 80.52±8.32 and 70.62±14.10,respectively.Correlational analysis showed that the total score of patients’stigma was negatively correlated with the total score of disability acceptance(ra=-0.748,P<0.001).Under the subdimensions of disability acceptability,the extended dimension,subordinate dimension,inclusive dimension and transformation dimension were negatively correlated with stigma(r1=-0.657,r2=-0.653,r3=-0.484,r4=-0.384,P<0.001).Conclusion:The stigma of hemiplegic patients with cerebral hemorrhage was moderately high,which was negatively correlated with disability acceptance.Health care providers should implement psychological measures adequately for patients to reduce their stigma and improve their disability acceptance ability.