青年脑卒中患者再就业影响因素分析

Analysis of influencing factors on re-employment of young stroke patients

目的 :探寻青年脑卒中患者再就业的影响因素,为青年脑卒中患者的康复治疗提供参考。方法 :纳入年龄18~49岁、病程<1年的首次脑卒中患者,进行电话随访。收集他们入、出院和随访时的病史资料,包括性别、年龄、文化程度、病程、常居住地、入院时上肢-手-下肢Brunnstrom分期、出院和随访时Barthel指数、首次康复治疗介入时间、康复治疗时程、是否交流受限、是否工作等。按是否工作将青年脑卒中患者分为2组,分析他们再就业的影响因素。结果 :纳入青年脑卒中患者70人,电话随访到58人,失访12人。2组患者在入院时上肢-手-下肢Brunnstrom分期、出院和随访时Barthel指数、文化程度上的差异均具有统计学意义(P均<0.05),在其他方面则无显著差异。结论 :日常生活能力强、文化程度高是青年脑卒中患者再就业的有利因素。加强对青年脑卒中患者的职业再培训,而不是执着于其某项机体功能的改善,可能对患者再就业更有益。

Objective:To investigate the social adaptation of youth stroke and explore factors affecting their return to work by telephone interviews.Methods:The stroke inpatients with ages 18-49 and disease course less than one year were included and followed up by telephone.The data were collected including their gender,age,course of disease,usual residence,upper extremity-hand-lower extremity Brunnstrom stage at first admission,Barthel index at discharge and follow-up,educational level,time of first rehabilitation intervention,rehabilitation schedule,whether the patient has limited communication and re-employment and so on.The patients were divided into two groups according to whether they were employed or not,and the factors influencing their re-employment were analyzed.Results:A total of 70 youth stroke patients met the inclusion criteria,among them,58 cases were followed up by telephone and another 12 patients lost follow-up,in which 2 rejected and 10 lost contact.The significant differences existed between the two groups in Brunnstrom stage of upper limbs-hands-lower limbs at admission,Barthel index at discharge and follow-up,and cultural degree(P<0.05),while the other information was not.Conclusion:Patients with higher ability of daily life and cultural degree would have a better chance to return to work.It may be more beneficial to strengthen vocational retraining for young stroke patients rather than obsessing about improvement of a certain function.