脑卒中患者病耻感现状及影响因素研究

Influencing factors of stigma in stroke patients

目的调查脑卒中患者病耻感现状,探讨脑卒中患者病耻感的影响因素,明确影响因素的作用机制。方法采用定点连续取样法按纳排标准抽取324例住院脑卒中患者,应用脑卒中患者病耻感量表、健康认知评价量表、心理弹性量表简化版、领悟社会支持量表、医学应对方式问卷进行调查。结果脑卒中患者病耻感总分(45.36±11.76)分。脑卒中患者病耻感与负性认知评价、屈服应对方式、回避应对方式呈正相关(P<0.05);与心理弹性、社会支持、面对应对方式呈负相关(P<0.05)。脑卒中患者病耻感影响因素中,负性认知评价总效应值0.023;心理弹性总效应值-0.601;社会支持总效应值-0.234;回避应对方式总效应值为0.110。结论脑卒中患者的病耻感处于中等偏上水平,脑卒中患者病耻感水平不容乐观,应予以重视。脑卒中患者对卒中事件的负性认知评价通过回避应对方式间接正向影响病耻感;心理弹性既可直接负向影响病耻感,又可通过负性认知评价及回避应对方式间接负向影响病耻感,直接影响大于间接影响;社会支持既可直接负向影响病耻感,又可通过负性认知评价及回避应对方式间接负向影响病耻感,直接影响大于间接影响;回避应对方式对病耻感有直接正向影响。

Objective To investigate the status quo of stigma in stroke patients and explore the influencing factors of stigma in stroke patients,and clarify the mechanism of the influencing factors.Methods A total of 324 inpatients with stroke were selected by fixed point continuous sampling according to the standard of inpatient arrangement.Stroke patients'stigma scale,health cognitive evaluation scale,simplified version of mental resilience scale,perceived social support scale and medical coping style questionnaire were used to investigate.Results The total score of stigma in stroke patients was 45.36±11.76.Stigmatism in stroke patients was positively correlated with negative cognitive evaluation,submission coping style and avoidance coping style.And psychologicalresilience,social support and coping style were significantly negatively correlated.Among the influencing factors of stigma in stroke patients,the total effect value of negative cognitive evaluation was 0.023;Total effect value of mental resilience-0.601;Total effect value of social support was-0.234;The total effect of avoidance coping style was 0.110.Conclusion The stroke patients'stigma is above the average level,among which the score of self-perception dimension is the highest.The situation of stigma is not optimistic,and medical workers should pay attention to it.The negative cognitive evaluation of stroke events in stroke patients indirectly affected stigma through avoidance coping style;Resilience can affect stigma directly and indirectly through negative cognitive evaluation and avoidance coping style.The direct effect is greater than the indirect effect.Social support not only directly affected stigma,but also indirectly affected stigma through negative cognitive evaluation and avoidance coping style.The direct effect is greater than the indirect effect.Avoidance coping style has a direct positive effect on stigma.