脑卒中患者心理弹性轨迹及影响因素的纵向研究

Longitudinal study on psychological resilience trajectory of stroke patients and its influencing factors

目的探讨脑卒中患者心理弹性轨迹及影响因素。方法采用便利抽样法,选取2018年10月—2020年10月新乡医学院第一附属医院收治的200例首发脑卒中患者为研究对象。采用一般资料调查问卷、疾病相关资料调查表、心理弹性量表(CD-RISC)对其进行调查。住院期间共发放问卷200份,回收有效问卷200份,出院后1个月随访时失访7例,3个月时失访8例,6个月时失访3例,最终共182例患者完成研究。结果最终获得心理弹性下降、心理弹性升高、心理弹性平稳、心理弹性低水平下降4条心理弹性类别轨迹。Logistic回归分析结果显示,有功能障碍、无人照顾、有宗教信仰、在职工作、独居生活、有吞咽功能障碍是脑卒中患者心理弹性轨迹的影响因素(P<0.05)。结论脑卒中患者在急性期、恢复期、后遗症期可呈现出不同类别的心理弹性轨迹,有功能障碍、无人照顾、有宗教信仰、在职工作、独居生活、有吞咽功能障碍是脑卒中患者心理弹性轨迹的影响因素,临床中应根据不同患者特点予以个性化干预。

Objective To explore the psychological resilience trajectory of stroke patients and its influencing factors.Methods From October 2018 to October 2020,convenience sampling was used to select 200 first-episode stroke patients admitted to the First Affiliated Hospital of Xinxiang Medical University as the research object.The General Information Questionnaire,Disease-related Information Questionnaire,and Connor-Davidson Resilience Scale(CD-RISC)were used to investigate the patients.A total of 200 questionnaires were distributed during hospitalization,and 200 valid questionnaires were recovered.After discharge,7 patients were lost to follow-up at 1 month,8 at 3 months,and 3 at 6 months.Finally,a total of 182 patients completed the study.Results Finally,4 types of trajectories of psychological resilience were obtained,namely,decreased psychological resilience,increased psychological resilience,stable psychological resilience,and decreased low level of psychological resilience.Logistic regression analysis showed that functional impairment,unattended care,religious belief,on-the-job work,living alone,and swallowing dysfunction were the influencing factors of the psychological resilience trajectory of stroke patients(P<0.05).Conclusions Stroke patients can show different types of psychological resilience trajectories in the acute phase,recovery phase,and sequelae phase.Functional impairment,unattended care,religious belief,on-the-job work,living alone,and swallowing dysfunction are the influencing factors of the psychological resilience trajectory of stroke patients.In clinical practice,individualized intervention should be given according to the characteristics of different patients.