中风后肩手综合征患者主动运动依从性相关影响因素分析及干预策略探讨

Analysis of Related Influencing Factors and Intervention Strategies of Active Exercise Compliance in Patients with Shoulder-Hand Syndrome after Stroke

目的:调查中风后肩手综合征患者主动运动依从性的影响因素并探讨有效干预策略。方法:选取郑州大学第一附属医院2018年1月—2020年8月收治的90例中风后肩手综合征主动运动依从性良好的患者作为高水平组,选取同期90例中风后肩手综合征主动运动依从性较差的患者作为低水平组,分析中风后肩手综合征患者主动运动依从性的影响因素。结果:高中及以上学历、无配偶、有合并症、失眠、日常生活能力量表(BI)评分低、贝克抑郁量表21版项(BDI-21)评分高、自我负担感量表(SPBS)评分高以及美国国立卫生研究院卒中量表(NIHSS)评分高为中风后肩手综合征患者主动运动依从性的影响因素。logistic回归分析显示,高中及以上学历为中风后肩手综合征患者主动运动依从性的保护因素,无配偶、有合并症、失眠、BI评分低、NIHSS评分高、BDI-21评分高、SPBS评分高为影响中风后肩手综合征患者主动运动依从性的危险因素。结论:无配偶、有合并症、失眠、BI评分低、NIHSS评分高、BDI-21评分高、SPBS评分高为影响中风后肩手综合征患者主动运动依从性的危险因素,因此,对应的护理干预有助于提升患者主动运动的依从性。

Objective:To investigate the influencing factors of active exercise compliance in patients with shoulder-hand syndrome after stroke and to explore effective intervention strategies.Methods:From January 2018 to August 2020, 90 patients with with shoulder-hand syndrome after stroke in the hospital with good active exercise compliance were selected as the high-level group. 90 patients with poor active exercise compliance after stroke during the same period were selected as the low-level group.The factors affecting the compliance of active exercise in patients with shoulder-hand syndrome after stroke were analyzed.Results:High school education or above, no spouse, comorbidities, insomnia, low Barthel Index(BI) score, high Beck Depression Inventory 21(BDI-21) score, high Self-Perceived Burden Scale(SPBS) score, and high National Institutes of Health Stroke Scale(NIHSS) score were the influencing factors of active exercise compliance in patients with shoulder-hand syndrome after stroke. Logistic regression analysis showed that high school education or above was a protective factor for active exercise compliance in patients with shoulder-hand syndrome after stroke. No spouse, comorbidities, insomnia, low BI score, high NIHSS score, high BDI-21score, and high SPBS score were risk factors affecting the active exercise compliance of patients with shoulder-hand syndrome after stroke.Conclusion:No spouse, comorbidities, insomnia, low BI score, high NIHSS score, high BDI-21 score, and high SPBS score are risk factors that affect the compliance of active exercise in patients with shoulder-hand syndrome after stroke. Therefore, giving patients corresponding nursing interventions can help improve their compliance with active exercise.