脑卒中后抑郁患者情绪-社交孤独影响因素及护理干预策略

Factors Influencing Emotional-Social Isolation and Nursing Intervention Strategies in Patients with Post-stroke Depression

目的探讨脑卒中后抑郁(PSD)患者情绪-社交孤独影响因素,并制定相关护理干预策略。方法选取2019年2月至2021年10月新安县中医院收治的103例PSD患者,收集性别、年龄、脑卒中病灶位置、体质量指数(BMI)、神经功能缺损程度、受教育程度、基础疾病、家庭人均月收入、医疗费用支付方式、婚姻状况、性格特征、既往脑卒中史、血浆5-羟色胺(5-HT)、血清神经元特异性烯醇化酶(NSE)等临床资料,采用多元线性回归分析PSD患者情绪-社交孤独影响因素。结果103例PSD患者中,22例严重情绪孤独,19例严重社交孤独。神经功能缺损程度(NIHSS)评分(≥15分)、家庭人均月收入(>6000元)、医疗费用支付方式(自费)、性格特征(内向)、既往脑卒中史(有)、血浆5-HT(降低)、血清NSE(升高)PSD患者情绪孤独、社交孤独严重;多元线性回归分析显示,NIHSS评分、家庭人均月收入、医疗费用支付方式、性格特征、既往脑卒中史、血浆5-HT、血清NSE是PSD患者情绪-社交孤独评分的影响因素(P<0.05)。结论PSD患者情绪-社交孤独评分受NIHSS评分、家庭人均月收入、医疗费用支付方式、性格特征、既往脑卒中史、血浆5-HT、血清NSE等多因素影响,重视上述因素进行针对性干预,对预防患者情绪-社交孤独具有积极现实意义。

Objective To explore the factors influencing emotional-social isolation and nursing intervention strategies in patients with post-stroke depression(PSD).Methods One hundred and three patients with PSD admitted to Xin’an County Hospital of Traditional Chinese Medicine from February 2019 to October 2021 were selected.Gender,age,stroke lesion location,body mass index(BMI),nerve function defect degree,level of education,basic diseases,family per capita income,medical treatment charge payment,marital status,traits of character,history of previous stroke,5-hydroxy tryptamine(5-HT),serum neuron specific enolase(NSE)and other clinical data were collected.Multiple linear regression was used to analyze the influencing factors of emotion-social loneliness in PSD patients.Results Among 103 patients with PSD,22 were severely emotionally isolated and 19 were severely socially isolated.Patients with National Institute of Health stroke scale(NIHSS)score(≥15 points),monthly per capita household income(>6000 yuan),medical cost payment method(self-pay),personality traits(introversion),previous stroke history(yes),plasma 5-HT(decreased),and serum NSE(elevated)had severe emotional isolation and social isolation in PSD.Multivariate linear regression analysis showed that NIHSS score,monthly per capita household income,health care payment method,personality traits,history of previous stroke,5-HT,and NSE were factors influencing emotional-social isolation scores in PSD patients(P<0.05).Conclusion The emotional-social loneliness scores of patients with PSD are influenced by multiple factors such as NIHSS scores,monthly per capita household income,health care payment method,personality traits,previous stroke history,5-HT,NSE,etc.Targeted interventions for relevant factors have positive practical implications for the prevention of emotional-social loneliness in patients.