缺血性脑卒中患者自我管理行为现状及影响因素分析

Current status and influencing factors of self-management behavior in patients with ischemic stroke

目的了解缺血性脑卒中患者自我管理行为现状及其影响因素,为缺血性脑卒中患者自我管理干预提供依据。方法采用便利抽样法选取2021年12月至2022年2月湖南省南华大学附属第一医院神经内科收治的250例缺血性脑卒中患者为研究对象,应用一般资料调查问卷、脑卒中患者自我管理行为评定量表、脑卒中患者康复自我效能量表进行问卷调查。结果缺血性脑卒中患者自我管理行为总均分为(110.54±19.76)分,总均分得分范围为37~185分,其中得分率最高的是饮食管理(67.80%)和情绪管理(64.40%),得分最低的是康复锻炼管理(54.0%)和疾病管理(55.68%);康复自我效能总均分为(59.96±10.72)分,得分率为54.51%。单因素分析显示,不同年龄、文化程度、居住地、职业状态、家庭人均月收入、医保类型、照顾者的态度、居家就医条件、自理能力、婚姻状况、主要照顾者、卒中危险因素的得分比较,差异有统计学意义(P<0.05)。多元线性回归分析显示,康复自我效能、医保类型、照顾者的态度、自理能力、脑卒中危险因素、居家就医条件、文化程度是影响患者自我管理行为的独立因素(P<0.05)。结论缺血性脑卒中患者自我管理水平亟需提升,其影响因素较多,应建立系统化、个性化的自我管理干预方案,以提高其自我管理行为水平。

Objective To understand the current status and influencing factors of self-management behavior in patients with ischemic stroke,and to provide a basis for self-management intervention in patients with ischemic stroke.Methods A total of 250 patients with ischemic stroke admitted to the Department of Neurology,The First Affiliated Hospital of the University of South China,Hu'nan Province from December 2021 to February 2022 were selected as the research objects by convenience sampling.The general information questionnaire,stroke patients'self-management behavior rating scale and stroke patients'rehabilitation self-efficacy scale were used to conduct the questionnaire survey.Results The total mean score of self-management behavior of patients with ischemic stroke was(110.54±19.76)points,and the total mean score ranged was 37-185 points.The highest score rates were diet management(67.80%)and emotion management(64.40%),and the lowest scores were rehabilitation exercise management(54.0%)and disease management(55.68%).The total mean score of rehabilitation self-efficacy was(59.96±10.72)points,and the score rate was 54.51%.Univariate analysis showed that there were statistically significant differences in the scores of different age,education level,place of residence,occupational status,family per capita monthly income,type of medical insurance,caregiver attitude,home medical conditions,self-care ability,marital status,main caregiver and stroke risk factors(P<0.05).Multiple linear regression analysis showed that rehabilitation self-efficacy,type of medical insurance,caregivers'attitude,self-care ability,stroke risk factors,home medical conditions and education level were independent factors affecting patients'self-management behavior(P<0.05).Conclusion The self-management level of ischemic stroke patients needs to be improved,and there are many influencing factors.A systematic and personalized self-management intervention program should be established to improve their self-management behavior.