首发脑卒中患者早期康复锻炼依从性的潜在剖面分析

Latent profile analysis of early rehabilitation exercise compliance in first-episode stroke patients

目的探讨首发脑卒中患者发病2周时康复锻炼依从性的不同类型及特点,并分析其影响因素,为制订针对性的健康教育提供参考。方法2021年1—6月,采用脑卒中功能锻炼依从性量表对浙江大学医学院附属第二医院收治的276例首发脑卒中患者发病2周时的康复锻炼依从性进行横断面调查,利用潜在剖面分析对其康复锻炼依从性进行特征分类,运用χ^(2)检验探究不同类别患者康复锻炼依从性的人口学差异,应用有序多分类Logistic回归探究康复锻炼依从性的影响因素。结果将患者分为高康复锻炼依从性型109例占39.5%,中等康复锻炼依从性型114例占41.3%,低康复锻炼依从性型53例占19.2%;单因素分析显示,3类患者在受教育程度、患者入院时意识水平、有无合并症、患肢肌力、出院后去向方面差异有统计学意义(χ^(2)值为6.17~31.50,P<0.05)。有序多分类Logistic回归分析显示,患者的受教育程度、入院时意识水平,有无合并症和患肢肌力是脑卒中患者康复锻炼依从性的影响因素(P<0.05)。结论首发脑卒中患者康复锻炼依从性有3个潜在类别,文盲、嗜睡、有合并症、患肢肌力差的患者康复锻炼依从性较差。

Objective To explore the different types and characteristics of rehabilitation exercise compliance of patients with first stroke at 2 weeks of onset,and analyze its influencing factors,so as to provide reference for the formulation of targeted health education.Methods A cross-sectional investigation was conducted in Neurology Department of the Second Affiliated Hospital of Zhejiang University School of Medicine from January to June,2021.276 patients with first-episode stroke were investigated by the Questionnaire of Exercise Adherence at 2 weeks of the onset.The potential profile analysis was conducted to explore characteristics classification of the rehabilitation exercise compliance.And the chi-square test was used to compare demographic differences among different categories and ordered multi classification Logistic regression was used to explore the influencing factors of rehabilitation exercise compliance.Results The patients were divided into 109 cases with high rehabilitation exercise compliance(39.5%),114 cases with moderate rehabilitation exercise compliance(41.3%),and 53 cases with low rehabilitation exercise compliance(19.2%).There were statistically significant differences in education level,consciousness level at admission,complications and limb muscle strength among the three types of patients(χ^(2) values were 6.17-31.50,all P<0.05).Ordered multi classification Logistic regression showed that the patient′s education level,the patient′s consciousness level at admission,whether there were complications and limb muscle strength would affect the rehabilitation exercise compliance of stroke patients(P<0.05).Conclusions There are three potential categories of rehabilitation exercise compliance in patients with first stroke.Patients with illiteracy,drowsiness,complications and poor limb muscle strength have poor rehabilitation exercise compliance.