上海华山医院神经外科围手术期癫痫患者自我管理能力影响因素分析

Analysis of factors influencing self-management ability of neurosurgical patients with perioperative epilepsy in Huashan Hospital, Shanghai

目的 了解神经外科围手术期癫痫患者自我管理能力并分析其影响因素。方法 选取复旦大学附属华山医院神经外科2020年7月1日—2021年7月30日颅脑手术治疗的208例癫痫患者为研究对象进行问卷调查,内容包括一般人口学特征及中文版成人癫痫患者自我管理量表(Epilepsy Self-Management Scale,ESMS)。采用单因素方差分析、多元逐步线性回归进行影响因素分析。结果 神经外科围手术期癫痫患者自我管理能力得分为(132.58±14.42)分;不同年龄、术前癫痫史、首次癫痫发作年龄患者的信息管理维度得分,不同年龄、病变性质患者的发作管理维度得分,不同文化程度患者的安全管理维度得分,不同年龄、文化程度、病变性质和病变位置患者的生活方式管理维度得分差异且均有统计学意义(P<0.05);多元线性回归分析结果显示患者自我管理能力与本科及以上学历、女性和手术时长<3 h呈正相关,与30~50岁呈负相关。结论 神经外科围手术期癫痫患者自我管理能力有提升的空间,尤其应对男性、30~50岁患者、低学历、手术时长>3 h的患者加强个性化健康教育,提高患者的自我管理能力。

Objective To investigate the self-management ability of neurosurgical perioperative epilepsy patients and analyze their influencing factors. Methods A total of 208 epilepsy patients treated with elective craniosurgery in the Department of Neurosurgery during Jul 1,2020 to Jul 30,2021,Huashan Hospital, Fudan University,were selected to conduct a questionnaire survey, which included general demographic characteristics and Epilepsy Self-Management Scale(ESMS). One-Way ANOVA and multivariate stepwise linear regression were used to analyze the influencing factors. Results The mean score of self-management ability in neurosurgical perioperative epilepsy patients was(132.58±14.42);the scores of information management dimension differed among patients with different ages, preoperative epilepsy histories, and ages of first seizure(P<0.05), the scores of seizure management dimension differed among patients with different ages and lesion natures(P<0.05), the scores of safety management dimension scores differed among patients with different educational levels(P<0.05),and lifestyle management dimension scores differed(P<0.05) among patients of different ages,educational levels, lesion natures, and lesion locations;the results of multiple linear regression analysis showed that patient self-management ability was positively correlated with bachelor’s degree or higher, female, and duration of surgery <3 h, and negatively correlated with 30-50 years of age. Conclusion There is room to improve the self-management ability of neurosurgical perioperative epilepsy patients. Personalized health education should be strengthened especially for men, patients aged 30-50 years, patients with low education, and patients with a surgery length >3 h, and improve the self-management ability of patients.