缺血性脑卒中患者心理弹性、自我护理能力与失志的关系研究

Correlation analysis of resilience,self-care ability and demoralization in patients with ischemic stroke

目的:探讨缺血性脑卒中患者的心理弹性、自我护理能力和失志现状及三者间的关系,为提升缺血性脑卒中患者的心理健康提供参考。方法:采用便利抽样法,选取2021年11月至2022年2月在神经内科住院的140例缺血性脑卒中患者为研究对象,使用中文版第二版失志量表(DS-Ⅱ-C)、心理弹性量表简化版(CD-RISC10)、汉化的修正版自我护理能力评估量表(ASAS-R-C)及人口社会学资料问卷开展调查。结果:缺血性脑卒中患者失志得分为8.00(6.00,13.00)分,中高度失志发生率为70.7%,心理弹性得分为(25.43±7.89)分,自我护理能力得分为(54.31±6.94)分。缺血性脑卒中患者的心理弹性、自我护理能力均与失志呈负相关(P<0.01),心理弹性在自我护理能力与失志间发挥中介作用,中介效应占总效应比为38.15%。结论:医护人员应重点关注缺血性脑卒中患者的心理动态变化,重视患者面临的失志问题,通过提升患者的自我护理能力,维护健康心理的过程中加强对心理弹性的干预,从而有利于患者后续内在心理调节,最终达到预防或降低失志的发生与发展的目的。

Objective:To explore the current status of resilience,self-care ability and demoralization in patients with ischemic stroke and analyze their relationship,so as to provide a reference basis for medical staffs to enhance the mental health management for patients with ischemic stroke.Methods:A convenience sampling method was used.From November2021 to February 2022,140 patients with ischemic stroke who were hospitalized in the department of neurology of a Class A tertiary hospital in Tianjin.The study instruments included the demographic questionnaire,the Chinese version of Demoralization Scale II(DS-II-C),the 10-item Connor-Davidson Resilience Scale(CD-RISC 10)and the Chinese version of the Revised Self-Care Ability Assessment Scale(ASAS-R-C).Results:The score of demoralization in patients with ischemic stroke was 8.00(6.00,13.00),and the incidence of moderate and severe demoralization was 70.7%.The total score of the CD-RISC 10 was 25.43±7.89.The total score of the ASAS-R-C was 54.31±6.94.Resilience,self-care ability and demoralization in patients were significantly negatively correlated(P<0.01),and resilience played a mediating role between self-care ability and demoralization,with a mediating effect ratio of 38.15%of the total effect.Conclusion:Health care providers should focus on the psychological dynamics of ischemic stroke patients,pay attention to the demoralization problem faced by this diseased population,and strengthen the intervention of resilience in the process of enhancing selfcare ability and maintaining healthy psychology.Thus,the patients can subsequently adjust their intrinsic psychology with the ultimate goal of preventing or reducing the occurrence and development of demoralization.