中青年出血性脑卒中患者康复运动依从性现状及其影响因素分析

Analysis of rehabilitation exercise compliance and its influencing factors in young and middle-aged patients with hemorrhagic stroke

目的多中心横断面调查中青年出血性脑卒中患者康复运动依从性现状并分析其影响因素。方法采用便利抽样法,多中心合作研究,于2021年7月—2022年1月选取中国中、东、北部3所三级甲等医院的397例中青年出血性脑卒中住院患者作为调查对象。依据健康行动过程取向(the health action process approach,HAPA)模型,采用一般资料调查量表、脑卒中功能锻炼依从性量表、运动自我效能量表、锻炼计划量表、脑卒中健康信念量表及Barthel指数量表进行横断面调查。结果中青年脑卒中患者功能锻炼依从性量表得分为(43.46±9.58)分,平均依从率为77.60%,康复运动依从性总体较高。多因素回归分析结果显示,运动自我效能、锻炼计划、感知到的易感性、感知到的严重性、感知到的益处、感知到的障碍、健康动力、自我效能是中青年脑卒中患者康复运动依从性的影响因素(P<0.05)。结论临床医护人员应依据HAPA模型,精准评估患者所处的康复运动阶段,根据患者的实际状况和各种可能的影响因素,制订和实施卒中康复运动策略,从而提高患者的康复运动依从性,改善其功能状态,进一步提高其生活质量。

Objective To investigate and analyze the current situation of rehabilitation exercise compliance and its influencing factors in young and middle-aged patients with hemorrhagic stroke.Methods By convenient sampling method,young and middle-aged patients with hemorrhagic stroke were selected from 3 hospitals in central,eastern and northern China from July 2021 to January 2022.According to the Health Action Process Approach(HAPA),a cross-sectional survey was conducted with the general information questionnaire,Exercise Adherence Questionnaire(EAQ),the Self-Efficacy for Exercise(SEE)Scale,exercise plan scale,stroke health belief scale and self-care ability scale.Results The total score of exercise adherence of young and middle-aged patients with stroke was 43.46±9.58,and the average compliance rate was 77.60%.Multivariate regression analysis showed that the total scores of exercise self-efficacy,exercise plan,perceived susceptibility,perceived severity,perceived benefits,perceived disorders,health motivation and self-efficacy were the influencing factors of exercise compliance in young and middle-aged stroke patients(P<0.05).Conclusion Clinical medical staff should accurately evaluate the rehabilitation exercise stage of patients according to HAPA model,formulate and implement stroke rehabilitation exercise strategies according to patients’actual conditions and various possible influencing factors,so as to improve patients’exercise compliance,their functional status and further improve their quality of life.