脑卒中患者出院安置现状及风险因素调查分析

Status and risk factors for discharge destination among patients with stroke

目的 了解脑卒中患者出院安置现状,分析影响因素,为针对性干预提供参考。方法 对神经内科371例脑卒中患者采用衰弱筛查量表、社会支持水平量表、医院焦虑抑郁量表,以及基于健康生态学自行设计的一般资料调查表进行问卷调查,以出院安置改变与否分析影响因素。结果 136例(36.7%)发生出院安置改变。logistic回归分析结果显示,卒中前衰弱、中度卒中、日常生活活动能力重度依赖、抑郁症状、独居及与配偶同住、认知障碍和中高跌倒风险是脑卒中患者出院安置改变的风险因素(均P<0.05)。结论 脑卒中患者出院安置改变发生率较高;医护人员应在患者入院早期进行评估与筛查,重点关注风险因素,早期干预,协助患者转入合适的出院住所。

Objective To investigate the status quo of discharge destination among stroke patients and analyze its influencing factors,so as to provide reference for targeted interventions.Methods A questionnaire survey was conducted on 371 stroke patients in neurology department.The questionnaires included the F RAIL Scale,Social Support Rating Scale,the Hospital Anxiety and Depression Scale,and a general information questionnaire designed based on the ecological model of health.The influencing factors were analyzed based on whether there was a change in discharge destination.Results Of the participants,136(36.7%)experienced change in discharge destination.Logistic regression analysis showed that pre-stroke frailty,moderate stroke severity,severe ADL dependency level,depressive symptoms,living alone or with a spouse,cognitive impairment,and moderate-to-high risk of falls were risk factors for change in discharge destination(all P<0.05).Conclusion The incidence of discharge destination change is relatively high among stroke patients.Medical staff should conduct assessment and screening in the early stage of hospitalization,focus on risk factors,provide early intervention,and assist patients to transit smoothly to appropriate post-discharge residence.