首发脑卒中患者心理痛苦轨迹及影响因素的纵向研究

Longitudinal study on psychological pain trajectory and influencing factors for first stroke patients

目的探讨首发脑卒中患者心理痛苦轨迹及影响因素。方法将2022-01—2023-01于郑州大学第二附属医院就诊的242例首发脑卒中患者纳入研究,失访率17.4%,共计200例患者全程参与研究,采用一般资料调查问卷、疾病相关资料调查问卷、心理痛苦温度计量表对患者出院后1个月、3个月、6个月的心理痛苦轨迹情况进行调查,并通过Logistic回归分析探讨首发脑卒中患者心理痛苦的影响因素。结果200例首发脑卒中患者的心理痛苦轨迹从出院1个月至出院6个月存在一定的降低趋势,根据DT评分评估,将患者分为3种类型,即无心理痛苦76例,持续型心理痛苦36例,心理痛苦降低型88例。Logistic回归分析显示,年龄、文化程度、工作状态、有无人照顾、吞咽障碍是脑卒中患者心理痛苦的主要影响因素(P<0.05)。结论首发脑卒中患者心理痛苦发生率较高,患者呈现不同的心理痛苦轨迹,年龄、文化程度、工作状态、有无人照顾、吞咽障碍是影响患者心理痛苦的主要因素,临床工作中应根据危险因素进行个性化干预。

Objective To investigate the psychological pain trajectory and influencing factors for first-episode stroke patients.Methods Totally 242 first-episode stroke patients who visited the Second Affiliated Hospital of Zhengzhou University from January 2022 to January 2023 were included in the study,with a loss of follow-up rate of 17.4%.A total of 200 patients participated in the study throughout the entire process.The psychological pain trajectory of patients at 1 month,3 months,and 6 months after discharge was investigated using general information survey questionnaire,disease related information survey questionnaire,and psychological pain temperature scale,and the influencing factors for psychological pain in first-episode stroke patients were investigated through Logistic regression analysis.Results The psychological pain trajectory of 200 first-episode stroke patients showed a certain decreasing trend from 1 month to 6 months after discharge.According to the DT score evaluation,the patients were divided into three types,namely 76 cases of no psychological pain,36 cases of sustained psychological pain,and 88 cases of reduced psychological pain.Logistic regression analysis showed that age,education level,working status,whether or not to take care of,and dysphagia were the main influencing factors for psychological pain in stroke patients(P<0.05).Conclusion The incidence of psychological pain in first-episode stroke patients is high,and patients present different psychological pain trajectories.Age,education level,working status,unattended,and dysphagia are the main factors affecting the psychological pain of patients.Personalized intervention should be carried out according to the risk factors in clinical work.