疾病感知和服药信念在脑卒中患者自我效能和康复依从性中的作用分析

Role of disease perception and treatment confidence in the compliance of self-efficacy rehabilitation of stroke patients

目的:分析疾病感知和服药信念在脑卒中患者自我效能和康复依从性中的作用。方法:以321例脑卒中患者为研究对象,采用脑卒中功能锻炼依从性量表(SFEAS)、服药信念量表(BMQ)、疾病感知问卷(B-IPQ)以及自我效能量表(SSEQ)进行问卷调查。分析疾病感知、服药信念与自我效能和康复依从性之间的关系。结果:剔除无效问卷21份,最终获得有效问卷300份。脑卒中患者B-IPQ评分为45.33±8.31分,BMQ评分为30.10±3.32分,SFEAS评分为34.89±8.90分,SSEQ评分为74.09±11.80分,各量表总分以及各维度得分均处于中等偏下水平;不同性别、年龄、身体质量指数(BMI)、学历、居住地患者B-IPQ、BMQ、SFEAS以及SSEQ得分对比均无显著性差异;Pearson相关性分析显示疾病感知同服药信念、自我效能和康复依从性呈负相关(r=-0.754、-0.741、-0.785;均P<0.001);服药信念和自我效能呈正相关(r=0.864;P<0.001);服药信念和康复依从性呈正相关(r=0.780;P<0.001);自我效能和康复依从性呈正相关(r=0.753;P<0.001);疾病感知和服药信念在脑卒中患者自我效能和康复依从性之间的中介作用显示,自我效能对康复依从性的路径系数是0.409,自我效能通过中介变量疾病感知和服药信念对康复依从性产生部分间接效应。结论:脑卒中的发生可影响患者的疾病感知、服药信念、自我效能以及康复依从性,并且疾病感知和服药信念可影响患者的自我效能和康复依从性。

Objective:To analyze the role of disease perception and medication belief in self-efficacy and rehabilitation compliance of stroke patients.Methods:Totally,321 stroke patients admitted to our hospital from May 2022 to April 2023 served as the research objects.The general information questionnaire and the functional exercise compliance scale for stroke(SFEAS),beliefs about medical questionnaire(BMQ),disease perception questionnaire(B-IPQ)and self-efficacy scale(SSEQ)were used to analyze the relationship between disease perception,medication belief,self-efficacy and rehabilitation compliance.Results:In total,21 invalid questionnaires were excluded,and 300 valid questionnaires were finally obtained.The scores of B-IPQ scale,BMQ scale,SFEAS scale and SSEQ scale were(45.33±8.31),(30.10±3.32),(34.89±8.90)and(74.09±11.80),respectively,and the total scores of each scale and each dimension were at the lower-middle level.There was no significant difference in the scores of B-IPQ,BMQ,SFEAS and SSEQ among patients with different gender,age,body mass index,education background and residence.Pearson correlation analysis showed that disease perception was negatively correlated with medication belief,self-efficacy and rehabilitation compliance(r=-0.754,-0.741,-0.785;P<0.001).There was a positive correlation between medication belief and self-efficacy(r=0.864;P<0.001);There was a positive correlation between medication belief and rehabilitation compliance(r=0.780;P<0.001).There was a positive correlation between self-efficacy and rehabilitation compliance(r=0.753;P<0.001).The mediating effect of self-perception and medication belief between self-efficacy and rehabilitation compliance of stroke patients showed that the path coefficient of self-efficacy to rehabilitation compliance was 0.409,and self-efficacy had a partial indirect effect on rehabilitation compliance through mediating variables of disease perception and belief intaking medicine.Conclusion:The oc-currence of stroke can affect patients’disease perception,medication belief,self-efficacy and rehabilitation compliance,and disease perception and medication belief can affect patients’self-efficacy and rehabilitation compliance.