基于潜在剖面分析的脑卒中患者夫妻二元应对现状及其影响因素

Status Quo and Influencing Factors of Dyadic Coping in Stroke Patients and Spouses Based on Latent Profile Analysis

目的 探讨脑卒中患者与配偶照顾者二元应对的潜在类别,并分析各类别在人口学资料、疾病相关资料上的差异,为医护人员制订个性化二元应对干预方案提供参考。方法 2021年4-12月,采用便利抽样法选取郑州市某三级甲等综合性医院神经内科202对脑卒中患者夫妻为研究对象,以二元应对量表、改良Rinkin评分等对其调查。使用潜在剖面分析脑卒中患者夫妻二元应对的潜在类别,采用多元Logistic回归分析潜在类别的影响因素。结果 脑卒中患者与其配偶照顾者的二元应对总分分别为(126.50±16.37)分、(128.15±17.85)分;存在4种类型,即夫妻均高水平应对组(24.8%)、夫妻均中水平应对组(51.5%)、照顾者中水平-患者低水平应对组(15.3%)、患者中水平-照顾者低水平应对组(8.4%)。4个潜在类别在脑卒中患者年龄、文化程度、患者预后和配偶照顾者年龄、文化程度、有无共同照顾者以及患者与照顾者的感情状态和婚龄间的差异均有统计学意义(均P<0.05)。Logistic回归分析显示,照顾者年龄、夫妻感情状态、有无共同照顾者是脑卒中夫妻二元应对潜在类别的独立影响因素(均P<0.05)。结论 脑卒中患者夫妻二元应对存在异质性,医护人员应更加重视年轻照顾者、夫妻感情状态一般和有共同照顾者的脑卒中夫妻的二元应对评估和干预。

Objective To explore the potential categories of dyadic coping in stroke patients and spouses,and to analyze the differences in demographic data and disease-related data of each category,so as to provide reference for medical staff to formulate personalized dyadic coping intervention programs.Methods From April to December 2021,202 couples of stroke patients in the Department of Neurology of a tertiary A general hospital in Zhengzhou were selected as the research objects by convenience sampling method,and investigated by using dyadic coping inventory(DCI)and modified Rankin scale(mRS).Potential profiles were used to analyze the potential categories of dyadic coping in stroke patients and spouses,and multiple logistic regression was used to analyze the influencing factors of potential categories.Results The total scores of dyadic coping of stroke patients and their spouse caregivers were(126.50±16.37)and(128.15±17.85),respectively.There were 4 types,namely,couples with high level of coping(24.8%),couples with medium level of coping(51.5%),caregivers with low level of coping(15.3%),patients with low level of coping(8.4%).The 4 potential categories showed statistically significant differences in stroke patients’age,education level,patient prognosis,spouse caregivers’age,education level,co-caregiver,relationship and years of marriage between patients and caregivers(all P<0.05).Logistic regression analysis showed that the age of the caregiver,the relationship of the couple,and the presence or absence of a co-caregiver were the independent influencing factors of the potential categories of stroke couple binary coping(all P<0.05).Conclusions There is heterogeneity in dyadic coping in stroke patients and spouse caregivers.Medical staff should pay more attention to the assessment and intervention of dyadic coping of young caregivers,couples with average relationship and stroke couples with joint caregivers.