脑卒中后吞咽障碍患者康复训练依从性及其影响因素

Rehabilitation training compliance and its influencing factors in patients with post-stroke dysphagia

目的探究脑卒中后吞咽障碍(post-stroke dysphagia,PSD)患者康复训练依从性及其影响因素。方法回顾性分析2020年1月至2023年12月成都市青白江区人民医院收治的320例PSD患者的临床病例资料,依据康复锻炼依从性量表(EAQ)评价结果分为依从良好组(依从指数≥50%)和依从性差组(依从指数<50%)。记录PSD患者依从性情况,单因素分析与多因素logistic回归分析导致PSD患者依从性差的独立风险因素。结果PSD患者康复训练依从性评价结果显示,总体康复训练依从指数在53.04%,依从性差占比41.25%;单因素分析显示,依从性良好组与依从差组年龄、Barthel指数<40分、家庭功能评定量表(FAD)、脑卒中知识问卷(SKQ)、脑卒中康复自我效能量表(SSEQ)、简易疾病感知问卷(BIPQ)及健康信念模型简表(SF-HBMS)评分比较差异有统计学意义(P<0.05);多因素logistic回归分析显示,年龄、Barthel指数<40分、FAD评分导致PSD患者康复训练依从性差的独立风险因素(P<0.05);SKQ评分、SSEQ评分、BIPQ评分、SF-HBMS评分为保护因素(P<0.05)。结论PSD患者普遍存在康复锻炼依从性不理想状况,年龄、日常生活能力、家庭功能为依从性差的风险因素。

Objective To explore the compliance of rehabilitation training and its influencing factors in patients with poststroke dysphagia(PSD).Methods The clinical case data of 320 PSD patients in the hospital were retrospectively analyzed from January 2020 to December 2023.According to the evaluation results of rehabilitation exercise adherence questionnaire(EAQ),PSD patients were divided into good compliance group(compliance index≥50%)and poor compliance group(compliance index<50%).The compliance of PSD patients was recorded.Univariate analysis and Multivariate logistic regression analysis were adopted to analyze the independent risk factors leading to poor compliance of PSD patients.Results The evaluation results of rehabilitation training compliance of PSD patients showed that the overall rehabilitation training compliance index was 53.04%and the proportion of poor compliance was 41.25%.Univariate analysis showed that there were statistical differences in age,Barthel index<40 points,Family Assessment Device(FAD)score,Stroke Knowledge Questionnaire(SKQ)score,Stroke Self-Efficacy Questionnaire(SSEQ)score,Brief Illness Perception Questionnaire(BIPQ)score and Short Form Health Belief Model Scale(SF-HBMS)score between the good compliance group and the poor compliance group(P<0.05).Multivariate logistic regression analysis indicated that age,Barthel index<40 points and FAD score were independent risk factors for poor rehabilitation training compliance in PSD patients(P<0.05),and SKQ score,SSEQ score,BIPQ score and SF-HBMS score were protective factors(P<0.05).Conclusion PSD patients generally have unsatisfactory rehabilitation exercise compliance.Age,daily living ability and family function are risk factors for poor compliance.