脑卒中患者病耻感现状调查及其影响因素

Investigation of stigma in patients with stroke and its influencing factors

目的:调查脑卒中患者病耻感现状及其影响因素。方法:采用方便抽样法,纳入2018年11月—2019年2月符合病例选择标准的408例脑卒中患者作为研究对象。使用自行设计的人口学资料调查问卷、慢性疾病病耻感量表(stigma scale for chronic illness,SSCI)、汉密顿抑郁量表(Hamilton depression scale,HAMD)(24项)和社会支持评定量表(social support rating scale,SSRS)对408例脑卒中患者进行评价。结果:408例脑卒中患者的病耻感平均评分为21.80±7.95,处于中度水平;内在病耻感评分为15.14±6.67,外在病耻感评分为6.65±3.38。单因素分析结果显示,职业(P=0.003)、婚姻状况(P=0.001)和脑卒中类型(P=0.025)与病耻感水平显著相关。病耻感水平与抑郁评分呈正相关(r=0.247,P<0.001),与年龄(r=-0.140,P=0.005)、主观支持评分(r=-0.241,P<0.001)和支持利用度评分(r=-0.286,P=0.012)呈负相关。多元线性回归分析结果显示,年龄、抑郁评分、主观支持评分和支持利用度评分与脑卒中患者病耻感水平显著相关(P<0.05)。结论:脑卒中患者的病耻感属于中度水平,年龄、抑郁评分、主观支持评分和支持利用度评分均为其影响因素。通过加强患者的个体化心理干预、建立良好的社会支持体系以及尽早执行有效的康复训练,对于降低脑卒中患者的病耻感水平以及提高其生活质量,具有积极的意义。

Objective:To investigate the status of stigma and its influencing factors in patients with stroke.Methods:A total of 408 patients with stroke who met the case selection criteria from November 2018 to February 2019 were enrolled in this study by convenient sampling.These408 patients were evaluated by using self-designed demographic data questionnaire,stigma scale for chronic illness(SSCI),Hamilton depression scale(HAMD)(24 items)and social support rating scale(SSRS).Results:The average score of stigma in 408 patients with stroke was 21.80+7.95,which was at a moderate level;the internal stigma score was 15.14+6.67 and the external stigma score was 6.65+3.38.Univariate analysis showed that occupation(P=0.003),marital status(P=0.001)and stroke type(P=0.025)were significantly correlated with the level of stigma.The level of stigma was positively correlated with depression score[r=0.247,P<0.001),and negatively correlated with age(r=-0.140,P=0.005),subjective support score(r=-0.241,P<0.001)and support utilization score(r=-0.286,P=0.012).Multiple linear regression analysis showed that age,depression score,subjective support score and support utilization score were significantly correlated with the stigma level of patients with stroke(P<0.05).Conclusion:The stigma of patients with stroke belongs to moderate level.The age,depression score,subjective support score and support utilization score are all influencing factors.By strengthening individual psychological intervention,establishing a good social support system and implementing effective rehabilitation training as soon as possible,it is of positive significance to reduce the level of stigma and improve the quality of life of patients with stroke.