Effects of professional rehabilitation training on the recovery of neurological function in young stroke patients

Young stroke patients have a strong desire to return to the society, but few studies have been conducted on their rehabilitation training items, intensity, and prognosis. We analyzed clinical data of young and middle-aged/older stroke patients hospitalized in the Department of Neurological Rehabilitation, China Rehabilitation Research Center, Capital Medical University, China from February 2014 to May 2015. Results demonstrated that hemorrhagic stroke （59.6%） was the primary stroke type found in the young group, while ischemic stroke （60.0%） was the main type detected in the middle-aged/older group. Compared with older stroke patients, education level and incidence of hyperhomocysteinemia were higher in younger stroke patients, whereas, incidences of hypertension, diabetes, and heart disease were lower. The average length of hospital stay was longer in the young group than in the middle-aged/older group. The main risk factors observed in the young stroke patients were hypertension, drinking, smoking, hyperlipidemia, hyperhomocysteinemia, diabetes, previous history of stroke, and heart disease. The most accepted rehabilitation program consisted of physiotherapy, occupational therapy, speech therapy, acupuncture and moxibustion. Average rehabilitation training time was 2.5 hours/day. Barthel Index and modified Rankin Scale scores were increased at discharge. Six months after discharge, the degree of occupational and economic satisfaction declined, and there were no changes in family life satisfaction. The degrees of other life satisfaction （such as friendship） improved. The degree of disability and functional status improved significantly in young stroke patients after professional rehabilitation, but the number of patients who returned to society within 6 months after stroke was still small.

Mortality from Stroke in Young People in Brazzaville

Introduction: Cerebrovascular accidents (CVA) are an absolute neurovascular emergency and the main cause of mortality and acquired disability in adults. In the Congo, stroke is the leading cause of mortality and the leading cardiovascular emergency, with a hospital frequency of between 49.74% and 56.2%. The aim of the study was to identify the mortality factors associated with stroke in young people in Brazzaville. Patients and Methods: This is a longitudinal analytical study conducted from February to period from February to September 2019 in the neurology, general intensive care and medical emergency departments of the Brazzaville University Hospital (CHUB). All subjects aged 18 - 55 years of completed age, admitted for arterial stroke confirmed by brain imaging, were included. Study variables were: age, gender, socioeconomic level, laterality, time to admission and CT scan, vascular risk factors, history of cardiomyopathy, atrial fibrillation, TIA (transient ischemic attack) or stroke, NIHSS (National Institutes of Health Stroke Scale) score, Glasgow score, blood pressure, temperature, heart rate, occurrence or non-occurrence of complications, blood glucose, creatinine, lipid profile and blood count. Data were analyzed using SPSS 21 software. Descriptive analyses were performed using SPSS 21 software. Results: 103 patients were included in the study, of whom 45 (43.7%) had ischemic stroke and 58 (56.3%) with hemorrhagic stroke. Mortality was high at 29.1% in our study, and mainly concerned hemorrhagic strokes (73.7%). Two-week mortality in our study accounted for 63.33% of total lethality. After simple logistic regression, the factors associated with death within two weeks were age between 40 - 44 years (OR (odds ratio) = 2.95;p = 0.01), hemorrhagic stroke (OR = 1.41;p = 0.07), mass effect (OR = 3.26;p < 0.01), ventricular flooding (OR = 2.86;p < 0.001), Glasgow score (OR = 2.95 (0.92 - 9.43);p = 0.06), NIHSS score on admission > 15 (OR = 5.89 (2.90 - 11.95);p < 0.001) and bronchopulmonary infection (OR = 30, 95 (4.04 - 236.88), p < 0.001). From multivariate logistic regression, only NIHSS score on admission > 15 emerged as a predictor of death within two weeks (OR = 5.89 (2.90 - 11.95);p Conclusion: This study confirms the basic data of the African literature concerning stroke, as several factors were identified as independent factors associated with mortality.

Risk factors for stroke recurrence in young patients with first-ever ischemic stroke:A meta-analysis

BACKGROUND At present,the incidence rate of ischemic stroke in young people is increasing yearly,and the age of onset is increasingly young.Therefore,primary and secondary prevention of ischemic stroke in young people,especially secondary prevention,is particularly crucial.AIM We aimed to comprehensively evaluate risk factors for stroke recurrence in firstever young ischemic stroke(YIS)patients.METHODS The meta-analysis was used to quantitatively analyze the research results on risk factors for stroke recurrence in first-ever YIS patients both domestically and internationally.Stata12.0 software was used for heterogeneity testing,publication bias analysis,sensitivity analysis,and the calculation of combined odds ratios and 95%confidence intervals.RESULTS The odds ratio(OR)values of the relationship between hypertension and hyperlipidemia and recurrence of first-ever YIS were 1.54(1.05-2.26)and 1.12(1.00-1.25),respectively.The OR values of male sex,type 2 diabetes,smoking,drinking and YIS recurrence were 1.66(0.98-2.79),1.01(0.64-1.59),1.21(0.83-1.76),and 1.28(0.82-2.53),respectively.The relationship between male sex,type 2 diabetes,smoking,drinking and YIS recurrence was ambiguous.CONCLUSION Hypertension and hyperlipidemia are important risk factors for stroke recurrence in first-ever YIS patients,and active intervention should be taken.

Angioplasty and stenting for a young stroke patient diagnosed as cerebrovascular fibromuscular dysplasia

Fibromuscular dysplasia(FMD)is a noninflammatory,nonatherosclerotic,and multifocal vascular disease,commonly involving the cerebral and renal arteries.Cerebrovascular stenosis and spontaneous dissection resulting from cerebrovascular FMD(cFMD)is one of the important causes of young stroke.Here,we reported the case of cFMD in a 28-year-old male patient with stroke.Digital subtraction angiogram demonstrated a dissecting aneurysm in the carotid artery and multiple stenoses in both vertebral arteries.Endovascular angioplasty with balloon predilation and stenting was successfully performed for the patient when the medical treatment was not adequate.The follow-up showed a remarkable improvement and no recurrence of stroke.

Recurrent ischemic strokes in a young celiac woman with MTHFR gene mutation

Celiac disease(CD) is frequently associated with neurological disorders,but very few reports concern the association with ischemic stroke.A 26-year-old woman affected by CD with secondary amenorrhea,carrier of a homozygous 5,10-methylenetetrahydrofolate reductase mutation with hyperhomocysteinemia,was affected by two occipital ischemic strokes within a period of 5 mo.At the time of the second stroke,while she was being treated with folic acid,acetylsalicylic acid and a gluten-free diet,she had left hemianopsia,left hemiparesthesias,and gait imbalance.Brain magnetic resonance imaging showed a subacute right occipital ischemic lesion,which was extended to the dorsal region of the right thalamus and the ipsilateral thalamocapsular junction.Antitransglutaminase and deamidated gliadin peptide antibodies were no longer present,while antinuclear antibodies,antineuronal antibodies and immune circulating complexes were only slightly elevated.Since the patient was taking folic acid,her homocysteine levels were almost normal and apparently not sufficient alone to explain the clinical event.A conventional cerebral angiography showed no signs of vasculitis.Finally,rare causes of occipital stroke in young patients,such as Fabry's disease and mitochondrial myopathy,encephalomyopathy,lactic acidosis and stroke-like symptoms,were also excluded by appropriate tests.Thus,the most probable cause for the recurrent strokes in this young woman remained CD,although the mechanisms involved are still unknown.The two main hypotheses concern malabsorption(with consequent deficiency of vitamins known to exert neurotrophic and neuroprotective effects) and immunemediated mechanisms.CD should be kept in mind in the differential diagnosis of ischemic stroke in young patients.

Stroke Coach方案对中青年脑卒中患者知识、态度水平及自我管理行为的影响

目的探讨Stroke Coach方案对中青年脑卒中患者知识、态度水平及自我管理行为的影响。方法选取入组患者70例,对照组采用常规护理干预,观察组在对照组的基础上增加Stroke Coach方案,两组患者干预前后均采用脑卒中患者知识、态度问卷及脑卒中患者自我管理行为评定量表进行评估。结果观察组干预后SKAQ知识总分、态度总分显著优于对照组(P<0.05)。两组患者SKAQ得分的组间效应(F=34382.385)、组内效应(F=618.395)、交互效应(F=230.936)具有统计学意义(P<0.05)。观察组干预后的自我管理总分及各维度(除社交管理和情绪管理外)得分与对照组比较差异有统计学意义(P<0.05)。两组患者自我管理行为得分的组间效应(F=44735.998)、组内效应(F=375.364)、交互效应(F=114.458)具有统计学意义(P<0.05)。结论Stroke Coach方案可提高中青年脑卒中患者的知识、态度水平及自我管理行为,但对社交管理和情绪管理作用不明显。

A Study on Stroke in Young and Elderly in Rajiv Gandhi Government General Hospital, Chennai

Stroke is a devastating and disabling cerebrovascular disease with some amount of residual deficit leading onto economic loss. Recent Indian studies have shown a stroke prevalence rate of 471.58/100,000 population. This study was undertaken to analyse the clinical profile and to arrive at important factors contributing to stroke in 45 years group. This is a descriptive, retrospective cross—sectional study carried out on acute CVA patients, admitted to the I.I.M., RGGGH, Chennai. 150 patients were studied over a period of 3 months in the 2011. 20% of /= 45 years constituted our study population. 18.4% and 22.2% of males and females respectively were young stroke patients. Only 33.3% of patients were brought to the hospital within 6 hours. 90% patients had mild GCS score (>/=13/15) and presented with hemiplegia 76% and 18% had infarct and intracerebral hemorrhage(ICH) respectively. Risk factors: Type A personality (70.7%), Tobacco (60.7%) and Alcohol (44.7%) abuse, Systemic Hypertension (60.7%), Diabetes Mellitus (33.3%), Cardiac disorders (14%). Stroke was seen to be more common in >45 years but still young stroke carries paramount importance due to loss of productive years in these patients. Female predominance was seen in young stroke, with particular reference to puerperal period. Among the comorbid illness systemic hypertension followed by cardiac disorders had important contributing role in young strokes. Most of the patients with infarct and ICH were tobacco and alcohol abusers respectively. A holistic approach encompassing further research in factors involved in young stroke, public awareness, behavioural modification and comorbid medical illness management is the need for the hour.

Risk Factors for Prevention Stroke (IS or TIA) Due to Cerebral Infarction in Young Adults: A Meta-Analytical Study

Ischemic strokes (IS), also referred to as cerebral ischemia or brain ischemia, is a significant cause to the brain cells damage or death. Approximately, 10% - 14% of ischemic strokes cases occurred in young adults. Hence, we conducted a meta-analysis to find the effective interventions to prevent the best strokes caused by cerebral infarction in young adults. The search was done in different databases, including Google scholar, PubMed, Embase, Medline, Cochrane Central Register of Controlled Trials, Cochrane Database, Scopus, and Web of Science from January 2016 to April 2020, and only English published articles were considered. Our analysis included studies that stratified the risk of ischemic stroke by CHA2DS2-VASc score for patients with nonvalvular atrial fibrillation. Further, random effects model was used to estimate the summary annual rate of IS. Pooled relative risks and odds ratios, with their 95% confidence intervals, were calculated, respectively. The analysis was conducted using STATA (version 12), pooled effect sizes were calculated using the random-effects model and heterogeneity was tested for using the I2 statistic. The analysis included 13 studies. The analysis shows that diabetes, high blood pressure, ischemic heart disease, atrial fibrillation, hypercholesterolemia, alcohol consumption and smoking are significant risk factors. In Caucasian and Chinese ischemic stroke patients, the risk factor associations associated with ischemic stroke subtypes are similar. Compared to all other ischemia subtypes, diabetes is more familiar with aortic stroke, atrial fibrillation, ischemic heart disease (with obstruction), hypertension and diabetes. Our research shows that atrial fibrillation, ischemic heart disease, and hypercholesterolemia are low in patients with ischemic stroke and the risk factors are higher. Further analysis of each patient’s data is required to enable confounders’ adjustments to confirm and expand these findings.

Stroke in the Young Adults: 6-Year Case Series of Community Hospital Stroke Unit

Stroke etiology in young adults and older patient differs considerably, as well as epidemiology and clinical features vary according to geographical criteria. To improve clinical management and optimize diagnostic work-up of young adults with acute cerebrovascular events, we analyzed retrospectively data of 6-year stroke unit case series. In this hospital case series study, we enrolled 145 patients with acute cerebrovascular events aged 16 to 49, consecutively admitted to a Community Hospital Hub Stroke Unit. We studied risk factors for stroke, the distribution of acute cerebrovascular events, stroke subtype, length of stay and clinical outcome: 70% of patients were admitted for acute ischemic event (45 female-F, 57 male-M), 10.5% intracranial hemorrhages (5F, 10M), 2.7% subarachnoid hemorrhage (2F, 2M), 2% venous sinus thrombosis (3F), 14.5 for acute ischemic attack (12F, 9M). Among ischemic stroke patients, the etiology was as follows: atherothrombosis 29.4%, cardioembolism 19.6%, arterial dissection 13.7%, other determined causes 8.8%, lacunar stroke 5.8%, and undetermined causes 22.54%. 15% of ischemic young patients were treated with r-TPA. The majority of patients returned home at discharge, whereas 30% needed intensive rehabilitation programme to regain independence in the activity of daily living. Dedicated health care programme targeting prevention and optimizing treatment of acute cerebrovascular events in young adults are desirable to improve prognosis among this socioeconomically active age group.

Stroke in Young Adults: Experience at Abakaliki South East Nigeria

Objectives: Stroke is a major cause of morbidity and mortality worldwide. It is increasingly common from the sixth decade, but is particularly tragic when it occurs in young adults. There are limited studies of stroke in young adults in Nigeria. It is against this background that we embarked on this prospective hospital based study to determine the epidemiology, pattern and case fatality rate of stroke in young adults in Abakaliki Southeastern part of Nigeria. Patients and Method: The stroke patients between the ages of 18 - 50 years admitted to the medical wards of a tertiary health centre at Abakaliki Nigeria from 1st August 2012 to 30th April 2019 were consecutively recruited. They were followed up till discharge. Relevant data like biodata, and clinical features of the patients were extracted and analyzed. Results: A total of 983 (males—511, females—472) stroke cases were seen with 197 between 18 - 50 years. One hundred and fifty two (77%) did neuroimaging (mean age—40.7 years). Eighty-eight (57.9%) had Cerebral infarct (males—42, females—46) while 64 (42.1%) had Hemorrhagic stroke (males—35, females—29). For those that had hemorrhagic stroke, 11 (17.2%) were Subarachnoid hemorrhage (SAH) while 52 (82.8%) were Intracerebral hemorrhage (ICH). The identified risk factors range from hypertension, DM, dyslipidemia, alcoholism, cigarette smoking, HIV infection and chronic use of coffee drinks. Sixteen patients died during the admission with case fatality rate of 10.5%. Conclusion: Stroke is actually prevalent in young adults as 1 in every 5 stroke patients seen was a young adult. In addition to the traditional risk factors, HIV/AIDS and chronic use of coffee drinks were also noted as emerging risk factors. There is need for a continuous health education and strong campaign on primary stroke prevention. Also, there is need for training of more neurologists with interest in stroke management and establishing comprehensive stroke centers at national, regional and local levels in order to contend adequately with the rising burden of stoke in young adults.

Epidemiological Aspects of Stroke in Young People at the Friendship University Hospital Center in Bangui in the Central African Republic

Introduction: Stroke is a major public health problem even more dramatic in young people. Goal of the study: To make our contribution to the knowledge of strokes of the young subject. Methodology: It was a retrospective study conducted over a period of 02 years (January 2017 to December 2018) including the files of patients aged 18 to 49 years hospitalized for any suspected case of stroke in the Department of Neurology of C between Hospitalier A Sino-Central African Friendship University (CHUSCA) from Bangui. Results: During the study, 225 cases of stroke were recorded, including 26 cases in young subjects, representing a hospital frequency of 11.5%. The average age was 42.5 years with extremes ranging from 24 to 49 years. The most represented age group was 45 and 49 with a sex ratio (M/F) of 1.36. The average age for men was 41.93 years compared to 39.27 years for women. Civil servants were in the majority in 50% of the cases. Alcohol was the main FDR (80.8%) followed by hypertension (61.5%) and tobacco (50%). The majority of patients (57.70%) were admitted to neurology after the first 24 hours. Ischemic stroke represented 73.08% compared to 26.92% of AVCH. The lethality was 20.08%. The sequelae were found in 69.20% of cases. Cardiac exploration had found 57.10% of LVH. Conclusion: This study confirms a high frequency of stroke in the young subject. The predominance of modifiable FRCVs requires the implementation of a specific strategy based on awareness, early detection and effective and adequate PEC.

Anterior Choroidal Artery Territory Stroke in Young Patient

Introduction: Stroke incidence in young patients is about 10 cases in 100.000, according to several European studies. In this age group arterial dissection is one of the main pathological mechanisms involved. The internal carotid’s artery (ICA) main supraclinoid branch is the anterior choroidal artery (AChA). The occurrence of infarction in its territory due to internal carotid dissection is considered to be a rare event and may have different clinical presentations due to anatomical variability. Clinical case: A 31-year-old male patient, without any known cardiovascular risk factors or chronic medication, presented with acute onset of stabbing right sided headache while practicing football. Visual disturbances and hemiparesis with hypesthesia of his left arm were also mentioned. On admission left homonymous hemianopsia, left hemiparesis and left extensor plantar reflex were present. Brain magnetic resonance showed hyperintensity of T2 and FLAIR signals and restricted diffusion pattern suggested acute/subacute infarctions in the thalamic and subcapsular area, corpus callosum, splenium and subcortical parietal right region. Magnetic resonance angiography (MRA) of the brain showed reduction of the right ICA’s caliber, mainly of its supraclinoid segment in which a marked irregular stenosis was visualized, suggestive of arterial dissection. This stenotic segment included the origin of the AChA and of the posterior communicating cerebral artery with an exchange in their territories. Lumbar puncture results were normal as were analytical investigations which included CBC, sedimentation rate, syphilis serology and immunologic and prothrombotic screen. There were no phenotype characteristics suggestive of connective tissue disease. Conclusion: Trauma seems to be the most probable lesion mechanism for the occurrence of intracranial carotid’s dissection in this particular case, as the patient was practicing vigorous sports at time of onset. In view of great anatomic variability and multiple anatomical sites supplied by the AChA its occlusion will induce a wide range of clinical manifestations.

Ischemic Stroke Revealing Infective Endocarditis in a Young Subject: About a Clinical Case

Introduction: Neurological complications are possible during infective endocarditis. They are often life-threatening and can be a source of sequelae. Case Presentation: We report the case of an 11-year-old patient admitted to the cardiology department of the CHU-ME “LUXEMBOURG” in Bamako for functional impotence of the left hemibody, accompanied by fever and NYHA stage II dyspnea. The clinical examination on admission shows the poor general condition, normal consciousness, and sensory-motor deficit of the pyramidal type of the left hemibody. The cardiovascular examination notes a systolic murmur at the mitral focus, hepato-jugular reflux, hepatomegaly, and slight edema in the lower limbs. Brain CT showed localized hypodensity in favor of an ischemic stroke. The electrocardiogram shows a sinus rhythm. Transthoracic Doppler echocardiography revealed mitral insufficiency with vegetation of 17 × 14 mm on the anterior mitral valve, with left ventricular ejection fraction estimated at 75%. Dual antibiotic therapy associated with conventional treatment for heart failure was initiated. The clinical evolution was marked by the persistence of the deficit of the left upper limb, the cardiac Doppler echography of control after 6 weeks of treatment found the same vegetation. A discussion with the heart team with a view to a surgical cure has been initiated for the rest of the treatment. Conclusion: A motor deficit associated with fever related to an ischemic vascular accident should lead to a search for infective endocarditis on cardiac Doppler ultrasound.

中青年脑卒中患者重返工作自我效能潜在剖面分析及影响因素研究

目的探讨中青年脑卒中患者重返工作自我效能(return-to-work self-efficacy,RTW-SE)的潜在分型并分析不同类别中青年脑卒中患者的特征差异。方法2020年11月至2021年4月,选取郑州市两个社区中共350例中青年脑卒中患者为研究对象,采用一般资料调查表、改良版Rankin量表、RTW-SE量表、疲劳严重程度量表、患者健康问卷-9、广泛性焦虑量表对其进行调查。采用潜在剖面分析患者RTW-SE的潜在分型,采用多元Logistic回归分析评估各种因素对不同分型的影响。结果中青年脑卒中患者RTW-SE分为3个类别:高内在应对-低工作应对组(19.9%);高工作应对-低内在应对组(55.8%);广泛中等水平组(24.3%)。婚姻状况、家庭人均月收入、职业类型、患病前是否为家庭主要经济支持、卒中后疲劳程度、功能障碍是影响中青年脑卒中患者RTW-SE潜在剖面分类的预测因素(均P<0.05)。结论中青年脑卒中患者RTW-SE具有3个潜在类别,医护人员应注意不同患者的RTW-SE特征,实施有针对性的干预措施,帮助其尽快重返社会。

中青年重症脑卒中患者主要照顾者预期性悲伤影响因素的结构方程模型构建

目的构建结构方程模型,探讨中青年重症脑卒中患者主要照顾者预期性悲伤影响因素的作用机制,为探索预期性悲伤的干预模式提供依据。方法2022年6月至2023年6月,选取于湖北医药学院附属襄阳市第一人民医院就诊的300例中青年重症脑卒中患者主要照顾者作为研究对象,采用一般资料调查表、预期性悲伤量表(AGS)、照顾者负担量表(ZBI)、社会支持评定量表(SSRS)和简易应对方式量表(SCSQ)进行调查。采用Pearson相关分析探讨各量表评分之间的相关性,采用AMOS 25.0进行模型拟合、路径及中介效应分析。结果中青年重症脑卒中患者主要照顾者AGS评分为(88.35±9.02)分,ZBI评分为(42.32±7.41)分,SSRS评分为(41.52±5.43)分,应对方式中采取积极应对方式的照顾者占39.3%,消极应对方式占60.7%。AGS评分与SCSQ消极应对评分(r=0.357)、ZBI评分(r=0.381)呈正相关(P<0.01),与SSRS评分(r=-0.436)、SCSQ积极应对评分(r=-0.369)呈负相关(P<0.01)。结构方程模型显示,照顾者负担对预期性悲伤的直接效应显著(效应值为0.458),社会支持、积极应对和消极应对在照顾者负担与预期性悲伤之间的中介效应显著(效应值分别为0.113、0.061、0.060)。结论中青年重症脑卒中患者主要照顾者预期性悲伤水平较高,各影响因素对主要照顾者的预期性悲伤显示出较强的预测和解释功能,医护人员可制定针对性的干预措施,从而降低预期性悲伤水平。

中青年脑卒中病人家庭照顾者照护体验质性研究的Meta整合

目的:系统整合中青年脑卒中病人照顾者照护体验的质性研究,全面了解中青年脑卒中病人家庭照顾者的情感体验和内心需求,为提高和改善照顾者生活质量提供参考。方法:检索中国生物医学文献数据库、中国知网、万方数据库、维普数据库、PubMed、Web of Science、CINAHL、EMbase、the Cochrane Library、PsycINFO数据库中关于中青年脑卒中病人照顾者照护体验的质性研究。检索时限为建库至2023年11月1日。采用澳大利亚乔安娜布里格斯研究所(JBI)循证卫生保健中心质性研究质量评价标准评价纳入文献质量,采用汇集性整合方法进行整合。结果:共纳入9篇文献,提炼33个研究结果,分为10个类别,最终得到3个整合结果:照顾者的多重负担,照护正向的心理体验,照顾者的需求与支持。结论:医护人员应重视中青年脑卒中病人照顾者的心理状况和照护需求,提供全方位的支持,包括心理疏导和专业教育培训等,以提升其照护能力。同时,政府和医疗机构等应提供家庭支持性的协助,以确保病人及其照顾者的生活质量得到有效保障。

中青年脑卒中患者复发风险感知与客观复发风险的一致性分析

目的分析中青年脑卒中患者复发风险感知与客观复发风险的一致性,并探讨影响一致性的因素,为提高评估准确性、减少复发提供参考。方法对337例中青年脑卒中患者采用一般资料调查表、Essen卒中风险评分、脑卒中复发风险感知问题、恐惧疾病进展简化量表、自我感受负担量表、社会支持评定量表、改良Barthel指数量表进行调查,分析一致性及影响因素。结果一致性分析结果为低估100例(29.7%),准确173例(51.3%),高估64例(19.0%),Kappa值为0.110(P<0.05);多因素logistic回归分析结果显示,年龄、文化程度、恐惧疾病进展、社会支持程度是中青年脑卒中患者复发风险低估的影响因素(均P<0.05);恐惧疾病进展、Barthel指数和自我感受负担是复发风险高估的影响因素(均P<0.05)。结论中青年脑卒中患者复发风险感知与客观复发风险不完全一致,需要重点关注年轻、文化程度低的患者,增加患者的社会支持,改善自理能力,减轻自我感受负担,从而提升其复发风险认知的准确性,促进患者采纳健康行为,减少复发。

积极反刍思维训练在中青年脑卒中病人中的应用及效果评价

目的:探索积极反刍思维训练在中青年脑卒中病人中的应用及效果评价。方法:将80例中青年脑卒中病人按照入院时间先后分为对照组和干预组,每组40例。对照组实施常规护理,干预组在常规护理基础上实施为期8周的积极反刍思维训练。采用恐惧疾病进展简化量表、一般自我效能感量表、Connor-Davidson心理弹性量表评估干预效果。结果:经过8周干预后,干预组对疾病进展的恐惧程度明显低于对照组,自我效能感、心理弹性得分高于对照组(均P<0.05)。结论:积极反刍思维训练可降低中青年脑卒中病人恐惧疾病进展水平,提高病人自我效能和心理弹性水平。

中青年脑卒中患者病耻感在领悟社会支持与抑郁间的中介作用

目的探讨中青年脑卒中患者领悟社会支持、病耻感及抑郁间的关系,分析病耻感的中介作用。方法2023年2—5月,采用便利抽样法选取某三甲医院223名中青年脑卒中患者,利用一般资料问卷、领悟社会支持量表、病耻感量表及抑郁量表进行调查。结果中青年脑卒中患者抑郁量表总分为(14.25±5.06)分,领悟社会支持量表总分为(66.62±15.52)分,病耻感量表总分为(47.42±11.36)分;领悟社会支持与病耻感、抑郁呈负相关关系,病耻感和抑郁呈正相关关系;病耻感在领悟社会支持与抑郁间起部分中介作用,占总效应的35.2%。结论中青年脑卒中患者抑郁程度处于中度及以上水平,病耻感在领悟社会支持与抑郁间发挥中介作用,可以通过提高患者领悟社会支持水平降低其病耻感,从而减轻抑郁症状。

青中年患者低盐低脂饮食干预与脑卒中发生发展的关联分析

目的研究青中年患者低盐低脂饮食干预与脑卒中发生发展的关联性。方法选取2021年7月至2023年2月住院的青中年脑卒中患者共计120例作为研究对象,遵循随机化原则分为观察组和对照组,每组60例。对照组运用常规营养支持医护模式;观察组运用低盐低脂饮食指导的医护理念。入院时和干预结束后3个月,评估2组患者的低盐低脂饮食指导指数。比较2组患者入院时、干预3周、干预结束时血红蛋白、血清白蛋白、总蛋白的变化。入院时、干预结束时、干预结束后3个月患者主观整体评估(PG-SGA)评分,并进行人体组成成分测定。结果低盐低脂饮食指导干预结束后3个月与入院时比较,2组自我保健、健康知识、生活方式、精神健康、生活技能及总分均有提高(P<0.05)。观察组与对照组相比,自我保健、生活方式、精神健康及总分提高的程度更明显(P<0.05)。2组从入院时干预3周、指导干预结束时血红蛋白、血清白蛋白、总蛋白呈明显下降趋势(P<0.05)。交互效应均有统计学意义(P<0.05),遂认为不同组间血红蛋白、血清白蛋白、总蛋白变化的趋势受到观察时间的影响。2组从入院时、干预3周、干预结束时PG-SGA得分呈明显下降趋势(P<0.05)。交互效应有统计学意义(P<0.05),遂认为不同组间PG-SGA得分变化的趋势受到观察时间的影响。2组从入院时干预3周、干预结束时体脂率、体重、BMI均呈明显下降趋势(P<0.05)。交互效应均有统计学意义(P<0.05),认为不同组间体脂率、体重、BMI变化的趋势受到观察时间的影响。结论对脑卒中采用低盐低脂饮食指导提高了患者的生活质量,具有良好、广阔的推广应用前景。