脑卒中后偏瘫患者心理健康状况及相关因素
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摘要
目的:分析脑卒中后偏瘫患者心理健康状况及其影响因素。方法:选取2013年5月-2016年10月我院收治的98例脑卒中后偏瘫患者作为研究对象,入院后均采用自拟一般资料调查表对患者基线情况调查,应用症状自评量表(SCL-90)评定患者心理健康状况,采用单因素及多因素Logistic回归分析筛选导致脑卒中后偏瘫患者出现心理问题的相关因素。结果:本组调查98例患者,心理问题发生率为47.96%,男性、年龄≥60岁、家庭月收入<2000元、合并基础疾病、出血性病变、重度神经功能损害程度、肢体运动功能分期为1～3期及社会支持评分<20分脑卒中偏瘫患者心理问题检出率较高(χ~2=19.800,5.760,12.647,7.478,7.903,7.025,19.722,16.221;P<0.05);家庭月收入、合并基础疾病、病变性质、神经功能损害程度、肢体运动功能分期、社会支持评分均为导致脑卒中后偏瘫患者发生心理问题的危险因素(OR=2.596,2.563,2.540,3.469,2.565,2.221;P<0.05)。结论:脑卒中后偏瘫患者心理问题发生率较高,且家庭月收入较低、合并基础疾病、出血性脑卒中、严重神经功能损害、肢体运动功能分期较低且社会支持评分较低的患者心理问题发生率较高。
Objective:To analyze the mental health status of patients with hemiplegia after stroke and its influencing factors.Methods:A total of 98 patients with hemiplegia after stroke who were admitted to our hospital during the period from May 2013 to October 2016 were selected as subjects.The baseline situation of patients was investigated with the self-made general information questionnaire,and the mental health status was evaluated with the symptom checklist(SCL-90).Related factors for psychological problems in patients with hemiplegia after stroke were screened by univariate and multivariate Logistic regression analysis.Results:The incidence of psychological problems in this study was 47.96%,and the detection rates of psychological problems were relatively higher in male patients,patients who were or older than 60 years old,patients whose family income was less than 2000 yuan,patients with underlying diseases,patients with hemorrhagic lesions,patients with severe neurological damage,patients whose limb movement function stage was stage 1～3 and patients whose social support score was lower than 20 points(χ~2=19.800,5.760,12.647,7.478,7.903,7.025,19.722,16.221;P<0.05).Family income,underlying diseases,character of lesions,degree of neurological damage,limb movement function stage and the social support score were risk factors for psychological problems in patients with hemiplegia after stroke(OR=2.596,2.563,2.540,3.469,2.565,2.221;P<0.05).Conclusion:The incidence of psychological problems is relatively higher in patients with hemiplegia after stroke.Besides,the incidence is relatively higher in patients with low family income,patients with underlying diseases,patients with hemorrhagic stroke,patients with severe neurological impairment,patients with lower limb movement function stage and lower social support score.
Objective:To analyze the mental health status of patients with hemiplegia after stroke and its influencing factors.Methods:A total of 98 patients with hemiplegia after stroke who were admitted to our hospital during the period from May 2013 to October 2016 were selected as subjects.The baseline situation of patients was investigated with the self-made general information questionnaire,and the mental health status was evaluated with the symptom checklist(SCL-90).Related factors for psychological problems in patients with hemiplegia after stroke were screened by univariate and multivariate Logistic regression analysis.Results:The incidence of psychological problems in this study was 47.96%,and the detection rates of psychological problems were relatively higher in male patients,patients who were or older than 60 years old,patients whose family income was less than 2000 yuan,patients with underlying diseases,patients with hemorrhagic lesions,patients with severe neurological damage,patients whose limb movement function stage was stage 1～3 and patients whose social support score was lower than 20 points(χ~2=19.800,5.760,12.647,7.478,7.903,7.025,19.722,16.221;P<0.05).Family income,underlying diseases,character of lesions,degree of neurological damage,limb movement function stage and the social support score were risk factors for psychological problems in patients with hemiplegia after stroke(OR=2.596,2.563,2.540,3.469,2.565,2.221;P<0.05).Conclusion:The incidence of psychological problems is relatively higher in patients with hemiplegia after stroke.Besides,the incidence is relatively higher in patients with low family income,patients with underlying diseases,patients with hemorrhagic stroke,patients with severe neurological impairment,patients with lower limb movement function stage and lower social support score.
引文
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[16]计海霞,张建凤,张蕾,等.缺血性脑卒中患者疾病感知的影响因素分析[J].中国动脉硬化杂志,2016,24(10):1001-1006
[17]杨莹莹,潘永惠,王森,等.MicroRNA与卒中后抑郁关系的研究进展[J].神经疾病与精神卫生,2015,15(6):625-628
[18]吴婉霞,徐武华,钟思琳,等.运动训练联合心理治疗对脑卒中患者康复的影响[J].中国康复医学杂志,2013,28(8):770-772
[19]原志芳,柴倩文,金奕,等.首发脑卒中患者医学应对方式及其影响因素调查研究[J].中国全科医学,2016,19(2):210-215
[20]梁明明,杜玉凤,李晓敏,等.脑卒中患者自我感受负担和主观幸福感的关系[J].中国健康心理学杂志,2017,25(6):832-835
[2]袁大伟,李瑾.认知行为治疗改善脑卒中后抑郁状况及生活质量的疗效研究[J].神经疾病与精神卫生,2015,15(3):243-245
[3]李小金,韩秀兰,田潇飞,等.脑卒中后偏瘫患者早期膝关节本体感觉干预对平衡功能及心理状态的影响[J].中华物理医学与康复杂志,2016,38(11):845-847
[4]陈人磊,周小艳,杨国帅.青年进展性卒中患者心理社会因素分析及护理对策[J].现代预防医学,2012,39(9):2209-2210
[5]Liman T G,Heuschmann P U,Endres M,et al.Impact of low mini-mental status on health outcome up to 5 years after stroke:The Erlangen Stroke Project[J].Journal of Neurology,2012,259(6):1125-1130
[6]刘莹,万丽红,李玲,等.缺血性脑卒中患者健康心理控制源及其相关因素调查分析[J].中国健康教育,2016,32(9):822-825
[7]陆春华,王凯,吴耀亮,等.Cameron教育模式对脑卒中患者康复效果和照顾者心理状况的影响[J].中国健康教育,2013,29(12):1106-1109
[8]赵海苹,罗玉敏.2012中国卒中大会暨第二届全国心脑血管病论坛--转化医学论坛会议纪要[J].中国脑血管病杂志,2012,9(6):335-336
[9]欧艳.NIHSS评分与SSS评分对脑梗死急诊溶栓后出血转化的预测价值[J].实用医学杂志,2014,30(19):3124-3126
[10]冯华,李瑶.根据Brunnstrom分期制定针对性康复方案对脑卒中患者康复效果的影响[J].国际神经病学神经外科学杂志,2015,42(4):316-319
[11]任浩进,王丽岳,杨俊,等.社会支持评定量表在迷走性晕厥患者使用的价值[J].心血管康复医学杂志,2015,24(3):249-252
[12]Urbán R,Kun B,Farkas J,et al.Bifactor structural model of symptom checklists:SCL-90-R and Brief Symptom Inventory(BSI)in a non-clinical community sample.[J].Psychiatry Research,2014,216(1):146-154
[13]杨英杰,苏志强,胡晓蕾.轻型卒中患者生活质量的研究进展[J].神经疾病与精神卫生,2016,16(4):494-496
[14]Zhang Y,Liu H,Wang L,et al.Relationship between functional connectivity and motor function assessment in stroke patients with hemiplegia:A resting-state functional MRI study[J].Neuroradiology,2016,58(5):503-511
[15]冯玉芳,张少丽,王春霞,等.脑卒中发病的心理社会因素路径分析[J].中华行为医学与脑科学杂志,2012,21(11):1017-1018
[16]计海霞,张建凤,张蕾,等.缺血性脑卒中患者疾病感知的影响因素分析[J].中国动脉硬化杂志,2016,24(10):1001-1006
[17]杨莹莹,潘永惠,王森,等.MicroRNA与卒中后抑郁关系的研究进展[J].神经疾病与精神卫生,2015,15(6):625-628
[18]吴婉霞,徐武华,钟思琳,等.运动训练联合心理治疗对脑卒中患者康复的影响[J].中国康复医学杂志,2013,28(8):770-772
[19]原志芳,柴倩文,金奕,等.首发脑卒中患者医学应对方式及其影响因素调查研究[J].中国全科医学,2016,19(2):210-215
[20]梁明明,杜玉凤,李晓敏,等.脑卒中患者自我感受负担和主观幸福感的关系[J].中国健康心理学杂志,2017,25(6):832-835