上海市社区缺血性脑卒中患者二级预防现状及相关因素的调查研究  

Investigation on the status of secondary prevention of ischemic stroke patients and the related factors in community of Shanghai

作　　者：沈洁[1] 邓娟[1] 姜安丽[1] 

机构地区：[1]第二军医大学护理学院,上海200433

出　　处：《中华现代护理杂志》2013年第35期4313-4318,共6页Chinese Journal of Modern Nursing

基　　金：上海市重点学科建设资助项目（B903）;上海市卫生局课题（2010242）

摘　　要：目的了解上海市社区缺血性脑卒中患者二级预防现状及其影响因素。方法利用自制的调查问卷，采取入户调查与电话调查相结合的方法，对上海市3个社区256例社区缺血性脑卒中患者进行问卷调查。结果共入选256例社区缺血性脑卒中患者，有效问卷204份，问卷有效率为91．0％。调查对象首次卒中距今平均（13．45±6．92）个月，有28例复发，占13．73％。他汀类降脂药物服用情况比较，社区1服用13例，社区2服用26例，社区3服用26例，差异有统计学意义（x2=7．226，P〈0．05）。不同社区、学历、家庭月收入患者服药及日常行为得分差异有统计学意义（F分别为7．768，3．418，4．769；P〈0．01）。多元线性回归分析结果显示：性别、家庭人均月收入、社区、居住情况、认知与态度可以共同解释患者服药及日常行为得分的40．90％的变异量。其中社区、独居、知识情况、态度与认知为患者服药及日常行为得分的影响因素（t分别为2．957，2．702，4．534，4．354；P〈0．01）。结论社区缺血性脑卒中患者二级预防现状与指南之间仍有一定的距离，需要进一步缩小实践与指南之间的距离。Objective To Investigate the status of secondary prevention of ischemic stroke patients and the related factors in community of Shanghai. Methods Using the combination of household survey and telephone survey, 256 ischemic stroke patients from 3 communities in Shanghai were investigated with self-made questionnaire. Results A total of 256 ischemic stroke patients in community were selected. 204 valid questionnaire were collected, with the response rate of 91.0%. The interval time between first onset stroke and investigation were （13.45 ＋ 6.92） months on average, and there were 28 patients of recurrence, accounting for 13.73% of all valid cases. There was statistically significant difference in the utilization status of statins between different communities （~2 =7. 226, P 〈 0.05 ）, and there were 13 patients taking statins in Community 1, 26 patients in Community 2 and 26 patients in Community 3, respectively. Significant differences also were found in the scores of medication compliance and daily behavior in patients who came from different communities, different education background, and have different household income （F = 7. 768, 3. 418, 4. 769, respectively; P 〈 0.01 ）. The result of multiple linear regression showed that gender, average monthly income, communities, living conditions, knowledge and attitude could explain 40.90% of the variance of the scores of medication compliance and daily behavior, and the contribution of communities, living alone, knowledge, attitude and cognition to the scores of medication compliance and daily behavior were still statistically significant （t = 2.957, 2. 702, 4. 534, 4. 354, respectively; P 〈 0.01 ）. Conclusions There is still a distance between guidelines and status of secondary prevention of ischemic stroke patients in community, and it need further minimize the gap between clinical practice and guidelines.

关 键 词：卒中 二级预防 社区卫生服务 调查 

分 类 号：R473.2[医药卫生—护理学]