首发脑卒中患者医学应对方式及其影响因素调查研究  

Investigation on Medical Coping Modes of First Stroke Patients and Its Influencing Factors

作　　者：原志芳[1] 柴倩文 金奕[2] 张清[1] 

机构地区：[1]天津医科大学护理学院,天津市300070 [2]天津环湖医院护理部

出　　处：《中国全科医学》2016年第2期210-215,共6页Chinese General Practice

摘　　要：目的探讨首发脑卒中患者医学应对方式及其影响因素。方法采用便利抽样方法,选取2015年3—5月在天津市某专科医院脑系科就诊的首发脑卒中患者150例。采用一般资料问卷、医学应对问卷(MCMQ)、残疾接受度量表修订版(ADS-R)、修正Rankin评分(MRS)、社会活动功能问卷(FAQ)、抑郁自评量表(SDS)、领悟社会支持量表(PSSS)对首发脑卒中患者进行调查,采用多元线性回归分析影响患者医学应对方式的因素。结果患者入院前生活满意度评分为(3.4±1.1)分,FAQ评分为(19.6±4.9)分,SDS评分为(43.0±7.8)分,PSSS评分为(54.4±8.4)分,家庭内支持评分为(25.1±2.2)分,家庭外支持评分为(29.3±7.9)分。患者面对维度和屈服维度得分均低于常模,差异有统计学意义(P<0.01);患者回避维度得分与常模进行比较,差异无统计学意义(P>0.05)。将性别、文化程度、月收入、吸烟史、饮酒史、卒中类型、冠心病病史、糖尿病病史、医疗费用来源等9个因素纳入影响首发脑卒中患者医学应对方式的单因素分析,结果显示,文化程度对面对维度有影响(P<0.05)。而所纳入的其他因素对首发脑卒中患者应对方式无影响(P>0.05)。首发脑卒中患者面对维度与入院前生活满意度、FAQ评分呈负相关(P<0.05),与ADS-R评分、PSSS评分及家庭内支持评分、家庭外支持评分呈正相关(P<0.05);回避维度与FAQ评分、SDS评分呈正相关(P<0.05),与PSSS评分、家庭内支持评分呈负相关(P<0.05);屈服维度与FAQ评分、SDS评分呈正相关(P<0.05),与PSSS评分、家庭外支持评分呈负相关(P<0.05)。多元线性回归分析结果显示,入院前生活满意度、ADS-R评分、家庭内支持及家庭外支持评分是患者医学应对方式面对维度的影响因素(P<0.05);SDS评分、家庭内支持评分是患者医学应对方式屈服维度的影响因素(P<0.05);入院前生活满意度、SDS评分、家庭外支持评分是患者医学应对方式Objective To study the medical coping modes of first stroke patients and its influencing factors. Methods Using convenience sampling method, we selected 150 first stroke patients who received treatment in the department of cerebral surgery of a specialized hospital from March to May, 2015. We employed general information questionnaire survey, medical coping modes questionnaire （ MCMQ ） , acceptance of disability scale - revised （ ADS-R ） , modified Rankin scale （ MRS ） , functional activities questionnaire （FAQ） , selfrating depression scale （SDS） and perceived social support scale （PSSS） to conduct investigation on the patients. Multivariate linear regression analysis was conducted to analyze the influencing factors for the medical coping mode of patients. Results The scores of life satisfaction degree before admission, FAQ, SDS, PSSS, support within family and support outside family were （3.4＋l. 1）, （19.6±4.9）, （43.0±7.8）, （54.4±8.4）, （25.1 ±2.2） and （29. 3 ± 7.9 ） respectively. The scores of facing dimension and yielding dimension were lower than norms （P 〈 0. 01 ） ; thescore of avoiding dimension was not significantly different from the norm （ P 〉 O. 05 ）. Gender, degree of education, monthly income, smoking, drinking, stroke type, coronary disease, history of diabetes and medical expenses were included in the univariate analysis of influencing factors for the medical coping mode of first stroke patients, and the analysis showed that degree of education had significant influence （P 〈 0. 05 ） on the facing dimension and other influencing factors had no influence （ P 〉 0. 05） on the medical coping mode of first stroke patients. The facing dimension of first stroke patient was negatively correlated （ P 〈 0. 05 ） with the satisfaction degree of life prior to admission and FAQ score and was positively correlated （ P 〈 0. 05 ） with the scores of ADS-R, PSSS, support within family and support outside family ; avoiding dimensi

关 键 词：卒中 医学应对方式 影响因素 

分 类 号：R743[医药卫生—神经病学与精神病学]