脑卒中病人症状特征的潜在类别分析  

Symptom characteristics of stroke patients latent class analysis

作　　者：石丹[1] 李铮[1] 杨坚[2] 刘邦忠[3] 夏会 Shi Dan;Li Zheng;Yang Jian(School of Nursing,Fudan University,Shanghai 200032 China)

机构地区：[1]复旦大学护理学院 [2]上海市徐汇区中心医院 [3]复旦大学附属中山医院

出　　处：《护理研究》2018年第20期3184-3189,共6页Chinese Nursing Research

基　　金：2016年复旦大学-复星护理科研基金立项项目;编号:FNF201611

摘　　要：[目的]对脑卒中病人症状特征进行分类,并探讨不同症状类别病人人口学特征和疾病特征的差异。[方法]采用方便抽样法选取上海市2所医院5个神经康复病房的275例住院脑卒中病人,使用自编脑卒中病人一般资料调查表和脑卒中症状体验量表进行调查,采用潜在类别分析(Mplus 7.0软件)将脑卒中病人按照症状特征进行分类,采用多项分类Logistic回归探讨不同类别病人人口学特征和疾病特征的差异。[结果]脑卒中病人按照症状特征可分为3个潜在类别(P<0.05),根据每个类别的条件概率,分别命名为"症状高发,低认知障碍,高心理症状组"[96例(34.9%)],"症状高发,高认知障碍,高心理症状组"[139例(50.5%)],"症状低发,低认知障碍,低心理症状组"[40例(14.5%)]。文化程度、卒中部位和疾病分期是影响脑卒中病人症状特征分类的主要因素。[结论]脑卒中病人可按症状特征分为3个类别。脑卒中病人的心理症状在不同疾病分期呈现一个折线变化过程,相较于其他分期病人,康复早期和康复后期的病人发生心理症状的风险较高。相较于高学历的病人,低学历的病人发生心理症状和认知障碍症状的风险高。在临床实践中,应对脑卒中病人进行早期心理干预,并重点多关注低学历病人。Objective:To classify the symptom characteristics of stroke patients and to explore the differences in demographic characteristics and disease characteristics between patients with different symptom categories.Methods:A total of 275 hospitalized stroke patients from 5 neurological rehabilitation wards of 2 hospitals in Shanghai were selected by convenient sampling method.The Self designed General Information Questionnaire and the Symptom Experience Scale for Stroke Survivors were used for investigation.Latent class analysis(Mplus 7.0 software)was used to classify the stroke patients according to the symptom characteristics,and multiple classification logistic regression was used to explore the differences in demographic characteristics and disease characteristics among patients with different symptom categories.Results:Stroke patients could be divided into 3 latent classes according to symptom characteristics(P<0.05).According to the conditional probability of each category,they were named as"high symptom,low cognitive impairment,high psychological symptom group"[96 cases(34.9%)],"high symptom,high cognitive impairment,high psychological symptoms group"[139 cases(50.5%)],"low symptom,low cognitive impairment,low psychological symptoms group"[40 cases(14.5%)].The educational level,stroke location,and disease stages were the main factors affecting the classification of symptom characteristics in stroke patients.Conclusions:Stroke patients could be divided into three categories according to symptom characteristics.The psychological symptoms of stroke patients showed a fold line change process in different disease stages.Compared with other staged patients,patients with early recovery and late rehabilitation had a higher risk of psychological symptoms.Compared with highly educated patients,patients with low education had a higher risk of psychological symptoms and cognitive symptoms.In clinical practice,early psychological intervention should be given to stroke patients,and more attention should be paid to low educat

关 键 词：脑卒中 症状 潜在类别分析 多项分类Logistic回归 认知障碍 疾病分期 心理学干预 心理症状 

分 类 号：R473.74[医药卫生—护理学]