新疆某二甲医院脑卒中患者及高危人群自我管理现状调查  

A status survey of self-management of individuals with stroke and high risk of stroke in a Second-class hospital in Xinjiang

作　　者：黄冰雪 杨婷[1] 宋金燕 韦艳[1] Huang Bingxue;Yang Ting;Song Jinyan;Wei Yan(Medical Department Changji Branch of the First Affiliated Hospital of Xinjiang Medical University,Changji 831100,China)

机构地区：[1]新疆医科大学第一附属医院昌吉分院医务部,831100

出　　处：《中华脑血管病杂志（电子版）》2021年第3期175-180,共6页Chinese Journal of Cerebrovascular Diseases(Electronic Edition)

基　　金：昌吉州科学研究与技术开发计划项目—经脑卒中防治中心筛查的高危患者的管理现状及需求分析(2019S02-14);新疆医科大学第一附属医院昌吉分院科研项目—应用微信公众平台进行卒中健康宣教的满意度调查(2018011)。

摘　　要：目的调查新疆某二甲医院住院患者中脑卒中高危人群的相关危险因素管理现状,分析促进自我管理的保护因素。方法2019年10月1日至12月31日在新疆医科大学第一附属医院昌吉分院通过调查问卷采集257例住院患者的人口学及行为学信息,按照患者的自我管理情况将其分为完全控制组、部分控制组和完全未控制组,采用单因素分析比较组间人口学及行为学信息的差异,差异具有统计学意义的因素采用多因素Logistic回归的方法分析影响患者自我管理的因素。并对患者希望得到的健康教育方式展开调查。结果相对于完全未控制组,部分控制组能够进行脑卒中相关自我管理的保护因素包括汉族[调整后优势比(AOR)=3.373,95%CI:1.182~9.623,P=0.023],愿意改变不良生活方式(AOR=4.261,95%CI:1.484~12.237,P=0.007),认为疾病监测有意义(AOR=5.601,95%CI:2.043~15.350,P=0.001),以及愿意做颈动脉超声检查(AOR=30.672,95%CI:10.035~93.754,P=0.001);完全控制组包括汉族(AOR=4.385,95%CI:1.060~18.139,P=0.041),获得过健康指导(AOR=10.405,95%CI:1.061~102.048,P=0.044),认为疾病监测有意义(AOR=22.400,95%CI:2.213~226.722,P=0.008),愿意做颈动脉超声检查(AOR=16.143,95%CI:3.823~68.163,P=0.001)。健康宣教方面,48.6%的患者希望得到住院指导,28.4%的患者希望能够在门诊咨询,24.9%的患者希望能够发放教育手册,20.6%的患者希望通过微信获得健康知识。结论通过分析脑卒中患者及高危人群自我管理的现状,有助于发掘促进自我管理的保护因素,通过健康宣教,扩大保护因素影响范围,进而增强患者自我管理的动机与效能。Objective To investigate the management status of risk factors and protective factors in order to promote self-management among inpatients at high risk of stroke in a second-class hospital in Xinjiang.Methods Demographic and behavioral information of 257 hospitalized patients were collected through questionnaires in the Changji Branch of the First Affiliated Hospital of Xinjiang Medical University from October 1 th,2019 to December 31 th,2019.According to the self-management status,the patients were divided into all control groups(AC),partial control group(PC),and no control group(NC).The multivariant Logistic analysis was applied to analyze the factors influencing patients’self-management.Results Compared with the NC group,the protective factors for stroke related self-management in the PC group included Han nationality[Adjusted odds ratio(AOR)=3.373,95% CI:1.182-9.623,P=0.023],willingness to change adverse lifestyle(AOR=4.261,95%CI:1.484-12.237,P=0.007),belief in the significance of disease surveillance(AOR=5.601,95% CI:2.043-15.350,P=0.001),and willingness to carotid ultrasound(AOR=30.672,95% CI:10.035-93.754,P=0.001).Those significant protective factors in the AC group included the Han nationality(AOR=4.385,95% CI:1.060~18.139,P=0.041),received health guidance(AOR=10.405,95% CI:1.061~102.048,P=0.044),considered that disease surveillance was significant(AOR=22.400,95% CI:2.213~226.722,P=0.008),and underwent carotid ultrasound examination(AOR=16.143,95% CI:3.823~68.163,P=0.001).In terms of health education,48.6% of patients hoped to receive inpatient guidance,28.4%hoped to receive consultation in outpatient service,24.9% hoped to receive educational manuals,and 20.6%hoped to obtain health knowledge through We Chat.Conclusion By analyzing the status of self-management of stroke patients and high-risk individuals,it was helpful to explore the protective factors that promote self-management,and to extend the influence of protective factors through health education,so as to enhance the motivation and efficiency o

关 键 词：脑卒中 自我管理 影响因素 健康教育 

分 类 号：R743.3[医药卫生—神经病学与精神病学]