周历活动规划评估脑卒中患者生态执行功能的初步研究  

A pilot study of the Weekly Calendar Planning Activity on evaluating ecological executive functions in patients with stroke

作　　者：公晨 王荣丽[1] 王宁华[1] GONG Chen;WANG Rongli;WANG Ninghua(Department of Rehabilitation Medicine,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]北京大学第一医院康复医学科,北京100034

出　　处：《中国心理卫生杂志》2022年第4期324-330,共7页Chinese Mental Health Journal

摘　　要：目的:应用周历活动规划初步评估成人脑卒中患者的生态执行功能特点。方法:选取57例符合中国急性脑卒中诊治指南中的诊断标准,经头颅CT或MRI证实的住院脑卒中患者和53例年龄、性别、受教育年限与之匹配的正常对照,使用周历活动规划中文版评估其生态执行功能。结果:脑卒中组WCPA准确数、填写数、规则遵守数、策略使用数、自我觉察数得分低于对照组,错误数高于对照组。两组总时间、计划时间差异无统计学意义。在策略使用类型上,脑卒中组使用“停顿重读”、“划线、圈,高亮关键词”、“使用手指”、“划掉或高亮已填安排”、“书面计划”以及“自我检查”的策略的比例低于正常对照组(均P<0.05)。策略使用与准确数、填入数呈现正相关(r=0.28~0.61,均P<0.05)。结论:本研究结果提示脑卒中患者存在抑制控制、问题解决、工作记忆、认知灵活性以及策略使用的缺陷,周历活动规划可作为评估脑卒中患者生态执行功能的有用工具。Objective:To evaluate the characteristics of ecological executive function with the Weekly Calendar Planning Activity in adults with stroke.Methods:Fifty-seven hospitalized patients diagnosed with stroke that confirmed by CT or MRI and 53 community controls matched with age,gender and education background were included in the study.The Chinese version of the Weekly Calendar Planning Activity(WCPA)was used to evaluate ecological executive function.Results:The stroke group had significantly fewer numbers of accurate appointments,numbers of entered appointments,rules followed,strategies used,self-recognized errors,and more numbers of errors than the control group(Ps<0.001).There were no significant differences between the two groups ontotal time required for WCPA completion and planning time.In types of used strategy,the stroke group was less likely to use reread,highlight keywords,uses finger,cross off,written plans and self-checks strategies than the control group(Ps<0.05).Strategy use was significantly correlated to WCPA accuracy and numbers of entered appointments in both groups(r=0.28-0.61.P<0.05).Conclusion:It shows that patients with stroke have deficits in inhibition control,problem solving,working memory,cognitive flexibility and strategy use.The Weekly Calendar Planning Activity may be a useful tool to evaluate ecological executive function in patients with stroke.

关 键 词：脑卒中 执行功能 周历活动规划 

分 类 号：R743.3[医药卫生—神经病学与精神病学]