急性缺血性脑卒中患者家庭动力学和习得性无助感对延迟就医的影响  

Effect of family dynamics and learned helplessness on delayed medical treatment in patients with acute ischemic stroke

作　　者：庄平[1] 张佛明[1] 陈凤梅[1] 覃小静[1] 易玲[1] 刁海娟 Zhuang Ping;Zhang Foming;Chen Fengmei;Qin Xiaojing;Yi Ling;Diao Haijuan(Brain Disease Centre,Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangzhou,510120,China)

机构地区：[1]广东省中医院脑病中心,广东广州510120

出　　处：《现代临床护理》2022年第5期15-19,共5页Modern Clinical Nursing

基　　金：广东省科技创新战略专项资金(省基础与应用基础研究基金自然科学基金)面上项目,项目编号为2021A1515011480。

摘　　要：目的探讨急性缺血性脑卒中(acute ischemic stroke,AIS)患者家庭动力学和习得性无助感与延迟就医的关系,为促进AIS患者得到及时诊治提供依据支持。方法采用便利抽样法,选取2020年11月至2021年8月本院收治的110例AIS患者为研究对象,按照患者的就医时间,将其分为及时就医组(n=49,就医时间<3h)和延迟就医组(n=61,就医时间≥3h),采用一般资料调查表、系统家庭动力学自评问卷和习得性无助量表对患者进行调查,并对AIS患者出现延迟就医的影响因素进行单因素分析和多因素Logistic回归分析。结果不同文化程度、就医方式和就诊途径的AIS患者延迟就医情况比较,差异均有统计学意义(均P<0.05)。延迟就医组的家庭动力学评分为(105.31±7.25)分,习得性无助感评分为(40.92±4.77)分,明显高于及时就医组的(87.69±5.28)分、(33.78±3.41)分,差异均有统计学意义(t=14.242、8.820,均P<0.001)。家庭动力学评分高(OR=0.934,95%CI:0.886~0.985)、习得性无助感评分高(OR=0.751,95%CI:0.606~0.929)、普通门诊就诊(OR=0.004,95%CI:0~0.450)是AIS患者延迟就医的独立危险因素(均P<0.05)。结论AIS患者延迟就医水平总体较高,家庭动力学、习得性无助感、就诊途径是影响AIS患者延迟就医的重要因素。医护人员应以家庭为单位进行脑卒中一级预防的科普宣传,以有效降低AIS患者延迟就医的发生。Objective To explore the correlations of family dynamics and learned helplessness in delayed medical treatment among the patients with acute ischemic stroke(AIS)so as to provide a basis for timely diagnosis and treatment of AIS patients.Methods A total of 110 AIS patients admitted to our hospital from November 2020 to August 2021 were selected as the research objects by the convenience sampling method.The patients were divided into timely treatment group(n=49,time for medical treatment<3 h)and delayed treatment group(n=61,time for medical treatment≥3 h).The patients were studied through a survey of general information questionnaire,the systematic family dynamics self-assessment questionnaire and the learned helplessness scale.The influencing factors of delayed medical treatment in AIS patients were analysed by univariate analysis and multivariate logistic regression analysis.Results There were significant differences in the delayed medical treatment across AIS patients with different educational levels,methods of medical treatment and approach to treatment(all P<0.05).The scores of family dynamics and learned helplessness in the delayed treatment group were significantly higher than those in the timely treatment group(105.31±7.25 vs 87.69±5.28;40.92±4.77 vs 33.78±3.41,t=14.242,8.820,respectively;both P<0.01).Family dynamics score at(OR=0.934,95%CI:0.886-0.985),learned helplessness score at(OR=0.751,95%CI:0.606-0.929)and approach to treatment with(OR=0.004,95%CI:0-0.450)were the influencing factors for the delayed medical treatment(all P<0.05).Conclusions The overall level of delayed medical treatment in AIS patients is relatively high.Family dynamics,learned helplessness and approach to treatment are the risk factors affecting the delayed medical treatment in AIS patients.Medical staff should take the family as whole in the public education on primary prevention of stroke so as to effectively reduce the incidence of delayed medical treatment of the patients.

关 键 词：急性缺血性脑卒中 延迟就医 家庭动力学 习得性无助感 

分 类 号：R473.74[医药卫生—护理学]