疾病感知在急性缺血性脑卒中溶栓治疗患者疾病不确定感和健康行为间的中介效应  

Mediating effects of disease perception on disease uncertainty and health behaviors among thrombolysis therapy in patients with acute ischemic stroke

作　　者：侯雪 王华妍[1] 蒋希旺 韩雪 Hou Xue;Wang Huayan;Jiang Xiwang;Han Xue(Department of Neurology,the Affiliated Huaian No.1 Hospital of Nanjing Medical University,Nanjing 223301,China)

机构地区：[1]南京医科大学附属淮安第一医院神经内科,南京223301

出　　处：《中国实用护理杂志》2023年第23期1785-1791,共7页Chinese Journal of Practical Nursing

摘　　要：目的探讨疾病感知在急性缺血性脑卒中溶栓治疗患者疾病不确定感和健康行为间的中介效应,为提高患者健康行为提供理论基础。方法采用横断面调查方法,2021年6月至2022年6月,采用一般资料调查表、Mishel疾病不确定感量表、脑卒中患者健康行为量表和修订疾病感知问卷,应用便利抽样法对南京医科大学附属淮安第一医院123例急性缺血性脑卒中溶栓治疗患者进行调查。通过构建结构方程模型,验证疾病感知在疾病不确定感与健康行为间的中介效应。结果急性缺血性脑卒中溶栓患者疾病不确定感得分为(52.21±7.67)分,健康行为得分为(63.77±9.40)分,疾病感知得分为(127.70±26.19)分。健康行为及各维度包括运动、服药、指令、营养、责任、烟酒与疾病不确定感呈负相关(r值为-0.762~-0.411,均P<0.01),与疾病感知呈正相关(r值为0.689~0.912,均P<0.01)。疾病不确定感可显著负向预测健康行为(β=-0.71,P<0.01);疾病不确定感也可显著负向预测疾病感知(β=-0.85,P<0.01)。疾病不确定感通过疾病感知对急性缺血性脑卒中溶栓患者健康行为的间接效应显著,疾病感知的中介效应占总效应的15.2%。结论疾病感知在急性缺血性脑卒中溶栓治疗患者疾病不确定感和健康行为间发挥中介调节作用。Objective To explore the mediating effects of disease perception on disease uncertainty and health behaviors among thrombolysis therapy in patients with acute ischemic stroke,to provide a theoretical basis for improving patient health behavior.Methods By cross-sectional survey methods,from June 2021 to June 2022,a total of 123 thrombolysis therapy in patients with acute ischemic stroke were investigated by general information,Mishel Uncertainty in Illness Scale,Health Behavior Scale for Stroke Patients and Revised Illness Perception Questionnaire by convenience sampling method.The mediating effect of disease perception between disease uncertainty and health behavior was verified by structural equation model.Results The scores of disease uncertainty,health behaviors and disease perception were(52.21±7.67),(63.77±9.40),(127.70±26.19)points in patients with acute ischemic stroke.Health behaviors and each dimension including exercise,medication,instruction,nutrition,responsibility,tobacco and alcohol were negatively correlation between disease uncertainty(r values were-0.762 to-0.411,all P<0.01),and positively correlation between disease perception(r values were 0.689 to 0.912,all P<0.01).Disease uncertainty was a significantly negative predictor for health behaviors(β=-0.71,P<0.01);disease perception was also a significantly negative predictor for disease perception(β=-0.85,P<0.01).Disease uncertainty had a significantly indirect effect on the health behaviors for thrombolysis therapy in patients with acute ischemic stroke through disease perception,which showed the mediating effect of health behaviors accounts for 15.2%of total effect.Conclusions Disease perception play a mediating role in the relationship between disease uncertainty and health behaviors among thrombolysis therapy in patients with acute ischemic stroke.

关 键 词：健康行为 急性缺血性脑卒中 静脉溶栓 疾病感知 疾病不确定感 中介效应 

分 类 号：R473.74[医药卫生—护理学]