脑卒中后吞咽障碍病人安全进食行为现状及影响因素  

Status quo and influencing factors of safe feeding behavior in patients with post⁃stroke dysphagia

作　　者：李璐璐[1] 朱明芳[1] 张驰[1] 范雯霏 杨梦园 马梦珂 LI Lulu;ZHU Mingfang;ZHANG Chi;FAN Wenfei;YANG Mengyuan;MA Mengke(Henan Provincial People's Hospital,Henan 450003 China)

机构地区：[1]河南省人民医院,河南450003

出　　处：《护理研究》2023年第23期4175-4181,共7页Chinese Nursing Research

基　　金：2021年河南省医学科技攻关计划联合共建项目,编号:LHGJ20210021。

摘　　要：目的:了解脑卒中后吞咽障碍(PSD)病人的安全进食行为现状,并分析其影响因素。方法:选取2021年2月—2022年10月某三级甲等医院就诊的PSD病人251例为研究对象。采用一般资料问卷、PSD病人安全进食行为评价量表、家庭关怀度量表、健康信念模式量表及慢性病自我效能量表对其进行调查,并分析家庭关怀度、健康信念与自我效能对安全进食行为的影响路径。结果:PSD病人的安全进食行为得分为(79.45±21.09)分;安全进食行为得分与家庭关怀度、健康信念及自我效能得分呈正相关(均P<0.01)。基于Bootstrap的路径分析显示,健康信念、自我效能对安全进食行为存在直接正向影响,健康信念、自我效能在家庭关怀度和安全进食行为间的间接效应显著,总间接效应为0.455,占总效应值的75.58%。结论:健康信念和自我效能在PSD病人家庭关怀度与其安全进食行为间起中介效应,应基于病人⁃照顾者的二元干预策略提升PSD病人的家庭关怀度,帮助病人树立积极的健康信念以及康复信心,以提升其安全进食行为水平。Objective:To understand the status quo of safe feeding behavior in patients with post⁃stroke dysphagia(PSD),and to analyze its influencing factors.Methods:A total of 251 patients with PSD in a tertiary grade A hospital from February 2021 to October 2022 were selected as the subjects by convenience sampling method.The general situation questionnaire,Safe Feeding Assessment Scale for Patients with Post⁃Stroke Dysphagia,Family APGAR Questionnaire,the Health Belief Model Scale and the Chronic Disease Self⁃Efficacy Scale were used to conduct the questionnaire survey.The influence of family caring degree,health belief and self⁃efficacy on safe eating behavior in patients with post⁃stroke dysphagia was analyzed.Results:The score of safe eating behavior in PSD patients was 79.45±21.09.There were positively correlated with the total score of safe eating behavior and the total score of family caring,health belief and self⁃efficacy(all P<0.01).The path analysis based on Bootstrap showed that health belief and self⁃efficacy had direct positive impact on safe eating behavior in PSD patients.The indirect effect of health belief and self⁃efficacy on family caring degree and safe eating behavior were significant,and the total indirect effect was 0.455,accounting for 75.58%of the total effect value.Conclusions:Health belief and self⁃efficacy played mediating effects between family caring and safe eating behavior of PSD patients.The patient⁃caregiver dual intervention strategy should be used to improve family caring degree of PSD patients,and help patients establish positive health belief and recovery confidence to improve their safe eating behavior level.

关 键 词：脑卒中后吞咽障碍 安全进食行为 家庭关怀 健康信念 自我效能 影响因素 相关性 

分 类 号：R473.74[医药卫生—护理学]