中青年脑卒中患者复发风险感知与客观复发风险的一致性分析  

Self-perceived and actual risk of stroke recurrence in young and middle-aged stroke patients

作　　者：李磊 张金梅 文喆卿 靳宇敏 李红玉 Li Lei;Zhang Jinmei;Wen Zheqing;Jin Yumin;Li Hongyu(Faculty of Nursing,Fenyang College of Shanxi Medical University,Lüliang 032200,China)

机构地区：[1]山西医科大学汾阳学院护理学系,山西吕梁032200 [2]山西省汾阳医院神经内科

出　　处：《护理学杂志》2024年第1期37-41,共5页Journal of Nursing Science

基　　金：吕梁市科技计划项目(吕科发(2020)33号-15)。

摘　　要：目的分析中青年脑卒中患者复发风险感知与客观复发风险的一致性,并探讨影响一致性的因素,为提高评估准确性、减少复发提供参考。方法对337例中青年脑卒中患者采用一般资料调查表、Essen卒中风险评分、脑卒中复发风险感知问题、恐惧疾病进展简化量表、自我感受负担量表、社会支持评定量表、改良Barthel指数量表进行调查,分析一致性及影响因素。结果一致性分析结果为低估100例(29.7%),准确173例(51.3%),高估64例(19.0%),Kappa值为0.110(P<0.05);多因素logistic回归分析结果显示,年龄、文化程度、恐惧疾病进展、社会支持程度是中青年脑卒中患者复发风险低估的影响因素(均P<0.05);恐惧疾病进展、Barthel指数和自我感受负担是复发风险高估的影响因素(均P<0.05)。结论中青年脑卒中患者复发风险感知与客观复发风险不完全一致,需要重点关注年轻、文化程度低的患者,增加患者的社会支持,改善自理能力,减轻自我感受负担,从而提升其复发风险认知的准确性,促进患者采纳健康行为,减少复发。Objective To analyze the consistency of perceived risk and actual risk of recurrent stroke in young and middle-aged patients,to explore the influencing factors,and to provide reference for enhancing accuracy of perceptions and reducing stroke recurrence.Methods A total of 337 young and middle-aged stroke patients were invited to complete a battery of questionnaires including a self-designed demographic questionnaire,the Essen Stroke Risk Score,Perceived Risk of Stroke Recurrence,short form of the Fear of Progression Questionnaire,Self-perceived Burden Scale,Social Support Rating Scale,and Modified Barthel Index Scale.Results Among 337 participants,100(29.7%)underestimated,173(51.3%)accurately estimated,and 64(19.0%)overestimated their risk,with the kappa coefficient of 0.110(P<0.05).Multinomial logistic regression analysis showed that age,education level,fear of disease progression,and social support were factors associated with the underestimation of recurrent risk,whereas fear of disease progression,Barthel index,and self-perceived burden were factors affecting overestimation of recurrent risk(all P<0.05).Conclusion The level of agreement between perceived and actual risk of recurrent stroke in young and middle-aged patients is low.There is a need to focus on young patients and those with lower education level,enhance social support,improve self-care ability,and alleviate self-perceived burden,thereby enhancing the accuracy of their recurrent risk perception.This,in turn,promotes the adoption of healthy behaviors and reduces the risk of recurrence.

关 键 词：中青年 脑卒中 复发风险感知 客观风险 社会支持 恐惧疾病进展 自我感受负担 自理能力 

分 类 号：R473.74[医药卫生—护理学] R743.3[医药卫生—临床医学]