脑卒中高危人群抑郁症状潜在类别分析及影响因素研究  

Analysis of potential categories of depression symptoms and influencing factors in high-risk stroke populations

作　　者：张杰[1] 何福培 林蓓蕾[1] 张振香[1] 张春慧[1] 张秋实[1] ZHANG Jie;HE Fu-ping;LIN Bei-lei;ZHANG Zhen-xiang;ZHANG Chun-hui;ZHANG Qiu-shi(School of Nursing and Health,Zhengzhou University,Zhengzhou,Henan 450000,China)

机构地区：[1]郑州大学护理与健康学院,河南郑州450000

出　　处：《现代预防医学》2024年第19期3643-3648,共6页Modern Preventive Medicine

基　　金：河南省科技厅科技公关项目(232102310170)。

摘　　要：目的 利用潜在类别分析法对脑卒中高危人群抑郁症状潜在类别进行探讨,并分析不同特征脑卒中高危人群抑郁症状的差异。方法 使用一般资料调查表、患者健康问卷-9和社会支持评定量表对河南省多家社区卫生服务中心585名脑卒中高危人群进行调查,利用Mplus 8.3进行潜在类别分析,通过单因素分析和无序多分类logistic回归分析探究不同类别脑卒中高危人群抑郁症状的影响因素。结果 最终共调查585例脑卒中高危人群,抑郁症状检出率为26.7%。脑卒中高危人群抑郁症状可分为:高水平-身心疲劳-专注困难抑郁型(C1,16.8%)、中水平-情绪低落抑郁型(C2,11.1%)、中水平-躯体疲劳抑郁型(C3,25.1%)、低水平-睡眠障碍抑郁型(C4,47.0%)。与低水平-睡眠障碍抑郁型脑卒中高危人群相比,女性(OR=0.473,95%CI:0.266~0.842)更容易归为中水平-情绪低落抑郁型,文化程度为初中及以下者(OR=2.684,95%CI:1.213~5.935)容易归为高水平-身心疲劳-专注困难抑郁型,社会支持水平低者(OR=0.941,95%CI:0.914~0.968)容易归为中水平-躯体疲劳抑郁型,具有≥5个脑卒中危险因素(OR=0.292,95%CI:0.123~0.697;OR=0.310,95%CI:0.122~0.788;OR=0.271,95%CI:0.122~0.599;OR=0.246,95%CI:0.104~0.579)、自评健康状况越差者(分别OR=2.197,95%CI:0.1.655~2.917;OR=0.1.353,95%CI:1.067~1.716)容易归于高水平-身心疲劳-专注困难抑郁型和中水平-躯体疲劳抑郁型。结论 脑卒中高危人群抑郁症状具有明显的分类特征。临床医护人员应积极识别脑卒中高危人群抑郁症状特征,针对不同潜在类别制定及时有效的干预措施,以改善脑卒中高危人群的抑郁情绪。Objective To explore the potential categories of depression symptoms in high-risk stroke populations using latent class analysis,and to analyze the differences in depression symptoms among various groups within this population.Methods A survey was conducted involving 585 individuals from multiple community health service centers in Henan Province,utiliz-ing a general information questionnaire,the Patient Health Questionnaire-9,and the Social Support Rating Scale.Latent class analysis was performed using Maples 8.3,and univariate analysis and unordered multi-class logistic regression were employed to investigate the influencing factors of depression symptoms across different categories of high-risk stroke popula-tions.Results A total of 585 high-risk stroke individuals were surveyed,revealing a depression symptom detection rate of 26.7%.The depression symptoms in this population could be categorized into four types:high-level-physical and mental fatigue-difficulty concentrating depression type(C1,16.8%),medium-level-low mood depression type(C2,11.1%),medi-um-level-physical fatigue depression type(C3,25.1%),and low-level-sleep disturbance depression type(C4,47.0%).Compared to the low-level-sleep disturbance depression type,females(OR=0.473,95%Cl:0.266-0.842)were more likely to be classified as medium-level-low mood depression type,individuals with a middle school education or below(OR=2.684,95%Cl:1.213-5.935)were more likely to be classified as high-level-physical and mental fatigue-difficulty con-centrating depression type,and those with low social support levels(OR=0.941,95%Cl:0.914-0.968)were more likely to be classified as medium-level-physical fatigue depression type.Additionally,individuals with≥5 stroke risk factors(OR=0.292,95%CI:0.123-0.697;0R=0.310,95%CI:0.122-0.788;0R=0.271,95%CI:0.122-0.599;OR=0.246,95%CI:0.104-0.579)and those with poorer self-rated health status(OR=2.197,95%CI:1.655-2.917;OR=1.353,95%CI:1.067-1.716)were more likely to fall into the high-level-physical and mental fatigue-difficulty co

关 键 词：脑卒中 高危人群 抑郁 潜在类别分析 影响因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R749.4[医药卫生—临床医学]