脑卒中失能患者恐惧疾病进展风险因素最佳临界值的探索  

Exploration of Optimal Cutoff for Fear of Disease Progression Risk Factors in Patients with Stroke Disability

作　　者：张艳[1] 张欢欢[1] 王珊珊 闫冰[1] 张运霞[1] 刘洁[1] 李博 ZHANG Yan;ZHANG Huanhuan;WANG Shanshan;YAN Bing;ZHANG Yunxia;LIU Jie;LI Bo(Huaihe Hospital of Henan University,Kaifeng 475099,China;School of Nursing and Health of Henan University,Zhengzhou 450000,China)

机构地区：[1]河南大学淮河医院,河南开封475099 [2]河南大学护理与健康学院,河南郑州450000

出　　处：《河南医学研究》2024年第22期4056-4062,共7页Henan Medical Research

基　　金：开封市科技发展计划项目(2203041);开封市科技发展计划项目(2303032);河南省科技攻关项目(192102310348)。

摘　　要：目的探讨脑卒中失能患者恐惧疾病进展现状、导致恐惧疾病进展心理功能失调的风险因素及其影响恐惧疾病进展心理功能失调的最佳临界值,为脑卒中患者恐惧疾病进展干预方案的制定提供依据。方法便利抽取河南大学淮河医院神经内、外科和康复医学科333例脑卒中失能患者,横断面调查患者一般资料、恐惧疾病进展、多维度疲乏、心理韧性和自我感受负担。结果脑卒中失能患者恐惧疾病进展得分为(32.55±8.48)分,发生心理功能失调的患者为170例(51.05%)。logistic回归分析表明医疗费用所占比例、受教育程度、婚姻状况、多维度疲乏、心理韧性和自我感受负担是脑卒中失能患者恐惧疾病进展的影响因素。中介效应分析结果显示疲乏是脑卒中失能患者恐惧疾病进展部分中介效应。最佳临界值分析显示中多维度疲乏得分52.50分,自我感受负担得分36.00分,心理韧性得分50.50分是诱发脑卒中患者恐惧疾病进展心理功能失调状况的最佳临界值。结论应重视脑卒中患者恐惧疾病进展的现状及影响因素,加强脑卒中失能患者病程的随访和高危风险因素评估,对于接近最佳临界值的风险因素及时给予管理,降低因恐惧疾病进展造成的潜在风险,提高脑卒中患者的生活质量及长期生存率。Objective This study aims to investigate the current status of fear of disease progression among stroke-disabled patients,identify the risk factors contributing to psychological dysfunction associated with this fear,and determine the optimal critical values of psychological dysfunction that impact fear of disease progression.The findings will provide a foundation for developing intervention programs tailored to address fear of disease progression in stroke patients.Methods A total of 333 stroke-disabled patients from the Department of Neurosurgery and Rehabilitation Medicine at Huaihe Hospital of Henan University were selected by convenience sampling.The general information,fear of disease progression,multidimensional fatigue,psychological resilience,and self-perceived burden of patients were cross-sectional investigated.Results The average score for fear of disease progression among stroke-disabled patients was(32.55±8.48)points,with 170 patients(51.05%)experiencing psychological dysfunction.Logistic regression analysis indicated that factors such as medical expenses,education level,marital status,multidimensional fatigue,psychological resilience,and self-perceived burden significantly influence fear of disease progression in this population.Mediation effect analysis revealed that fatigue serves as a partial mediator in the relationship between fear of disease progression and psychological dysfunction.Furthermore,the optimal critical value analysis identified that a moderate multidimensional fatigue score 52.50 points,a self-perceived burden score 36.00 points,and a mental toughness score 50.50 points represent the critical thresholds for inducing fear of disease progression and psychological dysfunction in stroke patients.Conclusion Attention should be focused on the current status and influencing factors related to fear of disease progression in stroke patients.It is essential to enhance the follow-up of disease progression and to evaluate high-risk factors in stroke patients with disabilities.Additionally,ti

关 键 词：脑卒中 恐惧疾病进展 疲乏 影响因素 调查研究 

分 类 号：R743[医药卫生—神经病学与精神病学]