老年脑卒中患者心理痛苦轨迹类别及预测因素研究  

Study on the trajectory categories and predictors of psychological distress in elderly stroke patients

作　　者：张新颖 井坤娟[1] 王贝[3] 杜小静[1] 袁蓓[4] 白利静[5] ZHANG Xinying;JING Kunjuan;WANG Bei;DU Xiaojing;YUAN Pei;BAI Lijing(College of Nursing,Hebei University,Baoding 071000,China;Department of Urology,Affiliated Hospital of Hebei University,Baoding 071000,China;Department of Gynecology,Affiliated Hospital of Hebei University,Baoding 071000,China;Department of Neurology,Affiliated Hospital of Hebei University,Baoding 071000,China;Health Science Center of Hebei University,Baoding 071000,China)

机构地区：[1]河北大学护理学院,河北保定071000 [2]河北大学附属医院泌尿外科,河北保定071000 [3]河北大学附属医院妇科,河北保定071000 [4]河北大学附属医院神经内科,河北保定071000 [5]河北大学医学部,河北保定071000

出　　处：《医学研究与教育》2024年第6期42-50,共9页Medical Research and Education

基　　金：2023-2024年度河北省社会科学基金项目(HB23RK003)。

摘　　要：目的探讨老年脑卒中患者心理痛苦发展轨迹及预测因素。方法采用前瞻性纵向研究设计,选取2023年6-7月保定市某三甲医院神经内科的230例老年脑卒中患者为研究对象,采用脑卒中患者心理痛苦温度计分别于入院当天,卒中后2周、6周、8周、12周和24周评估患者的心理痛苦水平,应用增长混合模型确定心理痛苦发展轨迹,应用单因素分析和Logistic回归分析轨迹类别的影响因素。结果共识别出3条心理痛苦轨迹,分别为持续心理痛苦组(23%)、心理痛苦不稳定组(21%)和无心理痛苦组(56%)。Logistic回归分析显示,年龄、功能障碍、应对方式、心理弹性是老年脑卒中患者心理痛苦轨迹的主要预测因素。结论老年脑卒中患者心理痛苦轨迹存在群体异质性,应针对患者的具体情况给予针对性的干预措施。Objective To explore the developmental trajectory and predictors of psychological distress in elderly stroke patients.Methods A prospective longitudinal study design was used to select 230 elderly stroke patients from the department of neurology of a tertiary A-level hospital in Baoding city from June to July 2023,and the level of psychological distress was assessed using a psychological distress thermometer in stroke patients on the day of admission at 2 weeks,6 weeks,8 weeks,12 weeks,and 24 weeks post-stroke respectively,applying a growth mixture model to identify the developmental trajectories of psychological distress,and applying univariate analyses and Logistic regressions to analyse the influences on the categories of trajectories.Results A total of three trajectories of psychological distress were identified,namely the“persistent psychological distress group”(23%),the“unstable psychological distress group”(21%),and the“no psychological distress group”(56%).Logistic regression analysis showed that age,functional impairment,coping style,and psychological resilience were the main predictors of psychological distress trajectories in elderly stroke patients.Conclusion There is group heterogeneity in the trajectory of psychological distress in elderly stroke patients,and patient-specific interventions should be given.

关 键 词：脑卒中 心理痛苦 轨迹 预测因素 增长混合模型 

分 类 号：R473.74[医药卫生—护理学]