不同病程脑卒中后残疾患者社会参与水平及影响因素分析

目的 :探索6、12、18个月3个不同病程脑卒中后残疾患者的社会参与水平及其影响因素。方法 :采用整群随机抽样,选取2018年6月至2019年3月哈尔滨医科大学附属第五医院3个不同病程脑卒中后残疾患者各70例,共210例。采用一般情况调查表、改良Rankin量表、自主参与问卷(ImpactonParticipation andAutonomyQuestionaire,IPA)、抑郁自评量表、一般自我效能量表、美国国立卫生院卒中量表(National InstituteofHealthstrokescale,NIHSS)、家庭关怀度指数测评表(APGAR问卷)进行问卷调查。结果 :描述性分析显示,脑卒中后6、12、18个月病程的患者多为中、重度残疾,中度残疾者分别占24.30%、44.30%、30.00%,重度残疾者分别占48.60%、40.00%、52.90%;3个病程患者的IPA评分分别为(44.41±14.99)分、(42.43±13.08)分、(48.60±14.03)分,其中3个病程间、12个月与18个月病程的IPA评分有统计学差异(P<0.05)。多元回归结果显示影响6、12、18个月脑卒中后残疾患者社会参与水平的因素分别为残疾程度、抑郁情绪;婚姻、抑郁情绪及NIHSS评分;残疾程度、抑郁情绪(P<0.05)。结论 :不同病程脑卒中后残疾患者的社会参与水平有待改善,社会参与水平的影响因素各异,应采取针对性干预策略以改善其社会参与水平。

Social participation level and its associated factors of disabled patients with different course of stroke

Objective: To explore the social participation level and its associated factors of disabled patients with stroke in 3 different disease stages disease of 6, 12, and 18 months. Methods: From June 2018 to March 2019, a total of 210 disabled patients with stroke within 3 months, 12 months and 18 months respectively in the Fifth Affiliated Hospital of Harbin Medical University were selected with 70 patients in each disease stages. A set of questionnaires including Self-made General Situation Questionnaire(SGSQ), modified Rankin Scale(mRS), Impact on Participation and Autonomy questionnaire(IPA), Self-rating Depression Scale(SDS), General Self-Efficacy Scale(GSES), National Institute of Health Stroke Scale(NIHSS), and Family Care Index Assessment Form(APGAR Questionnaire) was used. Results: It was showed that patients with a course of disease at 6, 12, and 18 months after stroke were mostly moderately or severely disabled. Those with moderate disabilities accounted for 24.30%, 44.30%, and 30.00%, for 6 months, 12 months, and 18 months respectively. Those with severe disabilities accounted for 48.60% and 40.00%, 52.90% for 6 months, 12 months, and 18 months respectively. IPA scores were(44.41±14.99),(42.43±13.08),(48.60±14.03) for these 3 different disease durations. The IPA scores among 3 coures were significantly different(P<0.05). The IPA scores of 12 and 18 months were significantly different(P<0.05). Multiple regression showed associated factors with the social participation level of disabled patients with stroke at 6, 12, and 18 months were disabled level and depression;marriage, depression, and NIHSS score, and disabled level and depression, respectively(all P<0.05). Conclusion: The social participation level of disabled patients with different disease duration after stroke needs to be improved. Associated factors with social participation level are different among patients with different disease duration. Targeted interventions are needed to improve the social participation level of patients with stroke.