中医体质下脑卒中患者自我管理行为现状及相关性分析

Current status and correlation analysis of self-management behaviors among stroke patients based on their traditional Chinese medicine constitutions

关键词:  脑卒中  自我管理行为  家庭关怀度  恐惧疾病进展  慢性病资源利用

Key words:  stroke  self-management behavior  family care  fear of disease progression  chronic disease resource utilization

摘要:

[目的] 了解中医体质下脑卒中患者自我管理行为现状及影响因素，并探讨其与家庭关怀度、恐惧疾病进展及慢性病资源利用四者之间的相关性。[方法] 采用便利抽样法，于2022年2月—2023年5月选取天津市某1所三级甲等医院共408例脑卒中住院患者为调查对象，使用一般资料调查表、家庭关怀度指数问卷(APGAR)、恐惧疾病进展量表(FoP-Q-SF)、慢性病资源调查问卷(CIRS)、中医体质分类与判定量表及中风患者自我管理行为评定量表进行问卷调查。[结果] 脑卒中患者自我管理行为总分为(168.29±44.01)分，家庭关怀度总分为(5.47±2.60)分，恐惧疾病进展总分为(31.86±13.36)分，慢性病资源利用总分为(68.67±14.53)分；脑卒中患者自我管理行为与家庭关怀度呈正相关(r=0.753，P<0.01)，与恐惧疾病进展呈负相关(r=-0.666，P＜0.01)；与慢性病资源利用呈正相关(r=0.660，P＜0.01)。多元线性回归分析结果显示，性别、居住地、居住情况、婚姻状况、文化程度、自理能力、家庭关怀度、恐惧疾病进展以及慢性病资源利用为脑卒中患者自我管理行为的独立危险因素(P＜0.05)。[结论] 中医体质下脑卒中患者自我管理行为处于中等水平，性别、居住地、居住情况、婚姻状况、文化程度、自理能力、家庭关怀度、恐惧疾病进展以及慢性病资源利用是影响脑卒中患者自我管理行为的独立危险因素。提示相关医务工作者应加强脑卒中患者健康宣教以及心理建设，发挥中医康复特色疗法干预患者，鼓励患者充分利用家庭关怀，正确认识疾病，重视积极心理品质对于患者康复的关键性，激发患者应对疾病的内在潜力，促进慢性病资源利用，削弱对于疾病进展的恐惧程度，有助于患者做好康复，进而促进其自我管理行为。

Abstract:

[Objective] To understand the current status and influencing factors of self-management behavior in stroke patients,and to explore its correlation with family care,fear of disease progression,and utilization of chronic disease resources. [Methods] Convenience sampling was used to select 408 stroke inpatients from a tertiary Grade A hospital in Tianjin from February 2022 to May 2023 as the survey subjects. The general information questionnaire,Family APGAR Scale,Fear of Disease Questionnaire,Chronic IHes Rsoures Survey,Traditional Chinese Medicine Constitution Classification and Judgment Scale,and the Stroke Patient Self Management Behavior Rating Scale were used to investigate the questionnaire. [Results] The total score of self-management behavior in stroke patients was 168.29±44.01,the total score of family care was 5.47±2.60,and the total score of fear of disease progression was 31.86±13.36,and the total score of chronic disease resource utilization was 68.67±14.53. The self-management behavior of stroke patients was positively correlated with family care(r=0.753,P<0.01),and negatively correlated with fear of disease progression(r=-0.666,P<0.01). It is positively correlated with the utilization of chronic disease resources(r=0.660,P<0.01). The results of multiple linear regression analysis showed that gender,place of residence,residential situation,marital status,educational level,self-care ability,family care level,fear of disease progression,and utilization of chronic disease resources were independent risk factors for self-management behavior in stroke patients(P<0.05). [Conclusion] Under the traditional Chinese medicine constitution,the self-management behavior of stroke patients is at a moderate level. Gender,place of residence,housing situation,marital status,education level,self-care ability,family care level,fear of disease progression,and utilization of chronic disease resources are independent risk factors affecting the self-management behavior of stroke patients. It is suggested that relevant medical workers should strengthen health education and psychological construction for stroke patients,utilize traditional Chinese medicine rehabilitation therapy to intervene in patients,encourage patients to utilize family carefully,correctly understand the disease,attach importance to the key role of positive psychological qualities inpatient rehabilitation,stimulate the intrinsic potential of patients to cope with the disease,promote the utilization of chronic disease resources,weaken the fear of disease progression,and help patients to do well in rehabilitation,thereby promoting their self-management behavior.