中青年脑卒中患者自我管理能力及影响因素研究

科研成果详情

题名	中青年脑卒中患者自我管理能力及影响因素研究
其他题名	Study on self-management ability and influencing factors of young and middle-aged stroke patients
作者	曹拂晓
学位类型	硕士
导师	张春梅
答辩日期	2021-11-29
学位授予单位	温州医科大学
学位专业	护理
关键词	中青年脑卒中家庭关怀自我管理
摘要	研究目的：了解中青年脑卒中患者自我管理的能力,分析影响自我管理能力的因素,探讨家庭关怀度与中青年脑卒中患者自我管理能力的影响，为进一步提升患者的自我管理能力提供理论依据。研究方法：本研究为量性研究和质性研究相结合的混合研究。量性研究部分：选取2021年1月至2021年6月对温州市两家三甲医院神经内科中符合纳入和排除标准的住院患者作为研究对象，用一般资料调查表、中青年脑卒中患者自我管理能力量表（包括症状管理、情绪管理、日常生活管理、康复锻炼、资源利用5个维度,共26个条目，总分130分，Cronbach's α系数为0.908）、家庭关怀度测评表（Family APGAR Index）（包括适应度、亲密度、合作度、成熟度、情感度5个维度，总分10分，Cronbach's α系数为0.813）、及Barthel指数评定量表(Barthel Index，BI）（包括进食、如厕、二便、转移等10个动作的评估），对研究对象进行问卷调查。采用T检验、方差分析、非参数检验、Spearman秩相关、多元回归分析等方法进行统计分析。质性研究部分：以现象学方法为指导，选取12名中青年脑卒中患者进行半结构式访谈，访谈结束后及时转录访谈资料，根据 Colaizzi 分析法进行资料分析，直至资料饱和状态，无新的信息出现。深入了解中青年脑卒中患者自我管理能力并挖掘影响因素。研究结果; 1.量性研究结果（1）中青年患者自我管理的总得分为109.25±22.67分。五个维度进行分析发现资源利用的分值最高为18.12±3.12分，得分率为90.6%，其他依次分别是日常生活管理24.96±6.44分，得分率为83.2%、康复锻炼15.87±4.97分，得分率79.3%、情绪管理15.47±4.86分，得分率为77.3%、症状管理30.79±5.63分，得分率为77%。（2）中青年脑卒中家庭关怀度的总得分为8.84±2.53分，处于中等偏上水平，各维度得分从高到低依次为：适应度1.80±0.48分、亲密度1.80±0.44分、合作度1.79±0.51分、成熟度1.77±0.55分、情感度1.71±0.61分。（3）通过Spearman相关性分析，结果显示中青年脑卒中患者的家庭关怀度与自我管理能力呈正相关（r=0.650，P<0.001）；（4）进行多元回归分析，结果显示:家庭月收入、患者居住地和家庭关怀度是影响中青年脑卒中患者自我管理能力的独立因素（显著性P<0.001）。 2.质性研究结果中青年脑卒中患者自我管理真实体现主要表现在一下四个方面：健康素养低、经历不同的心理变化过程、社会支持不足、未来生活展望。研究结论及建议： 1. 中青年脑卒中患者自我管理能力处于中等偏上水平，其中情绪管理和症状管理两个维度得分偏低；中青年脑卒中患者家庭关怀度处于中等偏上水平，其中其情感度的得分最低； 2. 家庭平均月收入、患者居住地和家庭关怀度是影响中青年脑卒中患者自我管理能力的主要因素；家庭关怀度与中青年脑卒中患者自我管理能力成正相关。 3.中青年脑卒中患者自我管理真实体现主要表现在以下四个方面：健康素养低、经历不同的心理变化过程、社会支持不足、未来生活展望。 4.建议在临床工作上关注中青年脑卒中患者的情绪，特别是病程的初期，对中青年脑卒中患者的负性情绪及时予以干预，帮助其更好的适应疾病后期漫长的工作生活。关注居住地在农村的患者，针对性开展多元化信息传递，开展以家庭为中心的护理干预,有效发挥家庭的支持作用,鼓励病人参与诊疗决策,增加对未来的希望。增加物资支持，如居住环境改造及合适的轮椅，助行器，安全保障相关设备提供。
其他摘要	Research Objectives: To understand the self-management ability of middle-aged and young stroke patients, analyze the factors affecting the self-management ability, explore the influence of family care degree and the self-management ability of middle-aged and young stroke patients, and provide theoretical basis for further improving the self-management ability of patients. Research methods: This study is a mixture of quantitative research and qualitative research. Quantitative research part: Choose between January 2021 and June 2021 in wenzhou two 3 armour hospital neurology in hospitalized patients met inclusion and exclusion criteria as the research object, using the general information questionnaire, middle-aged and young patients with cerebral apoplexy self-management ability scale (including symptoms, emotional management, daily management, rehabilitation exercise, the resources use five dimensions, a total of 26 items, The total score was 130, Cronbach's α coefficient was 0.908), and Family APGAR Index (including fitness, intimacy, cooperation, maturity and emotion, the total score was 10. Cronbach's α coefficient was 0.813), Barthel Index (BI) (including the evaluation of 10 actions such as eating, toilet-going, defecation and transfer), and questionnaire survey was conducted on the subjects. T test, variance analysis, non-parametric test, Spearman rank correlation and multiple regression analysis were used for statistical analysis. Qualitative research: Under the guidance of phenomenological method, 12 middle-aged and young stroke patients were selected for semi-structured interview. After the interview, the interview data were tranwritten in time and analyzed according to Colaizzi analysis method until the data were saturated and no new information appeared. To deeply understand the self-management ability of young and middle-aged stroke patients and explore the influencing factors. 1. Research Results (1) The total score of self-management in middle-aged and young patients was 109.25±22.67. The analysis of five dimensions found that the highest score of resource utilization was 18.12±3.12, with a scoring rate of 90.6%, followed by daily life management 24.96±6.44, with a scoring rate of 83.2%, rehabilitation exercise 15.87±4.97, emotional management 15.47±4.86, respectively. The scoring rate was 77.3% and symptom management was 30.79±5.63, with a scoring rate of 77%. (2) The total score of family care degree of stroke in young and middle-aged adults was 8.84±2.53, which was above the middle level. The scores of each dimension from high to low were as follows: Fitness 1.80±0.48 points, intimacy 1.80±0.44 points, cooperation 1.79±0.51 points, maturity 1.77±0.55 points, emotion 1.71±0.61 points. (3) Spearman correlation analysis showed that there was a positive correlation between family care and self-management ability in young and middle-aged stroke patients (R =0.650, P<0.001). (4) Multiple regression analysis showed that monthly family income, patient residence and family care were independent factors affecting the self-management ability of young and middle-aged stroke patients (significant P<0.001). 2. Qualitative research results The real self-management of young and middle-aged stroke patients is mainly reflected in the following four aspects:Low health literacy, different psychological change processes, insufficient social support and future life prospects. Research Conclusions and suggestions: 1. The self-management ability of young and middle-aged stroke patients was above the average level, and the scores of emotion management and symptom management were low; The family care degree of young and middle-aged stroke patients was above medium level, and the score of emotion degree was the lowest. 2. Average monthly family income, patient residence and family care were the main factors affecting the self-management ability of young and middle-aged stroke patients; The degree of family care was positively correlated with the self-management ability of young and middle-aged stroke patients. 3. The real self-management of young and middle-aged stroke patients is mainly reflected in the following four aspects: emotional response, insufficient knowledge and cognition, multidimensional support and outlook for future life 4. It is suggested to pay attention to the emotions of young and middle-aged stroke patients in clinical work, especially in the early stage of the disease, and timely intervene the negative emotions of young and middle-aged stroke patients to help them better adapt to the long working life in the later stage of the disease. We should pay attention to patients living in rural areas, carry out targeted diversified information transmission, carry out family-centered nursing intervention, effectively play the supportive role of family, encourage patients to participate in diagnosis and treatment decision-making, and increase hope for the future. Promote the physical and mental rehabilitation of stroke patients, reduce the recurrence of stroke.
学号	169001738
发布年限	2021-12-21
毕业论文分类号	R47
原始专题	护理学院
学位论文研究方向	临床护理
参考文献	Research Objectives: To understand the self-management ability of middle-aged and young stroke patients, analyze the factors affecting the self-management ability, explore the influence of family care degree and the self-management ability of middle-aged and young stroke patients, and provide theoretical basis for further improving the self-management ability of patients. Research methods: This study is a mixture of quantitative research and qualitative research. Quantitative research part: Choose between January 2021 and June 2021 in wenzhou two 3 armour hospital neurology in hospitalized patients met inclusion and exclusion criteria as the research object, using the general information questionnaire, middle-aged and young patients with cerebral apoplexy self-management ability scale (including symptoms, emotional management, daily management, rehabilitation exercise, the resources use five dimensions, a total of 26 items, The total score was 130, Cronbach's α coefficient was 0.908), and Family APGAR Index (including fitness, intimacy, cooperation, maturity and emotion, the total score was 10. Cronbach's α coefficient was 0.813), Barthel Index (BI) (including the evaluation of 10 actions such as eating, toilet-going, defecation and transfer), and questionnaire survey was conducted on the subjects. T test, variance analysis, non-parametric test, Spearman rank correlation and multiple regression analysis were used for statistical analysis. Qualitative research: Under the guidance of phenomenological method, 12 middle-aged and young stroke patients were selected for semi-structured interview. After the interview, the interview data were tranwritten in time and analyzed according to Colaizzi analysis method until the data were saturated and no new information appeared. To deeply understand the self-management ability of young and middle-aged stroke patients and explore the influencing factors. 1. Research Results (1) The total score of self-management in middle-aged and young patients was 109.25±22.67. The analysis of five dimensions found that the highest score of resource utilization was 18.12±3.12, with a scoring rate of 90.6%, followed by daily life management 24.96±6.44, with a scoring rate of 83.2%, rehabilitation exercise 15.87±4.97, emotional management 15.47±4.86, respectively. The scoring rate was 77.3% and symptom management was 30.79±5.63, with a scoring rate of 77%. (2) The total score of family care degree of stroke in young and middle-aged adults was 8.84±2.53, which was above the middle level. The scores of each dimension from high to low were as follows: Fitness 1.80±0.48 points, intimacy 1.80±0.44 points, cooperation 1.79±0.51 points, maturity 1.77±0.55 points, emotion 1.71±0.61 points. (3) Spearman correlation analysis showed that there was a positive correlation between family care and self-management ability in young and middle-aged stroke patients (R =0.650, P<0.001). (4) Multiple regression analysis showed that monthly family income, patient residence and family care were independent factors affecting the self-management ability of young and middle-aged stroke patients (significant P<0.001). 2. Qualitative research results The real self-management of young and middle-aged stroke patients is mainly reflected in the following four aspects:Low health literacy, different psychological change processes, insufficient social support and future life prospects. Research Conclusions and suggestions: 1. The self-management ability of young and middle-aged stroke patients was above the average level, and the scores of emotion management and symptom management were low; The family care degree of young and middle-aged stroke patients was above medium level, and the score of emotion degree was the lowest. 2. Average monthly family income, patient residence and family care were the main factors affecting the self-management ability of young and middle-aged stroke patients; The degree of family care was positively correlated with the self-management ability of young and middle-aged stroke patients. 3. The real self-management of young and middle-aged stroke patients is mainly reflected in the following four aspects: emotional response, insufficient knowledge and cognition, multidimensional support and outlook for future life 4. It is suggested to pay attention to the emotions of young and middle-aged stroke patients in clinical work, especially in the early stage of the disease, and timely intervene the negative emotions of young and middle-aged stroke patients to help them better adapt to the long working life in the later stage of the disease. We should pay attention to patients living in rural areas, carry out targeted diversified information transmission, carry out family-centered nursing intervention, effectively play the supportive role of family, encourage patients to participate in diagnosis and treatment decision-making, and increase hope for the future. Promote the physical and mental rehabilitation of stroke patients, reduce the recurrence of stroke.
全文文件名	169001738曹拂晓2021护理.pdf
文献类型	学位论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/179097
专题	温州医科大学
作者单位	溫州医科大学护理学院
第一作者单位	温州医科大学
推荐引用方式 GB/T 7714	曹拂晓. 中青年脑卒中患者自我管理能力及影响因素研究[D]. 温州医科大学,2021.