摘要
目的 探讨脑卒中半失能患者自我接纳的潜在类别并分析其影响因素.方法 采用便利抽样法,选取河南省郑州市某 2 所三级甲等医院神经内科及神经康复科的 308 例脑卒中半失能患者为研究对象,采用一般资料调查表、自我接纳问卷、中文版事件相关性反刍性沉思问卷和慢性病自我效能量表对其进行调查.采用潜在剖面分析法分析患者自我接纳的潜在类别,采用无序多分类Logistic回归分析检验不同类别的影响因素.结果 脑卒中半失能患者自我接纳分为 3 种类别:低接纳-低自评组(27.9%)、中等接纳-自评中庸组(43.8%)与高接纳-理性自评组(28.3%).无序多分类Logistic回归分析结果显示,年龄、文化程度、家庭人均月收入、症状数量、侵入性沉思、目的性沉思以及慢性病自我效能是脑卒中半失能患者自我接纳潜在剖面分类的影响因素(P<0.05).结论 脑卒中半失能患者的自我接纳存在 3种潜在类别,医护人员应重视年龄 18～45岁、初中及以下文化程度、家庭人均月收入较低以及症状≥3 个的脑卒中半失能患者,并通过减少患者的侵入性反刍、增强目的性反刍和自我效能感等干预措施来提升其自我接纳水平.
Abstract
Objective To explore the potential categorization of self-acceptance in semi-disabled patients with stroke and to analyze the influencing factors.Methods Convenience sampling was used to select 308 semi-disabled patients with stroke from the d epartments of neurology and neurorehabilitation in two tertiary grade-A hospitals in Zhengzhou City,and they were surveyed using the general information questionnaire,the Self-Acceptance Questionnaire,the Chinese version of the Event-Related Rumination Questionnaire,and the Chronic Disease Self-Efficacy Scale.Potential categories of patients'self-acceptance were analyzed using potential profile analysis,and the influencing factors of different categories were analyzed using unordered multicategorical logistic regression analysis.Results Self-acceptance of semi-disabled patients with stroke was categorized into 3 categories:low acceptance-low self-assessment group(27.9%),medium acceptance-moderate self-assessment group(43.8%)&high acceptance-rational self-assessment group(28.3%).Unordered multicategorical logistic regression analysis showed that age,education background,per capita monthly household income,number of symptoms,intrusive contemplation,purposeful contemplation,and chronic disease self-efficacy were influencing factors in the classification of potential profiles of self-acceptance in semi-disabled patients with stroke(P<0.05).Conclusion There are 3 potential categories of self-acceptance in semi-disabled patients with stroke.Medical staff should focus on semi-disabled stroke patients aged 18～45 years,with education background of junior high school or lower,lower per capita monthly household income,and experiencing three or more symptoms.Intervention measures such as reducing patients'invasive rumination,enhancing purposeful rumination and self-efficacy should be considered to improve their level of self-acceptance.
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