摘要
目的 探索首发脑卒中患者社会衰弱变化轨迹并分析其影响因素.方法 采用便利抽样法,选取2023年1-12月长春中医药大学附属第三临床医院脑病科收治的210例脑卒中患者为研究对象,采用一般资料问卷、中文版社会衰弱指数(SVI)、营养风险筛查2002及社会支持评定量表分别在入院时(T1)、发病后2周(T2)、发病后1月(T3)、发病后3月(T4)、发病后6月(T5)进行问卷调查.采用潜类别增长模型及单因素分析进行数据处理.结果 共回收有效连续问卷176份,有效回收率83.81％(176/210).T1～T5时间点SVI得分分别为(18.64±5.82)、(19.97±6.42)、(16.19±5.34)、(15.98±5.61)、(16.12±4.42)分;识别出首发脑卒中患者社会衰弱轨迹分为3个潜在类别,每个类别的首发脑卒中患者归属于各个潜在类别的平均概率分别为0.942、0.956,0.932.3个类别分别为高水平加重组(30.1％,53/176)、中水平改善组(52.3％,92/176)、中低水平平稳组(17.6％,31/176).不同年龄、居住方式、自评性格类型、患病后自理能力、是否存在营养不良及社会支持的脑卒中患者社会衰弱变化轨迹分组差异具有统计学意义(P＜0.05).结论 首发脑卒中患者从入院到发病后6月内的社会衰弱呈现3种不同的曲线轨迹类型,患者社会衰弱曲线轨迹存在差异.年龄、居住方式、自评性格类型、患病后自理能力、是否存在营养不良及社会支持是首发脑卒中患者社会衰弱曲线轨迹分组的影响因素.临床工作人员应密切关注高水平加重组的脑卒中患者,及时识别社会衰弱的高危患者,以降低社会衰弱带来的影响,并提供积极的、有针对性的保护性护理.
Abstract
Objective To explore the trajectory of social vulnerability in first-episode stroke patients and analyze its influencing factors.Methods Using convenience sampling,210 stroke patients admitted to the Department of Cerebrovascular Diseases in The 3rd Affiliated Hospital of CCUCM from January to December 2023 were selected as study subjects.The General Information Questionnaire,the Chinese version of the Social Vulnerability Index(SVI),Nutritional Risk Screening 2002,and the Social Support Rating Scale were used to conduct surveys at admission(T1),2 weeks post-onset(T2),1 month post-onset(T3),3 months post-onset(T4),and 6 months post-onset(T5).Latent Class Growth Model(LCGM)and univariate analysis were used for data processing.Results A total of 176 valid consecutive questionnaires were collected,with an effective response rate of 83.81％(176/210).The SVI scores at T,to T5 were(18.64±5.82),(19.97±6.42),(16.19±5.34),(15.98±5.61),and(16.12±4.42),respectively.Three latent classes of social vulnerability trajectories were identified among first-episode stroke patients,with average probabilities of 0.942,0.956,and 0.932 for patients belonging to each latent class.The three classes were the high-level worsening group(30.1％,53/176),the moderate-level improving group(52.3％,92/176),and the low-to-moderate-level stable group(17.6％,31/176).Age,living arrangement,self-rated personality type,activities of daily living after illness,presence of malnutrition,and social support were influencing factors for grouping the trajectories of social vulnerability in first-episode stroke patients(P＜0.05).Conclusions First-episode stroke patients exhibit three distinct trajectory types of social vulnerability from admission to 6 months post-onset,with variations in their social vulnerability trajectories.Age,living arrangements,self-rated personality types,activities of daily living after illness,presence of malnutrition,and social support are influencing factors for grouping social vulnerability trajectories in first-episode stroke patients.Clinical staff should closely monitor stroke patients in the high-level worsening group,promptly identify high-risk patients with social frailty,in order to reduce the impact of social vulnerability and provide proactive and targeted protective care.
维普
万方数据