Structural equation modeling analysis of influencing factors of psychological distress in young and middle-aged patients with stroke
Objective To explore the influencing factors of psychological distress in middle-aged and young stroke patients to provide evidence for improving the mental health of the patients and guiding clinical psychological nursing interventions.Methods A cross-sectional survey was conducted on 447 mid-dle-aged and young patients with stroke hospitalized in four hospitals in Tianjin from March 2022 to January 2023.Various assessment scales were employed,including a general data questionnaire,distress thermometer,numerical rating scale,family APGAR index,perceived social support scale,general self-efficacy scale,Herth hope index,self-rating anxiety scale and self-rating depression scale.Statistical analyses were performed using encompassing descriptive statistics,Wilcoxon Mann-Whitney test,Kruskal Wallis test,Spearman correlation analysis,and structural equation modeling of SPSS 25.0 and AMOS 24.0.Results The psychological dis-tress score of middle-aged and young stroke patients was 1(1,2).Age(Z=-5.497),marital status(Z=-2.755),number of children(H=25.448),co-residents(H=14.389),occupation(H=34.889),per capita monthly family income(H=19.105),hospitalized caregivers(H=23.794),stroke type(H=23.308),course of disease(H=10.649),number of chronic diseases(H=8.021),daily self-care ability(H=128.439),eat-ing status(H=41.904),physical status(H=49.786),excretion status(H=112.736),dressing ability(H=63.036),nutritional status(H=15.514),organ injury status(H=23.797)and edema status(Z=-4.307)af-fected the psychological distress of middle-aged and young stroke patients,and the differences were statisti-cally significant(all P＜0.05).Correlation analysis showed that psychological distress were positively correla-ted with pain(1(1,1)),anxiety(36(27,53))and depression(31(27,58))(r=0.390,0.525,0.591,all P＜0.001),while were negatively with family caring degree(10(10,10)),perceptive social support(72(67,74)),general self-efficacy(35(29,38))and hope level(41(36,45))(r=-0.200,-0.464,-0.647,-0.675,all P＜0.01).Results of the structural equation model of the influencing factors of psychological dis-tress in middle-aged and young stroke patients showed that a total of 5 common factors were extracted,which were named support system,daily activities,disease condition,general condition and physical burden.Disease condition and physical burden had direct positive effects on psychological distress(β=0.385,0.204,both P＜0.05).Support system,daily activities and general situation had direct negative effects on psychological distress(β=-0.332,-0.262,-0.258,all P＜0.05).Conclusions The influencing factors of psychological distress in middle-aged and young stroke patients are disease status,support system,daily activities,general conditions and physical burden,which can provide theoretical basis for nurses to carry out active and effective prevention and nursing intervention on psychological distress in middle-aged and young stroke patients.
StrokePsychological distressInfluencing factorsYoung and middle-agedStructural equation model
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