摘要
目的分析首发脑卒中致残后抑郁的影响因素。方法收集2010年4月—2012年5月首都医科大学附属北京世纪坛医院神经内科门诊、急诊收治的急性脑卒中致残患者161例,分别在患者患病后1个月、2个月、3个月时对其进行问卷调查,并定义为A组、B组、C组,其中A组为住院调查,B组、C组为出院门诊随访。调查工具包括:患者一般情况调查表、日常生活能力评定量表(BI)、神经功能缺损量表(NIHSS)、社会支持调查量表(MOS-SSS)。分析3组患者抑郁发病率,并对其影响因素进行单因素和多因素分析。结果 A、B、C组抑郁发病率分别为23.6%(38/161),32.9%(53/161),42.2%(68/161),差异有统计学意义(χ2=13.94,P<0.05);3组间轻度抑郁、中度抑郁、重度抑郁发病率比较,差异均有统计学意义(P<0.05)。A、B、C组患者的BI评分、NIHSS评分、MOS-SSS评分、既往病史、病程、月工资收入比较,差异均有统计学意义(P<0.05)。B、C组BI评分、既往病史比例、病程均高于A组,且C组BI评分、既往病史比例高于B组(P<0.05);B、C组NIHSS评分、MOSSSS评分、月工资收入均低于A组(P<0.05)。多因素Logistic回归分析显示,NIHSS评分高、既往病史、病程长是抑郁的独立危险因素(P<0.05),而BI评分高和月工资收入高是抑郁的保护因素(P<0.05)。结论 BI评分、NIHSS评分、既往病史、病程、月工资收入是脑卒中致残后抑郁的独立影响因素,为制定护理对策提供了参考依据。
Objective To investigate the influencing factors of depression after initial stroke damages. Methods From April 2010 to May 2012,a questionnaire was performed in 161 disable patients due to acute stroke admitted to Beijing Shijitan Hospital Affiliated to Capital Medical University in months 1（group A）,2（group B）,3（group C）after attacks. Group A had hospital investigation,groups B,C had outpatient follow-ups. The survey tools included general patient questionnaire, ADL Rating Scale（BI）,National Institutes of Health Stroke Scale（NIHSS）,Social Support Scale（MOS-SSS）. The depression incidence was analyzed. Univariate and multivariate analyses were used to analyze its influencing factors. Results The depression incidences of groups A,B,C were 23. 6%（38/161）,32. 9%（53/161）,42. 2%（68/161）,the difference was significant（χ2 =13. 94,P〈0. 05）. There was difference in the incidences of mild,moderate,severe depression among the 3 groups（P 〈0. 05）,and in BI,NIHSS,MOS -SSS,past medical history,duration,monthly income among the 3 groups（P〈0. 05）. The scores of BI,proportion of past medical history,duration were higher in groups B,C than in group A （P〈0. 05）,NIHSS,MOS-SSS score,monthly income lower in groups B,C than in group A（P〈0. 05）. By multivariate Logistic regression analysis,scores of NIHSS,past medical history,duration were independent risk factors of depression（ P〈0. 05）,scores of BI and monthly income were a protective factor of depression（P 〈0. 05）. Conclusion Scores of BI and NIHSS,past medical history,duration,monthly income are independent factors influencing depression of stoke-led disable pa-tients.
出处
《中国全科医学》
CAS
CSCD
北大核心
2014年第18期2115-2117,共3页
Chinese General Practice
关键词
卒中
抑郁
影响因素
护理
Stroke
Depression
Influence factors
Nursing care
