脑卒中后情感障碍患者的生存质量及其影响因素分析

摘要

Objective:To explore the quality of life (QOL)and its influencing factors in stroke patients with affec-tive disorder.Methods:Stroke patients were evaluated by Hamilton Depression Scale (HAMD)and Hamilton Anxi-ety Scale (HAMA)before discharge,and 128 were identified with post-stroke affective disorder.Those 128 patients were measured with Shot Form 36 Health Survey Questionnaire (SF-36)and questionnaire survey before discharge and 6 months after discharge.The patients'state of life was analyzed with the ordinal Logistic regression method to find out its influencing factors.Results:The QOL of the stroke patients with affective disorder decreased obviously with an average score between 22.67-62.95.The average scores increased during the 6 months of post-discharge, but only those of physical functioning (PF),role limitations due to physical health (RP),bodily pain (BP),general health perceptions (GH)and vitality (VT)increased significantly,and those of emotional functioning,social func-tioning and mental health were not.Some common factors that influenced physical and mental health of the patients included:gender,marriage state,family situation,life nursing,activity of daily living,cognitive function,commu-nity rehabilitation,etc (P <0.05).Conclusion:The QOL of the stroke patients with affective disorder was closely related with family situation,activity of daily living,cognitive function.Family caring and nursing,and community rehabilitation have a positive effect on QOL of the stroke patients with affective disorder.%目的：：探讨脑卒中后情感障碍患者的生存质量及影响因素。方法：对入住本院康复科的脑卒中患者在出院前进行汉密尔顿抑郁量表和焦虑量表评定，确定128例脑卒中后情感障碍患者。采用健康调查简表(SF-36)对128例脑卒中后情感障碍患者在出院前和出院后6个月进行测量并做一般情况问卷调查，分析生存质量状况及其相关影响因素。结果：脑卒中后情感障碍患者生存质量明显降低，生存质量评定的8个维度平均得分(42.81±20.14)分。出院6个月后各维度平均得分均较出院时有一定提高，其中生理功能，生理职能，躯体疼痛，总体健康，精力5项维度评分提高差异有显著性意义(P <0.05)，但情感职能、社会职能、精神健康3项维度评分提高无显著性差异。影响生存质量评分的共同因素有性别、配偶状况、子女状况、生活护理、日常生活活动能力、认知状况、是否接受社区康复治疗(P <0.05)。结论：脑卒中后情感障碍的生存质量与家庭状况、日常生活活动能力、认知功能密切相关，亲人的关爱与照护、社区康复的介入对生存质量改善起积极作用。