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急性缺血性脑卒中患者感知控制与认知功能关系的横断面研究
刘枝健1△,于龙娟2△,孔祥静1,3,金妍婷2,甘丽芬2,李冬梅2,李娟1,2*
0
(1. 海军军医大学(第二军医大学)护理系临床护理学教研室, 上海 200433;
2. 海军军医大学(第二军医大学)长海医院脑血管病中心, 上海 200433;
3. 东部战区空军医院护理部, 南京 210001
共同第一作者
*通信作者)
摘要:
目的 探讨急性缺血性脑卒中(AIS)患者感知控制与认知功能之间的关系。方法 2020年7月至11月,采取便利抽样法选择437例AIS患者作为调查对象,其中231例来自海军军医大学(第二军医大学)脑血管病中心、206例来自东部战区空军医院卒中中心。通过自编一般资料调查表、自编疾病相关资料调查表收集调查对象的社会人口学资料和AIS疾病相关资料,使用长沙版蒙特利尔认知评估量表评估认知功能,使用健康相关感知控制问卷评估感知控制水平。采用分层回归分析探索AIS患者感知控制和认知功能之间的关系。结果 437例AIS患者中男286例(65.4%)、女151例(34.6%),年龄为45~92岁,平均年龄为(64.8±9.6)岁,入院时美国国立卫生研究院卒中量表(NIHSS)评分为3(1,7)分,329例(75.3%)患者为AIS首次发病。437例患者的认知功能得分为(19.6±6.2)分,总体处于较低水平;感知控制得分为(78.8±22.8)分,总体处于中等水平。经分层回归模型调整AIS严重程度、年龄、性别、受教育年限后,分析结果显示AIS患者的感知控制与认知功能相关(β=0.11,P=0.014)。结论 低感知控制是AIS患者认知功能低的重要因素,提高感知控制有望成为AIS患者认知功能障碍干预的潜在策略之一。
关键词:  急性缺血性脑卒中  感知控制  认知功能  卒中后认知功能障碍  干预策略
DOI:10.16781/j.0258-879x.2022.01.0105
投稿时间:2021-09-17
基金项目:国家自然科学基金(72104243),上海市浦江人才计划(18PJC115)
Association between perceived control and cognitive function in acute ischemic stroke patients: a cross-sectional study
LIU Zhi-jian1△,YU Long-juan2△,KONG Xiang-jing1,3,JIN Yan-ting2,GAN Li-fen2,LI Dong-mei2,LI Juan1,2*
(1. Department of Clinical Nursing, School of Nursing, Naval Medical University (Second Military Medical University), Shanghai 200433, China;
2. Neurovascular Center, Changhai Hospital, Naval Medical University (Second Military Medical University), Shanghai 200433, China;
3. Department of Nursing, Air Force Hospital of PLA Eastern Theater Command, Nanjing 210001, Jiangsu, China
Co-first authors.
* Corresponding author)
Abstract:
Objective To explore the association between perceived control and cognitive function in patients with acute ischemic stroke (AIS).Methods Convenience sampling method was used to select 437 AIS patients from Jul. to Nov. 2020. Among them, 231 patients were from Neurovascular Center, Changhai Hospital, Naval Medical University (Second Military Medical University) and 206 were from Stroke Center, Air Force Hospital of PLA Eastern Theater Command. Demographic and sociological data and AIS-related data were collected using the self-made general data and disease-related data questionnaires. Cognitive function was assessed using Montreal cognitive assessment, Changsha version. Perceived control was assessed by perceived control in health care questionnaire. The association between perceptive control and cognitive function was analyzed by hierarchical regression analysis.Results Among the 437 AIS patients, 286 (65.4%) were male and 151 (34.6%) were female, aged from 45 to 92 years, with an average age of (64.8±9.6) years. The National Institutes of Health stroke scale (NIHSS) score was 3 (1, 7) on admission, and 329 (75.3%) patients had the first onset of AIS. The average score of cognitive function of the 437 patients was 19.6±6.2, which was generally at a low level. The average score of perceived control was 78.8±22.8, which was generally at a middle level. After adjusting the severity of AIS, age, gender and education level, the analysis results of hierarchical regression model showed that perceived control was associated with cognitive function in AIS patients (β=0.11, P=0.014).Conclusion Low perceived control is an important factor related to low cognitive function in AIS patients. Improving perceived control is a potential intervention method for cognitive impairment in AIS patients.
Key words:  acute ischemic stroke  perceived control  cognitive function  post-stroke cognitive dysfunction  intervention strategy