| 摘要: |
| 目的 探讨慢性缺血性脑卒中患者及其主要家庭照顾者的家庭功能对患者抑郁和生活质量的影响。方法 采用便利抽样法，选择2020年4月至12月在中国人民解放军东部战区空军医院卒中中心住院治疗并在出院后6个月接受随访的124对慢性缺血性脑卒中患者及其主要家庭照顾者。通过自编人口社会学资料调查表、疾病相关资料调查表分别收集患者及其主要家庭照顾者的人口社会学资料和患者的疾病相关资料，使用家庭功能评定量表（FAD）测量患者及其主要家庭照顾者的家庭功能，使用流调中心抑郁量表（CES-D）测量患者的抑郁症状，使用脑卒中专用生活质量量表（SS-QOL）测量患者的生活质量水平。采用χ2检验分析患者与主要家庭照顾者之间家庭功能的差异，并分别用多因素logistic回归模型和多元线性回归模型分析两者的家庭功能与患者抑郁和生活质量的关系。结果 124例慢性缺血性脑卒中患者中男75例（60.5%）、女49例（39.5%），年龄为（65.5±8.9）岁。患者的FAD总分为（136.6±19.7）分，主要家庭照顾者的FAD总分为（137.4±21.3）分。患者的CES-D得分为（14.2±10.6）分，其中54例（43.5%）存在抑郁症状；SS-QOL评分为（191.3±46.3）分，总体处于中等水平。在FAD的问题解决、角色、情感反应、情感介入、行为控制和总体功能6个维度中，患者与主要家庭照顾者报告的功能不良率［31.5%（39/124）vs 32.3%（40/124）、43.5%（54/124）vs 47.6%（59/124）、60.5%（75/124）vs 46.8%（58/124）、76.6%（95/124）vs 71.0%（88/124）、91.1%（113/124）vs 93.5%（116/124）、65.3%（81/124）vs 62.9%（78/124）］差异有统计学意义（P均＜0.01）。多因素logistic回归和多元线性回归模型分析显示，主要家庭照顾者报告的角色功能与患者的抑郁症状（OR＝3.152，95% CI 1.142～8.702，P＝0.027）和生活质量（b＝－20.642，P＝0.029）有关。结论 主要家庭照顾者角色功能不良会增加慢性缺血性脑卒中患者抑郁症状的发生风险，同时降低其生活质量。 |
| 关键词: 慢性缺血性脑卒中 卒中后抑郁 家庭功能 生活质量 |
| DOI：10.16781/j.CN31-2187/R.20230126 |
| 投稿时间：2023-03-20修订日期：2023-07-06 |
| 基金项目:国家自然科学基金(72104243),中华医学基金会公开竞标项目(22-473). |
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| Correlation analysis of family function of chronic ischemic stroke patients and their primary family caregivers with depression and quality of life of patients |
| ZHU Huanzhi1△,LI Dongmei2△,KONG Xiangjing3,LI Juan4* |
(1. Department of Clinical Nursing, School of Nursing, Naval Medical University(Second Military Medical University), Shanghai 200433, China;
2. Neurovascular Center, The First Affiliated Hospital of 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;
4. Department of Nursing, Huashan Hospital, Fudan University, Shanghai 200040, China
△Co-first authors.
* Corresponding author) |
| Abstract: |
| Objective To explore the effects of family function of chronic ischemic stroke patients and their primary family caregivers on depression and quality of life of patients. Methods Convenience sampling method was used to select 124 pairs of chronic ischemic stroke patients who were hospitalized in Stroke Center of Air Force Hospital of PLA Eastern Theater Command from Apr. to Dec. 2020 and their primary family caregivers, and they were followed up 6 months after discharge. Demographic sociological data and disease-related data of patients with chronic ischemic stroke and their primary family caregivers were collected using the self-maded demographic sociological data and disease-related data questionnaires, respectively. Family function of patients and their primary family caregivers was assessed using family assessment device (FAD), depression symptoms of patients were measured by center for epidemiological studies depression scale (CES-D), and quality of life level of patients was assessed by the stroke specific quality of life (SS-QOL) scale. Chi-square test was used to investigate the differences in family function between patients and their primary family caregivers. Multivariate logistic regression analysis and multiple linear regression analysis were used to explore the correlations of family function with depression and quality of life of patients. Results Among the 124 chronic ischemic stroke patients, 75 (60.5%) were males and 49 (39.5%) were females, with an age of (65.5±8.9) years old. The total score of FAD was 136.6±19.7 in patients and 137.4±21.3 in primary family caregivers. The CES-D score of the patients was 14.2±10.6, of which 54 cases (43.5%) had depressive symptoms. The average score of SS-QOL (191.3±46.3) was generally at a medium level. There were significant differences in the dysfunction rate of dimensions of problem solving, roles, affective response, affective involvement, behavioral control, and general function (31.5% ［39/124］ vs 32.3% ［40/124］, 43.5% ［54/124］ vs 47.6% ［59/124］, 60.5% ［75/124］ vs 46.8% ［58/124］, 76.6% ［95/124］ vs 71.0% ［88/124］, 91.1% ［113/124］ vs 93.5% ［116/124］, and 65.3% ［81/124］ vs 62.9% ［78/124］) between the patients and primary family caregivers (all P＜0.01). Multivariate logistic regression analysis and multiple linear regression analysis showed that the role function reported by primary family caregivers was correlated with depressive symptoms (odds ratio＝3.152, 95% confidence interval 1.142-8.702, P＝0.027) and quality of life (b＝－20.642, P＝0.029). Conclusion The role dysfunction of primary family caregivers may increase the risk of depressive symptoms in patients with chronic ischemic stroke and reduce their quality of life. |
| Key words: chronic ischemic stroke post-stroke depression family function quality of life |
