中青年脑卒中患者疾病进展恐惧现状及影响因素

目的 调查中青年脑卒中患者疾病进展恐惧现状,分析相关影响因素,进而开展针对性的干预缓解患者心理困扰。方法 采用恐惧疾病进展简化量表,疾病感知问卷,医学应对方式问卷,配偶恐惧疾病进展简化量表及简易应对方式问卷对218对中青年卒中患者-配偶进行调查。结果 患者疾病进展恐惧总分为（38.73±7.22）分,得分≥34分者有158人,占72.5%;多元线性回归分析结果显示,患者居住地、医疗负担、心理辅导需求、疾病感知、应对方式,配偶疾病进展恐惧及应对方式是中青年脑卒中患者疾病进展恐惧的独立影响因素,解释总变异的57.7%,其中配偶疾病进展恐惧可单独解释总变异的36.9%。结论 中青年脑卒中患者疾病进展恐惧水平较高,建议医护工作者关注患者的心理状况,基于影响因素开展针对患者及配偶的二元干预,引导夫妻双方积极应对,进而缓解疾病进展恐惧水平。

The status and influencing factors for the fear of disease progression in young and middle-aged stroke patients

Objective To investigate the level and influencing factors associated with Fear of Progression (FoP) in young and middle-aged stroke patients, and to carry out targeted intervention to alleviate the psychological distress of patients. Methods A total of 218 middle-aged and young stroke patients and their spouses were investigated by the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), the Brief Illness Perception Questionnaire (BIPQ), the Medical Coping Modes Questionnaire (MCMQ), the Fear of Progression Questionnaire-Short Form for Partner (FoP-Q-SF/P) and Simplified Coping Style Questionnaire (SCSQ). Results The score of FoP-Q-SF in young and middle-aged stroke patients was 38.73±7.22, 158 patients (72.5%) had fear progression score≥34. Multiple linear regression analysis showed that the patient’s place of residence, medical burden, psychological counseling needs, BIPQ, MCMQ and the FoP-Q-SF/P and SCSQ were independent influencing factors of FoP of middle-aged and young patients. The above variables accounted for 57.7% of the total variation of patients’ FoP, and the FoP-Q-SF/P could account for 36.9% of the total variance alone. Conclusion Middle-aged and young stroke patients have a high level of fear disease progression, so it is suggested that paramedics pay attention to the psychological state of patients, and carry out dual intervention for patients and their spouses based on the influencing factors, and guide the couple to actively face the disease, and then alleviate the fear level of disease progression.