脑卒中病人急性期抑郁发生的原因分析及护理对策

[目的]探讨脑卒中病人抑郁发生的原因及护理对策。[方法]采用Zung抑郁自评量表(SDS)、社会支持评定量表(SRSS)、NIH卒中量表、ADL量表(BI)以及自设问卷评价了76例脑卒中病人。[结果]抑郁发生的原因与病人年龄、性别、发病部位、发病性质等因素无关,与合并症(糖尿病)、卒中病史、神经功能缺损程度、日常生活自理能力、医疗负担及社会支持情况等有关。37例(48.7%)病人出现抑郁症状,其中轻度抑郁19.7%,中度15.8%,重度13.2%。神经功能缺损程度轻度为37.2%,中度47.1%,重度81.3%;无医疗负担的抑郁发生率为40.8%,有些医疗负担的为41.7%,负担极重者为80.0%;日常生活自理能力为良、中、差的抑郁率分别为28.6%、55.0%、76.2%;各组之间的差异有统计学意义(P<0.05);社会支持评定量表总分(r=-0.31)与主观支持得分(r=-0.27)呈负相关(P<0.05)。[结论]脑卒中病人急性期发病率较高,与病人的日常生活能力、神经功能缺损程度、合并症、社会支持系统、医疗负担有很大关系,因此护理脑卒中急性期的病人时,应注意对以上方面进行同一系统化护理干预,促进病人的遵医行为,解除抑郁发生的因素,提高病人的自护能力,提高生活质量。

Causative analysis on depression occurrence of cerebral apoplexy patients in acute period and its nursing strategies

Objective:To probe into the causes and nursing strategies of depression occurrence of cerebral apoplexy patients.Methods:A total of 76 cerebral apoplexy patients were evaluated by adopting Zung self-rating depression scale(SDS),social rating support scale(SRSS),NIH stroke scale,ADL inventory(BI)and self-designed questionnaire.And the causes of depression occurrence of cerebral apoplexy patients have been analyzed.Results:The occurrence of depression in cerebral apoplexy patients was not related to their age,gender,invasive place and invasive nature,but was related to complications(diabetes mellitus),history of apoplexy,degrees of neurologic impairment,daily life self-care ability,medical burden and social support.Totally 37 cases(48.7%)were with depressive symptoms.Among them,19.7% cases were with mild degree of depression,15.8% with moderate depression,and 13.2% with severe degree depression.And 37.2% of patients were with mild neurologic impairment,41.7% with moderate,and 81.3% with severe degree neurologic impairment.The incidence of depression among patients without medical burden was 40.8%,among patients with some medical burden was 41.7%,and among patients with very heavy medical burden was 80.0%.The incidence of depression among patients of good,moderate and poor daily life self-care ability were 28.6%,55.0% and 76.2% respectively.There were significant differences among three groups(P < 0.05).It showed a negative correlation between social support rating scale total scorings(r =-0.31)and subjective support scorings(r=-0.27)(P <0.05).Conclusion:The incidence of depression among acute phase apoplexy patients is higher.It was related to daily life ability,neurologic impairment,complications,social support system and medical burden of patients.Therefore,as one provide nursing care for patients with cerebral apoplexy in acute phase,one should pay attention to above mentioned aspects and provide unified holistic nursing intervention,enhance compliance behaviors of patients.One should also eliminate those factors of depression happening,enhance self-care ability for patients and promote the quality of life for them.