摘要
[目的]研究急性缺血性脑卒中病人延迟就医与家庭动力学的相关性,为急性缺血性脑卒中病人制定个体化护理方案提供理论依据。[方法]选取2015年2月—2017年12月于新疆医科大学第一附属医院就诊的564例明确诊断为急性缺血性脑卒中(AIS)的首发病人作为研究对象。根据就医时限,时间≥3 h为延迟就医组,时间<3 h为及时就医组。[结果]延迟就医组病人文化程度、家庭年收入及医疗保险、在职状态比例明显低于及时就医组病人(P<0.05);延迟就医组病人离异或丧偶比例和美国国立卫生院卒中评估量表得分(NIHSS)水平明显高于及时就医组病人(P<0.05)。延迟就医组病人家庭动力学评分、家庭气氛、个性化、疾病观念和系统逻辑得分均明显高于及时就医组病人(P<0.05)。Spearman相关性分析显示,AIS病人家庭动力总分及各维度得分均和延迟就医时间呈负相关(P<0.05)。以延迟就医为应变量,基线资料为自变量,Logistic回归分析显示,婚姻状况(离婚/丧偶与已婚)、家庭年收入(<10元万与≥10元万)、职业状态(退休/无业与在职)和家庭动力学评分(每标准差变化)是延迟就医的影响因素(P<0.05)。[结论]AIS病人家庭动力总分及各维度得分均和延迟就医时间呈负相关关系,且家庭动力学评分是延迟就医的影响因素。
Objective:To study correlation between delayed medical treatment and family dynamics in patients with acute ischemic stroke,and to provide theoretical basis for individualized nursing program for patients with acute ischemic stroke.Methods:A total of 564 patients who was diagnosed as acute ischemic stroke(AIS)firstly were selected from first affiliated hospital of Xinjiang Medical University from February 2015 to December 2017.According to medical treatment time,patients with medical treatment time≥3 h were classified into the delayed medical treatment group,and patients with medical treatment time<3 h were classified into timely medical treatment group.Results:The educational level,annual family income and ratio of medical insurance and on-the-job status of patients in delayed medical treatment group were significantly lower than those of patients in timely medical treatment(P<0.05).Divorce or widowhood ratio,and score of NIHSS of patients in delayed medical treatment group were significantly higher than those of patients with timely medical treatment(P<0.05).The scores of family dynamics,family atmosphere,personalization,disease concept and system logic of patients in delayed medical treatment group were significantly higher than those in timely medical treatment group(P<0.05).Spearman correlation analysis showed that there were negative correlations between total score of family motivation,scores of each dimension and delayed medical treatment time in AIS patients.The differences were statistically significant(P<0.05).In Logistic regression analysis,delayed medical treatment was taken as dependent variable,baseline data as the independent variable.Results showed that marital status(divorce/widow vs married),annual family income(<100000 vs≥100000 RMB),occupational status(retirement/unemployment vs in-service)and family dynamics score(change of each standard deviation)were risk factors of delayed medical treatment.Difference were statistically significant(P<0.05).Conclusion:Total score of family dynamics and scores of each dimension in AIS patients are negatively correlated with delayed of medical treatment time.In addition,score of family dynamics is a risk factor for delayed medical treatment time.
作者
何晶
马琴
范珊
姜淑霞
HE Jing;MA Qin;FAN Shan;JIANG Shuxia(First Affiliated Hospital of Xinjiang Medical University,Xinjiang 830000 China)
出处
《护理研究》
北大核心
2020年第2期197-201,共5页
Chinese Nursing Research
基金
新疆维吾尔自治区自然科学基金，编号：SYTG-Y201928
关键词
急性缺血性脑卒中
延迟就医
影响因素
家庭动力学
护理
生存质量
acute ischemic stroke
delayed medical treatment
influencing factors
family dynamics
nursing
quality of life
作者简介
何晶,护师,本科;通讯作者:姜淑霞。
