急性缺血性脑卒中合并心房颤动患者运动恐惧现状及其影响因素分析

Current status of exercise fear and its influencing factors in patients with acute ischemic stroke combined with atrial fibrillation

摘要:

目的 调查急性缺血性脑卒中合并心房颤动患者运动恐惧现状及影响因素。方法 采用便利抽样法，选取2020年1月至2021年12月上海市某三级甲等综合医院神经内科住院的急性缺血性脑卒中合并心房颤动患者248例，采用心脏病运动恐惧量表、活动特异性平衡信心量表、运动自我效能量表及家庭关怀指数量表对其进行调查，采用单因素分析及多元线性回归分析影响因素。结果 纳入分析的248例患者中，男性126人（占50.8%），女性122人（占49.2%）；平均年龄（74.19±11.65）岁。单因素分析显示，影响急性缺血性脑卒中合并心房颤动患者运动恐惧的因素包括文化程度（Z=26.326，P<0.001）、职业状况（Z=9.323，P=0.009）、居住情况（Z=26.990，P<0.001）、跌倒史（Z=2.976，P=0.003）、脑卒中复发次数（Z=24.996，P<0.001）、心功能分级（Z=32.097，P<0.001）；多重线性回归结果显示，文化程度、跌倒史、脑卒中复发次数、心功能分级、运动自我效能、家庭关怀指数进入回归方程，共解释患者运动恐惧水平总变异的37.6%。结论 急性缺血性脑卒中合并心房颤动患者运动恐惧现状不容乐观，临床护理人员在指导患者运动康复时可重点关注，对患者综合评估后制定具有针对性的护理措施，以期提升急性缺血性脑卒中合并心房颤动患者运动康复依从性。

Abstract:

Objective To investigate the current situation of exercise fear and its influencing factors in patients with acute ischemic stroke combined with atrial fibrillation.Methods A total of 248 patients with acute ischemic stroke combined with atrial fibrillation who were hospitalized in the department of neurology of a 3A-grade hospital in Shanghai during January 2020 to December 2021 were selected in the study using convenience sampling method. They were investigated with the fear of heart disease exercise scale，activity-specific balance confidence scale，exercise self-efficacy scale and family care index scale，and the influencing factors were analyzed by univariate analysis and multivariate linear regression.Results Among the 248 patients included in the analysis，126（50.8%） were male and 122 （49.2%） were female，with the mean age of （74.19 ± 11.65） years old. Univariate analysis showed that factors affecting exercise fear in patients with stroke and atrial fibrillation included educational background （Z=26.326，P<0.001），occupational status （Z=9.323，P=0.009），residence（Z=26.990，P<0.001），falling history（Z=2.976，P=0.003），number of stroke relapses （Z=24.996，P<0.001），and cardiac function classification（Z=32.097，P<0.001）. The results of multiple linear regression showed that education level，falling history，number of stroke recurrences，cardiac function classification，motor self-efficacy and family care index entered the regression equation，and altogether accounted for 37.6% of the total variation in the level of exercise fear of patients.Conclusion The current situation of exercise fear in patients with acute ischemic stroke combined with atrial fibrillation is not optimistic. Clinical nursing staff should focus on them when guiding patients' exercise rehabilitation，and formulate targeted nursing measures after comprehensive evaluation of patients，in order to improve the compliance of patients with acute ischemic stroke combined with atrial fibrillation in exercise rehabilitation.