中华护理杂志 ›› 2024, Vol. 59 ›› Issue (8): 953-959.DOI: 10.3761/j.issn.0254-1769.2024.08.009
收稿日期:
2023-07-04
出版日期:
2024-04-20
发布日期:
2024-04-22
通讯作者:
杨丽,E-mail:yangli81@qdu.edu.cn作者简介:
侯佳雨:女,本科(硕士在读),E-mail:houjiayu97@163.com
基金资助:
HOU Jiayu(), YANG Li(), LI Jia, LÜ Runtian
Received:
2023-07-04
Online:
2024-04-20
Published:
2024-04-22
摘要:
目的 通过网络分析模型探究首发脑卒中患者创伤后应激障碍症状网络的核心症状及护理对策,为症状的精准干预与护理提供依据。 方法 采用横断面研究,便利抽取2022年10月—2023年4月在青岛市某三级甲等综合医院神经内科住院的232例首发脑卒中患者为调查对象,采用修订版创伤后应激障碍症状筛查量表进行调查,应用R软件进行创伤后应激障碍症状网络分析,包括网络关系分析、核心症状分析及网络结构的准确性和稳定性分析。 结果 症状网络分析显示,症状“高警觉”和“惊跳反应过度”、“回避与创伤事件相关的想法或感觉”和“回避易使人联想起创伤事件的活动或情景”、“负性信念”和“责备自己或怪罪他人”之间的关系最强,正则化偏相关系数分别为0.650、0.635、0.381;症状“与创伤相关的遗忘”的可预测性最高;症状“难以体验积极的情绪”的预期影响最高,该症状与其他症状的连接更紧密。经检验,网络的准确性和稳定性较好,网络模型较为可靠。 结论 该研究利用症状网络分析法探究首发脑卒中患者创伤后应激障碍的症状网络,针对网络中关系最强及可预测性高的症状,提示临床医护人员在干预过程中要预防性地切断这些症状间的较强连接,提高干预效率;“难以体验积极的情绪”是网络中最核心的症状,提示在未来研究中为提高患者的创伤后应激障碍控制效果,促进心理康复,应将该症状作为干预的靶点,拟订科学的心理干预措施,促进患者心理健康状况的改善。
侯佳雨, 杨丽, 李佳, 吕润田. 首发脑卒中患者创伤后应激障碍症状的网络分析及护理对策[J]. 中华护理杂志, 2024, 59(8): 953-959.
HOU Jiayu, YANG Li, LI Jia, LÜ Runtian. Network analysis and nursing implications of post-traumatic stress disorder symptoms in first stroke patients[J]. Chinese Journal of Nursing, 2024, 59(8): 953-959.
图1 创伤后应激障碍症状网络 注:边的粗细代表节点间相关性的强弱,绿色边表示正关联,红色边表示负关联。B1=闯入性的创伤记忆;B2=与创伤相关的噩梦;B3=创伤事件闪回;B4=创伤事件的线索引发情绪反应;B5=创伤事件的线索引发生理反应;C6=回避与创伤事件相关的想法或感觉;C7=回避易使人联想起创伤事件的活动或情景;D8=与创伤相关的遗忘;D9=负性信念;D10=责备自己或怪罪他人;D11=与创伤相关的负性情绪;D12=兴趣减退;D13=疏远他人;D14=难以体验积极的情绪;E15=烦躁易怒;E16=自伤行为;E17=高警觉;E18=惊跳反应过度;E19=注意力难以集中;E20=睡眠问题。
Figure 1 Network of post-traumatic stress disorder symptoms
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