脑卒中患者淡漠症状的潜在剖面及影响因素研究

doi:10.3761/j.issn.0254-1769.2025.13.010

摘要/Abstract

摘要：

目的识别脑卒中患者淡漠症状的潜在类别及影响因素，为医护人员精准分型及个体化干预提供依据。方法采用便利抽样法，选取2023年11月—2024年8月新疆维吾尔自治区某2所三级甲等医院的530例脑卒中患者作为调查对象，采用一般资料调查表、淡漠评定量表-知情者版、自主性感知量表、脑卒中康复自我效能量表、改良Barthel指数进行调查，采用潜在剖面分析识别淡漠症状的潜在类别，采用Logistic回归探讨脑卒中患者淡漠症状潜在剖面的影响因素。结果回收有效问卷521份，有效问卷回收率为98.3%。521例脑卒中患者的淡漠症状可分为3个潜在类别：淡漠症状较轻组（23.6%）、淡漠症状中等-低兴趣-低行为组（46.5%）、淡漠症状较重-低兴趣-低认知组（29.9%）。Lo-gistic回归显示：年龄45~<60岁、病程<6个月和高康复自我效能是淡漠症状中等-低兴趣-低行为组和淡漠症状较重-低兴趣-低认知组的共同保护因素，日常生活活动依赖是淡漠症状中等-低兴趣-低行为组的危险因素，高自主性感知是淡漠症状较重-低兴趣-低认知组的保护因素。结论脑卒中患者的淡漠症状具有明显的类别特征，医护人员应针对不同潜在类别的保护因素与危险因素，采取有效策略进行精准干预，改善其淡漠症状。

关键词: 脑卒中, 淡漠, 潜在剖面分析, 影响因素分析, 护理

Abstract:

Objective To identify the potential categories and influencing factors of apathy in stroke patients，providing a basis for precise typing and individualized interventions by healthcare professionals. Methods Using the convenience sampling method，stroke patients from 2 tertiary hospitals in Xinjiang Uggur Automous Region were selected from November 2023 to August 2024，and were surveyed using the General Information Questionnaire，Apathy Evaluation Scale-Informant，Perceived Autonomy Scale，and Stroke Self-Efficacy Questionnaire.The latent profile analysis was used to identify potential categories of apathy，and logistic regression analysis was used to explore the differences in the characteristics of patients in different categories. Results The apathy symptoms of 521 stroke patients could be divided into 3 potential categories：mild apathy group（23.6%），moderate apathy-low interest-low behavioral group （46.5%），and heavy apathy-low interest-low cognitive group（29.9%）. Logistic regression showed that age 45~<60 years，duration of the disease <6 months，and high rehabilitation self-efficacy were the common protective factors of the moderate apathy-low interest-low behavioral group and the heavy apathy-low interest-low cognitive group.The dependence on activities of daily living was a risk factor for the moderate apathy-low interest-low behavioral group，and high perception of autonomy was a protective factor for the heavy apathy-low interest-low cognitive group. Conclusion Apathy symptoms in stroke patients are characterized by distinct categories，which are influenced by age，stroke duration，ADL，rehabilitation self-efficacy，and perception of autonomy. Healthcare professionals should adopt effective strategies to precisely intervene based on different potential categories of protective factors and risk factors to alleviate their apathy.

Key words: Stroke, Apathy, Potential Profile Analysis, Root Cause Analysis, Nursing Care

李华, 周静, 祖百法, 吴复琛, 姚恩生. 脑卒中患者淡漠症状的潜在剖面及影响因素研究[J]. 中华护理杂志, 2025, 60(13): 1595-1602.

LI Hua, ZHOU Jing, ZU Baifa, WU Fuchen, YAO Ensheng. Potential profiling analysis and influencing factors of apathy among stroke patients[J]. Chinese Journal of Nursing, 2025, 60(13): 1595-1602.

图/表 4

表1 脑卒中患者淡漠症状潜在剖面拟合指标

Table 1 Potential profiles of apathy symptoms in stroke patients

图1 脑卒中患者淡漠症状的3个潜在类别特征分布

Figure 1 Characteristic distribution of 3 potential profiles of apathy symptoms in stroke patients

表2 脑卒中患者淡漠症状潜在剖面的单因素分析

Table 2 Univariate analysis of the potential profile of apathy symptoms in stroke patients

表3 脑卒中患者淡漠症状潜在类别的无序多分类Logistic回归分析

Table 3 Logistic regression analysis of the latent categories of apathy symptoms in stroke patients

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