中年脑卒中恢复期患者症状网络结构与康复信心的相关性研究

doi:10.3761/j.issn.0254-1769.2025.15.007

摘要/Abstract

摘要：

目的调查中年脑卒中恢复期患者症状间的作用关系，并探讨其与康复信心的相关性，为实施精准化康复护理提供参考。方法采用横断面研究，便利选取2024年4月20日—8月31日在武汉市4所三级甲等综合医院神经内科与康复医学科住院的365例中年脑卒中恢复期患者作为调查对象。采用一般资料调查表、脑卒中症状体验量表、脑卒中后康复信心测量问卷收集资料。应用R 4.4.2软件进行症状网络分析，并构建症状-康复信心的网络结构模型，同时评估网络结构的稳定性。结果最终纳入中年脑卒中恢复期患者350例。发生率最高的症状为肢体无力（81.1%）；症状网络分析结果显示，肢体活动受限是核心症状（r_s=1.118）。与康复信心存在较强相关性的症状为肢体活动受限、因不能做想做的事而烦恼、反应变慢。稳定性检验提示模型结果均良好。结论中年脑卒中恢复期患者症状相互关联，且不同症状对康复信心的作用机制存在差异。建议医护人员依据核心症状和症状间作用关系制订干预的优先级，以期精准提升患者干预效果，改善康复结局。

关键词: 中年, 脑卒中, 恢复期, 网络分析, 康复信心, 康复护理

Abstract:

Objective To investigate the interaction relationship among symptoms in middle-aged patients during the recovery period of stroke and explore its correlation with rehabilitation confidence，providing a reference for the implementation of precise rehabilitation nursing. Methods A cross-sectional study was conducted，and 365 middle-aged patients in the recovery period of stroke who were hospitalized in 4 tertiary general hospitals in Wuhan from April 20 to August 31，2024 were conveniently selected as the subjects of the investigation. Data were collected using the General Information Questionnaire，Stroke Symptom Experience Scale，and Confidence after Stroke Measure Questionnaire. Symptom network analysis was conducted using R software，and a network structure model of symptoms-rehabilitation confidence was constructed； meanwhile，the stability of the network structure was evaluated. Results Finally，350 middle-aged stroke patients in the recovery period were included. The most common symptom was “limb weakness”（81.1%）. Symptom network analysis showed that “limited limb movement” was the core symptom（r_s=1.118）. The symptoms strongly associated with recovery confidence were “limited physical movement”，“annoyance at not being able to do what you want to do” and “slow reaction times”. Stability tests suggest that the model results are all good. Conclusion Symptoms of middle-aged patients in the recovery period after stroke are interrelated，and the mechanisms by which different symptoms affect rehabilitation confidence are also different. It is recommended that healthcare professionals prioritize interventions based on core symptoms and inter-symptom relationships in order to accurately enhance patient outcomes and improve recovery outcomes.

Key words: Middle Aged, Stroke, Recovery Phase, Network Analysis, Recovery Confidence, Rehabilitation Nursing

郭沛然, 张志霞, 叶椒, 程蓉, 乔林茹, 陈秋霞, 姜芳, 刘亚萍. 中年脑卒中恢复期患者症状网络结构与康复信心的相关性研究[J]. 中华护理杂志, 2025, 60(15): 1837-1842.

GUO Peiran, ZHANG Zhixia, YE Jiao, CHENG Rong, QIAO Linru, CHEN Qiuxia, JIANG Fang, LIU Yaping. A study on the correlation between symptom networks structure and rehabilitation confidence in middle-aged patients during the recovery period of stroke[J]. Chinese Journal of Nursing, 2025, 60(15): 1837-1842.

图/表 4

表1 调查对象的一般资料（n=350）

Table 1 General information of participants（n=350）

表2 中年脑卒中恢复期患者症状发生情况（n=350）

Table 2 Symptom occurrence of middle-aged patients in the recovery period of stroke（n=350）

图1 中年脑卒中恢复期患者症状的网络结构注：A1四肢动作不协调，A2无法身体平衡，A3疲乏，A4自理能力下降，A5肢体活动受限，A6肢体无力，A7肢体疼痛，A8注意力下降，A9反应变慢，A10容易着急，A11对前途失望，A12因不能做想做的事而烦恼。

Figure 1 The network structure of symptoms of middle-aged patients in the recovery period of stroke

图2 中年脑卒中恢复期患者症状-康复信心的网络结构注：A1四肢动作不协调，A2无法身体平衡，A3疲乏，A4自理能力下降，A5肢体活动受限，A6肢体无力，A7肢体疼痛，A8注意力下降，A9反应变慢，A10容易着急，A11对前途失望，A12因不能做想做的事而烦恼。CaSM为脑卒中后康复信心测量问卷。

Figure 2 Network structure of symptom-rehabilitation confidence of middle-aged patients in the recovery period of stroke

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