脑卒中患者及其配偶二元心理资本的潜在剖面分析及护理对策

doi:10.3761/j.issn.0254-1769.2025.03.011

摘要/Abstract

摘要：

目的探究脑卒中患者及其配偶二元心理资本的潜在剖面特征及相关影响因素，为改善其心理健康提供参考。方法采用便利抽样法，于2023年3月—8月在河南省某3所三级甲等医院神经内科的脑卒中患者及其配偶作为调查对象。采用一般资料调查表、改良Rankin评分、心理资本量表、凯斯勒心理状况评定量表以及领悟社会支持量表进行调查。潜在剖面分析探索二元心理资本潜在分型，通过多元Logistic回归分析评估各种因素对不同分型的影响。结果共发放问卷235份，回收有效问卷232份，有效问卷回收率为98.7%。潜在剖面分析结果显示，脑卒中患者及其配偶二元心理资本分为二元低心理资本-低自我效能组（6.0%）、二元高心理资本-低韧性组（15.9%）、二元中心理资本组（78.1%）3个潜在类别。脑卒中患者文化程度、预后情况、患病后工作状况、领悟社会支持量表得分以及配偶工作状况是二元心理资本潜在剖面的影响因素（P<0.05）。结论脑卒中患者及其配偶二元心理资本水平存在异质性，且存在相依关系，提示医护人员应从二元整体视角出发对不同心理资本特征的脑卒中患者及其配偶制订针对性的干预措施，促进其心理健康。

关键词: 脑卒中, 配偶, 心理资本, 潜在剖面分析, 心理护理

Abstract:

Objective To explore the potential categories of dyadic psychological capital and related factors among stroke patients and their spouses，in order to inform the improvement of their mental health. Methods Stroke patients and their spouses were recruited in the Neurology Department of 3 tertiary general hospitals from March，2023 to August，2023 by convenience sampling method. The general information questionnaire，Modified Rankin Scale（mRs），Psychological Capital Questionnaire，The Kessler Psychological Distress Scale（K10） and Perceived Social Support Scale（PSSS） were used for investigation. Latent profile analysis was adopted to explore the categories of dyadic psychological capital，and multiple Logistic regression analysis was used to assess the effect of various factors on different categories. Results A total of 232 returned questionnaires（out of the 235） were valid，resulting an effective response rate of 98.7%. Stroke patients and their spouses were divided into 3 categories，including dyadic low psychological capital-low self-efficacy group（6.0%），dyadic high psychological capital-low resilience group（15.9%） and dyadic medium psychological capital group（78.1%）. The stroke patients’ education level，mRs scores，occupational status after the illness，level of perceived social support，and spouses’ working condition were the influencing factors on potential profiles of dyadic psychological capital（P<0.05）. Conclusion There are heterogeneity and interdependence in the level of dyadic psychological capital of stroke patients and their spouses. Healthcare professionals should promote dyadic mental health by developing targeted interventions for stroke patients and their spouses with different psychological capital characteristics from a dyadic holistic perspective.

Key words: Stroke, Spouses, Psychological Capital, Latent Profile Analysis, Psychological Care

刘博文, 王珊珊, 孙倩倩, 梅永霞, 林蓓蕾, 刘腊梅, 张振香. 脑卒中患者及其配偶二元心理资本的潜在剖面分析及护理对策[J]. 中华护理杂志, 2025, 60(3): 332-339.

LIU Bowen, WANG Shanshan, SUN Qianqian, MEI Yongxia, LIN Beilei, LIU Lamei, ZHANG Zhenxiang. Latent profile analysis of dyadic psychological capital among stroke patients and their spouses and nursing countermeasures[J]. Chinese Journal of Nursing, 2025, 60(3): 332-339.

图/表 5

表1 脑卒中患者及其配偶的一般资料及二元心理资本潜在剖面的单因素分析[例（百分比，%）]

Table 1 General information of stroke patients and their spouses and univariate analysis of potential categories [cases（percentage，%）]

表2 脑卒中患者及其配偶二元心理资本的潜在剖面分析结果（n=232）

Table 2 Results of latent profile analysis of dyadic psychological capital among stroke patients and their spouses（n=232）

图1 脑卒中患者及其配偶二元心理资本3个潜在剖面的特征分布

Figure 1 The characteristic distribution of 3 potential categories of dyadic psychological capital among stroke patients and their spouses

表3 自变量赋值方式

Table 3 Assignment of independent variables

表4 脑卒中患者及其配偶二元潜在类别的多元Logistic回归分析（n=232）

Table 4 Results of multiple logistic regression of dyadic potential category influencing factors among stroke patients and their spouses（n=232）

参考文献 31

[1]	Labori F, Persson J, Svensson M, et al. The impact of stroke on spousal and family income:a difference-in-difference study from Swedish national registries[J]. Top Stroke Rehabil, 2024, 31(4):381-389.
[2]	Luthans F, Youssef-Morgan C, Avolio B. 心理资本(第二版)[M]. 王垒,译. 北京: 中国轻工业出版社, 2018.
	Luthans F, Youssef-Morgan C, Avolio B. Psychological capital (second edition)[M]. Wang L,trans. Beijing: China Light Indu-stry Press, 2018.
[3]	张阔, 张赛, 董颖红. 积极心理资本:测量及其与心理健康的关系[J]. 心理与行为研究, 2010, 8(1):58-64.
	Zhang K, Zhang S, Dong YH. Positive psychological capital:measurement and relationship with mental health[J]. Stud Psy-chol Behav, 2010, 8(1):58-64.
[4]	何叶, 王元姣, 谢珺, 等. 心理资本在恢复期脑卒中患者领悟社会支持与患者积极度的中介效应分析[J]. 护理学报, 2023, 30(7):65-70.
	He Y, Wang YJ, Xie J, et al. Analysis on the mediating effect of psychological capital on perceived social support and patient’s positive degree of stroke patients in recovery period[J]. J Nurs(China), 2023, 30(7):65-70.
[5]	黄竞仪, 许严江, 岳秋菊, 等. 心理资本在肝癌患者的照顾者负担与焦虑间的中介效应[J]. 心理月刊, 2023, 18(13):20-22. DOI
	Huang JY, Xu YJ, Yue QJ, et al. The mediating effect of psychological capital on caregiver burden and anxiety in liver cancer patients[J]. Psychol Monthly, 2023, 18(13):20-22.
[6]	Czikmantori T, Hagemeyer B, Engeser S. A dyadic typology of social desires in couples[J]. J Pers, 2018, 86(4):590-603. DOI PMID
[7]	彭斌, 刘鸣, 崔丽英. 与时俱进的新指南:《中国急性缺血性脑卒中诊治指南2018》解读[J]. 中华神经科杂志, 2018, 51(9):657-659.
	Peng B, Liu M, Cui LY. New evidence,new guideline:inter-pretation of the Chinese guidelines for diagnosis and treatment of acute ischemic stroke 2018[J]. Chin J Neurol, 2018, 51(9):657-659.
[8]	方积乾. 生物医学研究的统计方法[M]. 北京: 高等教育出版社, 2007.
	Fang JQ. Statistical methods for biomedical research[M]. Bei-jing: Higher Education Press, 2007.
[9]	范玉华, 姬晓昙, 蓝琳芳. 国内脑卒中临床试验疗效判断方法中改良Rankin评分的应用现状[J]. 中国神经精神疾病杂志, 2015, 41(7):412-415.
	Fan YH, Ji XT, Lan LF. The application of mRS in the methods of outcome assessment in Chinese stroke trials[J]. Chin J Nerv Ment Dis, 2015, 41(7):412-415.
[10]	张世洪, 吴波, 谈颂. 卒中登记研究中Barthel指数和改良的Rankin量表的适用性与相关性研究[J]. 中国循证医学杂志, 2004, 4(12):871-874.
	Zhang SH, Wu B, Tan S. Appropriateness assessment and cor-relation analysis of Barthel Index and Modified Rankin Scales in a stroke data register[J]. Chin J Evid Based Med, 2004, 4(12):871-874.
[11]	刘志薇, 张振香, 梅永霞, 等. 脑卒中患者配偶照顾者抑郁症状潜在类别分析及影响因素[J]. 军事护理, 2023, 40(4):56-59.
	Liu ZW, Zhang ZX, Mei YX, et al. Latent class analysis of depressive symptoms in spouse caregivers of stroke patients and the influencing factors[J]. Nurs J Chin PLA, 2023, 40(4):56-59.
[12]	Kessler RC, Andrews G, Colpe LJ, et al. Short screening scales to monitor population prevalences and trends in non-specific psychological distress[J]. Psychol Med, 2002, 32(6):959-976. DOI PMID
[13]	周成超, 楚洁, 王婷, 等. 简易心理状况评定量表Kessler10中文版的信度和效度评价[J]. 中国临床心理学杂志, 2008, 16(6):627-629.
	Zhou CC, Chu J, Wang T, et al. Reliability and validity of 10-item Kessler scale(K10) Chinese version in evaluation of men-tal health status of Chinese population[J]. Chin J Clin Psy-chol, 2008, 16(6):627-629.
[14]	Zimet GD, Powell SS, Farley GK, et al. Psychometric charac-teristics of the Multidimensional Scale of Perceived Social Support[J]. J Pers Assess, 1990, 55(3-4):610-617. DOI PMID
[15]	姜乾金. 领悟社会支持量表[J]. 中国行为医学科学, 2001, 10(10):41-43.
	Jiang QJ. Perceived Social Support Scale[J]. Chin J Behav Med Sci, 2001, 10(10):41-43.
[16]	王孟成. 潜变量建模与Mplus应用[M]. 重庆大学出版社, 2014.
	Wang MC. Latent variable modeling using Mplus[M]. Chong-ging: Chonging University Press, 2014.
[17]	孙倩倩, 李婷, 梅永霞, 等. 基于交叉滞后分析的脑卒中患者夫妻二元应对与抑郁关系研究[J]. 护理学杂志, 2023, 38(19):71-76.
	Sun QQ, Li T, Mei YX, et al. Relationship between dyadic coping and depression in stroke patients and their spouses:a cross lagged panel analysis[J]. J Nurs Sci, 2023, 38(19):71-76.
[18]	Zhang LY, Zhang ZX, Mei YX, et al. Dyadic appraisals,dyadic coping,and mental health among couples coping with stroke:a longitudinal study protocol[J]. J Adv Nurs, 2020, 76(11):3164-3170.
[19]	Wang JY, Cui J, Tu SY, et al. Resilience and caregiving ability among caregivers of people with stroke:the mediating role of uncertainty in illness[J]. Front Psychiatry, 2022, 13:788737.
[20]	Liu Z, King M. The influencing factors and coping styles of mental health stress responses of stroke caregivers[J]. Work, 2021, 69(2):499-513. DOI PMID
[21]	Terrill AL, Reblin M, MacKenzie JJ, et al. Intimate relation-ships and stroke:piloting a dyadic intervention to improve depression[J]. Int J Environ Res Public Health, 2022, 19(3):1804.
[22]	庞晨晨. 中青年脑卒中患者积极心理资本、应对方式与健康行为的相关性研究[D]. 开封: 河南大学, 2020.
	Pang CC. Study on the correlation between positive psycholo-gical capital,coping style and health behavior in young and middle-aged stroke patients[D]. Kaifeng: Henan University, 2020.
[23]	刘志薇, 梅永霞, 张振香, 等. 脑卒中患者夫妻疾病沟通体验的质性研究[J]. 中华护理杂志, 2024, 59(5):576-581. DOI URL
	Liu ZW, Mei YX, Zhang ZX, et al. A qualitative study of disease communication experiences in couples with stroke[J]. Chin J Nurs, 2024, 59(5):576-581. DOI URL
[24]	徐广怡, 刘婷, 徐颜红, 等. 炎症性肠病患者心理韧性的潜在剖面分析及护理对策[J]. 中华护理杂志, 2023, 58(10):1212-1218. DOI URL
	Xu GY, Liu T, Xu YH, et al. Latent profile analysis and nursing decision-making of psychological resilience among patients with inflammatory bowel disease[J]. Chin J Nurs, 2023, 58(10):1212-1218.
[25]	车洪, 关晋英, 许叶华, 等. 五种干预措施对癌症儿童主要照顾者心理韧性影响的网状Meta分析[J]. 医学与哲学, 2022, 43(24):46-50+56.
	Che H, Guan JY, Xu YH, et al. Effectiveness of five inter-ventions on resilience of primary caregivers of children with cancer:a network Meta-analysis[J]. Med Philos, 2022, 43(24):46-50+56.
[26]	李怡璇. 脑卒中患者积极心理资本、照护依赖、自我护理能力与生活质量的相关性研究[D]. 兰州: 甘肃中医药大学, 2024.
	Li YX. Correlation between positive psychological capital,care-dependent,self-care ability and quality of life in stroke patients[D]. Lanzhou: Gansu University of Chinese Medicine, 2024.
[27]	司雨朦, 杜静, 余红, 等. 卒中后疲劳患者疲劳体验及应对策略的质性研究[J]. 护理学杂志, 2024, 39(07):109-112.
	Si MY, Du J, Yu H, et al. Experience of fatigue and coping strategies among patients with post-stroke fatigue:a qualitative study[J]. J Nurs Sci, 2024, 39(07):109-112.
[28]	Gao C, Li M, Guo L, et al. Developing a conceptual model for understanding caregiving experience and their impacts on quality of life for Chinese breast cancer family caregivers:a qualitative study[J]. Nurs Open, 2024, 11(3),e2139.
[29]	Hassan M, Fang SH, Malik AA, et al. Impact of perceived so-cial support and psychological capital on university students’ academic success:testing the role of academic adjustment as a moderator[J]. BMC Psychol, 2023, 11(1):340. DOI PMID
[30]	杨梦竹. 老年维持性血液透析患者积极心理资本、社会支持与生活质量的相关性研究[D]. 开封: 河南大学, 2021.
	Yang MZ. Correlation between positive psychological capital,social support and quality of life in elderly maintenance hemodialysis patients[D]. Kaifeng: Henan University, 2021.
[31]	孙倩倩, 梅永霞, 宋王涛, 等. 脑卒中患者及其配偶获益感与积极心理资本的二元关系研究[J]. 中华护理杂志, 2024, 59(17):2116-2122. DOI URL
	Sun QQ, Mei YX, Song WT, et al. A study on dyadic relation-ship between benefit finding and positive psychological capital in stroke patients and their spouses[J]. Chin J Nurs, 2024, 59(17):2116-2122.