脑卒中发病风险感知与客观发病风险的关系及护理对策

doi:10.3761/j.issn.0254-1769.2025.07.002

摘要/Abstract

摘要：

目的探讨脑卒中发病风险感知和客观发病风险的关系，为脑卒中预防提供依据。方法于2023年2月—5月便利选取郑州市、漯河市2所社区卫生服务中心560名健康体检的居民作为调查对象，评估其客观发病风险，并采用一般资料调查表和脑卒中高危人群发病风险感知问卷进行调查。利用Logistic回归模型及限制性立方样条模型分析发病风险感知与客观发病风险间的关联和剂量反应关系。结果共回收有效问卷542份，脑卒中高危人群检出率为48.71%。Logistic回归分析结果显示，总人群及不同性别分层下的脑卒中客观发病风险均随着发病风险感知水平的升高呈先下降后上升趋势。限制性立方样条结果显示，总人群及性别分层下脑卒中发病风险感知与客观发病风险均呈非线性剂量反应关系（P_非线性<0.05），曲线呈现“U”型变化，发病风险感知为90.0~110.0分时为客观发病风险的保护因素。结论脑卒中客观发病风险随发病风险感知的升高先下降后上升。医护人员应维持个体发病风险感知水平在适当程度内，并要关注不同性别人群发病风险感知的差异，实施针对性的风险沟通策略，以促进其健康行为产生，降低脑卒中发病率。

关键词: 脑卒中, 风险感知, 高危人群, 限制性立方样条, 护理

Abstract:

Objective To explore the relationship between disease risk perception and objective risk in stroke risk population，and to provide theoretical basis for prevention and control of stroke. Methods From February to May 2023，560 residents who participated in medical examinations in 2 community health service centers of Zhengzhou and Luohe were selected as respondents. The objective risk of stroke was assessed，and the general data questionnaire and Risk Perception Questionnaire for People at High Risk of Stroke were used for investigation. Logistic regression model and restricted cubic spline model were used to analyze the correlation and the dose-response relationship between disease risk perception and objective stroke risk. Results A total of 542 effective questionnaires were collected. The detection rate of stroke high-risk groups was 48.71%. Logistic regression analysis showed that after adjusting confounding factors，the objective risk of stroke in the general population and in different gender stratification decreased first and then increased with the increase of the level of disease risk perception. The results of the restricted cubic spline showed that the disease risk perception and objective risk of stroke in the total population and gender stratification showed a nonlinear dose-response relationship（P nonlinear<0.05），and the curve showed a “U” type change. The disease risk perception score of 90.0~110.0 was the protective factor of objective risk of stroke. Conclusion The objective risk of stroke decreases first and then increases with the increase of the perceived risk. Medical staff should maintain individual disease risk perception within the appropriate level，and pay attention to the difference in disease risk perception of different gender groups to implement targeted risk communication strategies，so as to promote the development of healthy behaviors and reduce the incidence of stroke.

Key words: Stroke, Risk Perception, High Risk Group, Restricted Cubic Spline, Nursing Care

周辰茜, 林蓓蕾, 张杰, 任慧, 王辉, 张振香. 脑卒中发病风险感知与客观发病风险的关系及护理对策[J]. 中华护理杂志, 2025, 60(7): 779-784.

ZHOU Chenxi, LIN Beilei, ZHANG Jie, REN Hui, WANG Hui, ZHANG Zhenxiang. Dose-response relationship between disease risk perception and objective risk of stroke and nursing strategies[J]. Chinese Journal of Nursing, 2025, 60(7): 779-784.

图/表 5

表1 调查对象的一般资料和脑卒中客观发病风险感知单因素分析结果

Table 1 General data of respondents and results of univariate analysis

表2 总人群不同风险感知水平与客观发病风险的Logistic回归分析

Table 2 Logistic regression analysis of different risk perception levels and objective stroke risk in the total respondents

表3 男性不同风险感知水平与客观发病风险的Logistic回归分析

Table 3 Logistic regression analysis of different risk perception levels and objective stroke risk in males

表4 女性不同风险感知水平与客观发病风险的Logistic回归分析

Table 4 Logistic regression analysis of different risk perception levels and objective stroke risk in females

图1 发病风险感知与客观发病风险的剂量反应关系

Figure 1 Dose-response relationship between disease risk perception and objective stroke risk

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